Chapter 586: Strategic Growth and Power Dynamics in the Emergency Department

From a strategic perspective, the Emergency Department genuinely needs this.

Take this year for example. The department has two senior associate physician slots. Tang Wangnian just about meets all the requirements to compete for a promotion, so the department will back him up. That’s what you’d call supporting someone’s rise.

Why is everyone scrambling to get into a high-priority department? Besides better pay and brighter prospects, there are more job openings, more training opportunities, and way more chances for promotions to senior and even chief physician.

On top of that, working in a core department brings a stronger sense of honor.

And it’s way easier to expand your network.

Imagine a class reunion where someone asks where you work. If it’s just a small hospital, you might feel a bit embarrassed. But if you work at a top-tier hospital like Tuyu Hospital, you can proudly say, “I work at Tuyu Hospital.”

Which department you’re in matters too.

Say you work in Cardiothoracic Surgery—a critical department—your status in the hospital isn’t bad at all. If a classmate or relative needs a favor, popping over to the Emergency Department or some lesser department to help out isn’t any trouble.

High status at least gives you a solid advantage.

But if you’re in the Emergency Department, which is weaker, going to Cardiothoracic or Neurology to ask for help makes you feel lacking in confidence.

You feel the pressure before you even open your mouth.

Weak nations have no diplomacy; the powerless get no say. The same logic applies here.

A department’s rise to strength doesn’t happen overnight.

If the Emergency Department wants to shake off its ‘weak department’ label, it needs well-rounded development. That means adding more operating rooms and finally having its own top-grade laminar flow operating room and endoscopy suite. These are real upgrades in hardware.

But they still lack top-tier talent, academic achievements, and research success. These are all real problems.

How many masters and PhDs does a department have? How many top papers have they published? How many have senior and chief physician titles, or hold special honors? It all adds up to show the department’s true strength and heritage.

The Emergency Department might look lively these days, but its foundation is still shaky.

Why do doctors in Cardiothoracic Surgery and Neurosurgery walk with their heads held high? Why do they look down on other doctors?

Because Cardiothoracic Surgery has more associate and chief physicians than the Emergency Department has attending doctors.

That’s real power.

So, for strategic reasons, the Emergency Department has every reason to help Tang Wangnian secure his associate chief physician title.

As long as Tang Wangnian doesn’t mess it up for himself, the department is happy to give him that precious slot.

The OR is the Emergency Department’s core business. Having an associate chief physician on the team makes developing services a lot easier.

First, the Emergency Department’s OR stripped away Dr. Fu Chachun’s old seniority, sending a strong message that shook up the veterans. The whole atmosphere noticeably improved.

Now, they’ve managed to tame their biggest troublemaker, Tang Wangnian, making it much easier to push ahead with improving the OR.

It can’t be all punishments, though.

Balanced management is always essential.

Whenever he has time, Zhou Can gives individual guidance to any doctors who ran into problems during surgery—helping them find their mistakes, showing them how to fix things, and teaching them how to avoid or improve next time.

But if someone’s actions are intentionally malicious, he never tolerates or goes easy on them.

Punishment is always dealt out as needed.

He’s mastered the art of holding both a carrot and a stick.

In just under a month, the OR’s entire environment in the Emergency Department has turned upside down. Walk into any operating room and you’ll feel the discipline and the laser-focused work ethic.

Doctors and nurses no longer dare neglect their duties or treat patient interests lightly.

Meanwhile, a welcome trend has appeared: every doctor and nurse in the OR clearly feels their skills improving.

…

That day, Zhou Can went to work in the Emergency Department as usual.

Director Lou called him over. “Zhou, come to my office for a minute.”

Once inside, Director Lou treated Zhou Can with uncommon politeness.

There was tea, small talk, and all sorts of warm gestures—so much so that Zhou Can felt pretty uncomfortable.

But since Director Lou didn’t say why, Zhou Can couldn’t just come out and ask.

When Director Lou felt their rapport was strong enough, he finally smiled kindly and said, “Director Zhu talked to me yesterday and praised our Emergency Department for dramatically improving surgery quality. That’s a huge compliment.”

Who says the hospital director sits high above and doesn’t care about department affairs?

Director Zhu noticed the OR’s transformation in the Emergency Department faster than anyone expected.

“Usually, we don’t get much praise from Director Zhu, so this really boosted my standing. I told Director Zhu that our surgery quality improved mostly thanks to Zhou Can, who proposed our new surgical evaluation and reward system. Every single surgery gets rated, problems get spotted right away, and we find the doctor involved that night or the next day to correct it.”

“Not only has the patient experience improved, but our doctors have become more conscientious at work. They’re actively putting patient interests first, and especially focus on whether there will be complications after surgery. Medical ethics in the department have risen greatly as a result.”

Director Lou made no move to take the credit, instead putting most of the achievement on Zhou Can.

This is the department’s way of showing how committed they are to nurturing Zhou Can.

“Director Zhu was thrilled. He even asked about how you’ve been performing, especially when it comes to management. I explained that when we first rolled out the surgical evaluation system, plenty of the doctors objected, and some protested really intensely. Even Dr. Xu nearly gave up, but you held your ground, arguing them all into agreeing, so we could finally put the system in place.”

Getting recognized by top leadership is invaluable.

If Director Lou didn’t value Zhou Can, there’s no way he’d go to such lengths to praise him in front of Director Zhu.

Some recognition will still go to Zhou Can, but most credit could have easily gone to Dr. Xu or even been kept by Director Lou himself.

Anyone in the workplace knows leadership determines your fate. If they say you’re good, you are; if not, even real results won’t save you.

“Oh, I was just cheering from the sidelines. The new surgical evaluation system only succeeded because of your strong leadership, plus the hard work of Dr. Xu and Dr. Cui, and the cooperation of everyone involved. Really, Director, I just want to thank you for supporting me—I can’t say how grateful I am.”

Even though Zhou Can contributed the most, he deflected credit to the team.

Never forget to credit your leaders.

No matter how much Director Lou likes him, Zhou Can knows better than to overlook this.

“You’re the future of our Emergency Department. You can never be too well nurtured. Especially because you really are outstanding.” Director Lou paused before continuing, “Director Zhu said you should prepare to take on more responsibilities. You might be getting a bigger role soon.”

Zhou Can felt his heart race as he listened.

His application to join the Quality Control Office had been stuck, blocked by Hospital Assistant Qin. Over the past month, Zhou Can tried all sorts of ways to get around it, but Assistant Qin was even tougher than expected—never giving him a shot.

Zhou Can couldn’t even take Assistant Qin out for a meal.

Assistant Qin put up an ironclad defense, cutting off every path Zhou Can might use to pull favors or offer gifts.

Only after asking around through roundabout connections did Zhou Can learn why Assistant Qin seemed so ‘hostile’ toward him.

He and Assistant Qin had no personal grudge. They’d never clashed before.

Granted, Zhou Can did bring down the previous hospital assistant, but that was justified. Technically, Zhou Can doesn’t even pose a threat to Assistant Qin—in fact, Zhou Can actually helped him.

If Zhou Can hadn’t removed the last assistant, Assistant Qin never would have gotten his promotion.

To stand out in fierce competition and become a dark horse like he did, Assistant Qin’s ability and tactics must be top-notch.

No question about it.

Assistant Qin refuses to let Zhou Can join the Quality Control Office because there’s only one extremely rare opening. In the past three years, only two spots have opened up.

That tells you how hard it is to get in.

Remember, Zhong Hui of the Quality Control Team once barged straight into the operating room with his people just to check on Zhou Can. That’s serious authority.

But even so, Zhong Hui is only a middle manager in the Quality Control Office.

Not even close to the real power players.

Quality Control—short for Medical Quality Control—has broad authority. It oversees nearly all clinical doctors and nurses, all clinical departments, and even some non-clinical ones.

Anyone who’s worked as a pharma rep knows this: even if your department head and the pharmacy pass your drug, if the Quality Control Office director blocks it, that medicine is going nowhere.

As for doctors, nurses, and departments punished by the Quality Control Office for mistakes—the list goes on.

So much so that everyone recoils when they hear “Infection Control” or “Quality Control.”

Many doctors and nurses think the Medical Department is scary, but it actually exists to protect medical staff. It’s relatively friendly to them.

It’s just that those with power always want to misuse it, and human nature gets in the way.

That’s why so many people dislike the Medical Department.

But the real silent killer is the Quality Control Office.

It can even directly disrupt an entire department’s operation.

That’s why Assistant Qin won’t let Zhou Can in—there’s just one opening.

The rarer something is, the more prized.

There’s also a very young chief physician from Neurosurgery who wants in. He only got his chief title last year at thirty-nine—he’s not even forty yet! That’s practically a prodigy.

If that was the only challenge, it wouldn’t worry Zhou Can.

Because even though Zhou Can is currently just a resident doctor, he’s more of a prodigy than most chief physicians.

His potential points straight at the position of hospital director.

Barring surprises, Zhou Can could very well reach the top in under ten years.

That’s no exaggeration.

In a lot of public hospitals, the choice of director is basically set in stone.

Take the Provincial People’s Hospital for instance. The current director is the grandson of a previous director, and that former director’s predecessor was his own student. If no outsider is parachuted in, it’s nearly impossible to break that chain of inherited leadership.

Tuyu Hospital’s situation is a bit better, but it’s politics all the way down.

Hospitals everywhere have their own versions of the same story.

Only bringing in an outsider can sometimes break these inherited power chains.

But in practice, incoming directors without roots or strong backers are often sidelined and stripped of real power.

Just look at ancient history: how many county magistrates got pushed out before finishing even a year in office? Many were run off as soon as they landed.

Local clans ruled, minor officials ran wild, and the local scene was a shark tank.

There was a case where a humble registrar drove out seven county magistrates in a row, even forcing the emperor to come in person. And even after the emperor investigated and jailed him, those “local snakes” weren’t easy to root out.

All the local officers and officials were tied together by mutual interests—no one would help the emperor arrest that registrar.

So they had to get officials sent from above to do the job.

The two outside officials sent in didn’t know the first thing about the area, not even where the registrar lived. They still had to rely on local staff for help.

Meanwhile, the registrar had already turned the whole area into his fortress.

By the time the outsiders were on the road, he’d received the warning letter.

What did he do next?

He sent a trusted aide to take those two officials on a pleasure tour, letting them stay at a widow’s house, eating, drinking, and enjoying themselves so much they forgot all about home.

Naturally, they kept putting off the arrest.

It wasn’t until three urgent imperial edicts came down that the two officials finally returned—with a corpse already rotting beyond recognition.

They reported to their superiors that the registrar committed suicide out of guilt, and that the body was in such bad shape because of the heat.

Local officials and villagers confirmed the identity of the dead man as that registrar.

And just like that, a case that stunned historians was closed.

The perpetrator then simply changed his name and lived happily ever after. His son soon took his old position, keeping control of the county office.

Hospitals—especially big ones—are tangled webs of vested interests, just like these old government offices.

An outsider coming in as director can be easily sidelined.

But someone local like Zhou Can is different. He saved the lives of Cao Zhengguo’s daughter and her unborn child.

Cao Zhengguo is Director Zhu’s superior. It was Cao Zhengguo who helped Director Zhu rise to his position.

Director Zhu’s own son is outside the medical field, so him taking over is unlikely.

With Cao Zhengguo’s support and a good working relationship with Director Zhu, Zhou Can’s odds of reaching the top are high.

Of course, nothing is set in stone yet. Zhou Can still has a long road ahead if he wants to become Tuyu’s director.

First, he’ll need major achievements he can show off.

Like Director Xueyan, who single-handedly saved Cardiothoracic Surgery from collapse under outside competition, achieving unprecedented success. That level of accomplishment is the real deal.

Last time they talked, Deputy Director Ye pointed out that Director Xueyan’s achievements alone would qualify her to compete for the deputy director’s seat.

And she’d have a very strong chance of success.

If Zhou Can can lead the Emergency Department to greatness, that will be a milestone that could help him compete for director in the future.