Doctor Nguyen Lan Hieu: My favorite position is in the interventional surgery room.

Not afraid to answer difficult questions in a conversation with Dan Tri newspaper, doctor Nguyen Lan Hieu said, "Working at Hanoi Medical University Hospital, my tax money is probably at least second or third."

The interview with Associate Professor, Dr. Nguyen Lan Hieu, Director of Hanoi Medical University Hospital and Director of Binh Duong General Hospital, a member of the 15th National Assembly, was an open and interesting interview, when the doctor who takes on many roles shared very frankly and did not avoid difficult questions. Spending an hour with Dan Tri reporter in a busy weekend schedule, Dr. Nguyen Lan Hieu showed a colorful picture and many emotional levels of those who "serve a hundred families".

Honestly, I am a person who hates festivals. Almost every year on February 27 or November 20 (because I am still a teacher), I escape from Hanoi or go to intervene abroad. I am afraid of congratulations because I feel they are empty. Especially during the time when the health andeducation sectors are still facing many difficulties, so many things happen but we keep congratulating each other, then the next day, the same problems appear again. This year is quite special because February 27 is close to Tet, I also just had Tet holiday with my family so there is no reason to escape from Hanoi and Binh Duong. Therefore, I will have February 27 in both Hanoi and Binh Duong.

In my heart, I always thought of myself as just a doctor. The place where I felt most passionate was in the interventional surgery room. Before, there were times when my wife said, "You should go see a doctor, you might be autistic", because I still wore a surgical gown when I came home. But I felt very comfortable in that outfit.

Yes (Laughs). I was "criticized" before, especially my daughter didn't agree when I wore surgical clothes in the house, so I gave up that strange hobby of mine.

There is a very simple reason, that is I like to reason about logic. In cardiology, most symptoms and diseases can be explained by logic. It is like a circulatory cycle, there are principles and causes, and because of that logic, I find it very interesting. It is as simple as listening to a murmur in the heart, we can understand the logic of where the blood flows through a hole, how it flows, what it is accompanied by... It is very easy for us to remember right from the day we went to school. At that time, I thought in my head that I would join the cardiology industry, but Professor Nguyen Lan Viet, my uncle, who was then the Deputy Director of the National Heart Institute, was very afraid of this. Because he thought "Hieu was very naughty when he was young, now going into cardiology could be dangerous, affecting the patient and the family's reputation". He wanted me to do another field, but I said if I did not become a cardiologist, I would not take the residency exam anymore. My whole family persuaded me and finally he supported me. However, the first stage was very difficult because he was very strict. Others learned one, I had to learn at least twice as much to meet his expectations.

My family is not a "noble family", but has a principle, the children and sons-in-law are all doctors or teachers. At that time, my grandfather almost made an unwritten rule, anyone who was a teacher or doctor would be welcomed into the family, so many of his children and grandchildren went into medicine or education. This made me feel pressured. I still remember when my father came back from America, he bought jeans with the word USA on them and my grandfather immediately used scissors to cut the word off. Anything unusual was not allowed in my family. Luckily, my father "lived in with his wife" so I often stayed with my mother's family, but I still remember the feeling every time I went to my grandfather's house in Kim Lien, I was very scared because he was very strict. But when I grew up, I realized that those were very good values that he and his family passed on to us, which were seriousness in work and most importantly, ethics. The saying "a good doctor is like a mother" is heavy because of the responsibility, but the ethics passed down by my grandfathers and uncles are very simple, which is to treat the people you treat and teach as family members, to be strict with them but strict with love. That is what I learned the most from my family.

That has seeped into my blood. At the hospital, my colleagues are very afraid because I am very strict. Just this morning, in front of my room door, there were two nurses holding two reports, just because the day before I caught them in the elevator having an inappropriate attitude towards a patient. However, the way I treat my colleagues, friends as well as hospital staff, is strict but I consider them as my relatives, my blood brothers to have a humane way of behaving. That is not only me but also the hospital Board of Directors as well as the leaders of the departments and offices of Hanoi Medical University Hospital. We consider this as a collective, a big family, covering our small family.

This question was easier for me to answer before. Because I was in a familiar environment, Hanoi Medical University, everyone knew me, so even though I was not a party member, the coordination with the Party system here was very good. The Party cell and the school's Party Committee supported me a lot. But coming to Binh Duong was quite a difficult story because many people were not used to the fact that the hospital director was not a party member, the Party Committee Secretary. After 1 year of working, thanks to sincerity and hard work, we have built a very strong new Party Committee.

What I am concerned about is not "being a party member or not", but the people and the solidarity within the party cell and party committee have a great influence. In a hospital or any organization, solidarity within the party committee and government is very important, deciding all successes. Party members who do bad things, do not know how to fight and contribute to society are more dangerous than those who are not party members.

I once shared that if I were just a doctor, I would definitely be more advanced in my profession than now, invited to work in many countries and hospitals, and my skills would also be better. However, treating diseases can only treat a limited number of patients. At best, I can only treat 1,000 patients per year, but if we can organize well in a hospital, like Hanoi Medical University Hospital, in just a few years we can do a huge amount of work. This is much more beneficial. The same thing happened in Binh Duong. When I joined the fight against the epidemic, the Secretary and Chairman of the province shared numbers that surprised me. The provincial hospital only had more than 300 doctors, like the district hospital; there were only more than 400 nurses. A 1,000-bed hospital with a total of more than 800 medical staff, that is extremely absurd. In the hospital, important equipment was not working, the MRI machine, CT machine, interventional machine were all broken, the testing machine had no chemicals to run... Because of hearing those things, I wanted to try, wanted to commit, not because I liked being a manager or doing politics . Being a hospital manager in Binh Duong did not add any prestige or awe to me, but I wanted to try my best to change, to change myself because I thought I still had the ability and could contribute more. I committed myself to help many people and also to help myself, to motivate myself. This is also difficult to explain, it is like a desire for myself to achieve some purpose in each stage of life that is more meaningful.

I have been managing Binh Duong General Hospital for 2 years this April. At first, when my colleagues saw a doctor with a Northern accent come to be the manager, they did not cooperate. The first year was difficult, really difficult, but from the second year onwards, the work has been much more favorable. We have recruited many medical staff. In 2023, we recruited 150 doctors, including interns and masters. Even a provincial hospital like Binh Duong has 2 PhDs, 1 PhD and 1 associate professor who are applying to work. That means we have created a playground for talented people. I also recently shared with the provincial leaders that for the first time, Binh Duong held a civil service exam for doctors and 30% failed, while before, the province had to "ask people to return but could not". That is what I am most happy about. In terms of expertise, we have deployed many new techniques in Binh Duong. It can be said that Binh Duong has some of the leading techniques in Vietnam, patients from many places come to Binh Duong for surgery in great numbers. In Binh Duong there are also very good doctors, such as Dr. Vo Thai Trung, whom I admire very much, when I became the director I created all the conditions because he is a talent.

In short, there are only two words: "set an example". It sounds cliché, but in reality, we have to set an example in every action. When I returned to Binh Duong, I did not receive a salary or a bonus. With the money I was forced to receive, I usually gave it to the most difficult department, such as the neonatal department. Setting an example is also being fair, all for the sake of work, those who do well will be rewarded, those who do not do well will be punished. In addition, setting an example at work, devoting yourself to the job. In difficult and complicated cases, we have to roll up our sleeves and do it, if the patient complains, we have to step up and resolve it. The role of the leader is the most important. All of us doctors, especially hospital leaders, are always under pressure from society. That is natural, because medicine is a profession that serves hundreds of families, and when you become a daughter-in-law, you will inevitably encounter a difficult mother-in-law, you have to accept that and from there learn from experience to overcome difficulties together.

I had to rely on an assistant, there was no other way. In Hanoi I had a very good secretary. In the South I also had a good assistant to help me organize my work. I often told you my priorities, if they overlapped and couldn’t be arranged, I had to cut them down. You guys were doing well and I survived until today.

This is a very difficult question. Actually, the time is not rigid, exactly one hour to do all three jobs. But if unfortunately there is something related to a patient, I will give it priority number 1. If during a National Assembly meeting, a patient has complications in the operating room that the staff cannot handle, I will leave the meeting to handle it, but that is very rare.

I have been criticized for this statement. I meant it very clearly, that "good doctors cannot be poor", but many people understand it the other way around, "poor doctors are ignorant". That is not true, I would like to confirm that so that the journalist can clarify for me. Doctors cannot get rich as quickly as businessmen, because they cannot trade or play the stock market to get rich quickly. Young doctors, with a short time of practice and low skills, cannot get rich; if they want to get rich, they must gradually accumulate skills and experience over time. When they are good, money will come to them in many different ways, not from surgery or patient examination fees, but from very special money.

For example, a good doctor of mine in Binh Duong, he is very poor, his circumstances are very difficult, but the Provincial Party Committee and the People's Committee are willing to buy him a house, but he has not received it yet. So, the doctor is good, the respect of society comes to him in many ways. As for me, it is not true to say that I am rich. My whole family, from my father to my mother, is not rich, but no one has to think about money, because we have the ability to earn income from our professional skills very well. Working at Hanoi Medical University Hospital, my tax revenue is probably the second or third largest. In addition to the income from medical examination and treatment, I also have other income from teaching and from surgical intervention abroad. I almost never think about how much money I have and have never had to borrow money from anyone in my life. That is something I feel very lucky about.

There are three issues that I have presented to the Minister of Health and the leaders. One is human training. We must standardize training, standardize the doctors sent to study and practice. There must be certain output standards, not allowing quality to differentiate because patients entering the hospital do not know that this doctor was trained at the Medical University of City A, that doctor was trained in Province B or Province C. In foreign countries, when passing the medical doctor exam, the standards and foundation must be the same. Second, the regulations are still overlapping. Although there are many laws, there are too many management levels to lead a medical facility. I propose that we need to give more power to hospital directors and leaders of medical facilities. We say we are afraid of them making mistakes, afraid of them being corrupt, but clearly the more levels, the more corruption. And when something happens, the most serious crime is still the hospital director who must take responsibility. Currently, we are very confused in procurement and bidding. The recognition of shortcomings in this issue has decreased but is only a temporary cover-up, and one day it will flare up again because it has not been resolved from the root. If we give power, add legal mechanisms and supervision and inspection from management agencies, that will be a feasible solution.

The third issue is that the income of medical staff needs to change. I have proposed to the leaders of many provinces such as Binh Duong or Binh Dinh where I am running for the National Assembly, that if hospitals cannot be autonomous, do not force them to be autonomous. If you force them to earn money to support the army, they will do wrong things, do too much. Currently, the biggest fear is not the lack of medical equipment, but the fear of patients being abused. Without the means, people go to private hospitals to do it, but how will they know about abuse of prescriptions? They should not have surgery, but they do surgery, they should not have stents, but they do stents... That is why I propose that medical staff should have a fixed salary like civil servants in the public system. Why do teachers receive a monthly salary but doctors are forced to earn money, doctors must be autonomous? Any hospital that can be autonomous is good, but for hospitals that are still facing difficulties such as those in mountainous areas and district hospitals, do not force them to be autonomous. We should still empower and pay doctors and medical staff a fixed salary, so that the hospital director does not have to worry about how much money he can earn to cover all the expenses and salaries for the entire team when he wakes up every morning. To increase the income of medical staff, we must provide new services and techniques, improve patient satisfaction, and then use the money to improve the quality and treatment services to pay for the increased income for them.

Regarding human training, I think everyone understands, it is clearly stated in the law. The Law on Medical Examination and Treatment also clearly states that there must be a national medical doctor graduation exam. However, when implementing, although the leaders were enthusiastic, the number of people helping to operate this change was very small, so there were many difficulties. As for the issue of salary and income, many provinces supported it. For example, Binh Duong has a resolution of the People's Council on increasing income for medical staff. I told the provincial leaders that in the past, we had to spend money, some places even had to spend billions to invite doctors to work. Now that we have passed that stage, there are a lot of doctors, so there must be a mechanism to retain people and create conditions for them to develop. Or in Lao Cai, there have also been very good steps forward, the number of doctors has increased, income is better, surgical techniques are more numerous, and the rate of referrals has decreased significantly. Lao Cai is the only province in the country that currently equips all modern CT scanners down to the district level with budget funds. That boldness brings immediate success, not having to wait 5-10 years like other sectors.

There are poor provinces and rich provinces, but in the places I have been, I have not seen any place lacking money for healthcare. Recently, the Deputy Secretary of Hanoi, when visiting the University of Medicine and Pharmacy Hospital, said that the locality is preparing a huge program for healthcare with tens of thousands of billions. The locality is interested in and wants to develop healthcare, the important thing is to choose well to avoid waste. The same goes for other provinces, they do not lack money for healthcare, but the important thing is the direction and method to make it effective and sustainable.

The answer is probably known to everyone, it is very sad. People we still meet every day, still discuss work, even very close friends, are caught up in the law. The lesson learned is that in the past we were too subjective, too lax in management. For the simple reason of not providing enough legitimate income for doctors, people made one mistake, then two mistakes, three mistakes... When the whole system made a mistake, everyone nodded to that mistake, thinking it was normal, it was natural. After the recent events, it is sad, it is painful, but I think there will be many positive changes; everything will become more transparent, clearer in the health system.

Pride - that seems like a funny question but it is a sad question for me. There are only a few prides, and they are all small. We can perform this or that case, a certain procedure, be good at a certain surgery, so that foreign patients can come to Vietnam or Vietnamese doctors can go abroad for treatment. But overall, we are far behind our friends in neighboring countries, because they do it very systematically. Doctors usually have 2 groups. One is application doctors - doctors who perform a lot of surgeries and are very good at them, commonly called "golden hands". The second is inventor doctors - those who come up with new methods and tools. There are many of the first group in Vietnam, but there are almost no of the second group. The first reason is that we have not invested in basic science in medicine. Simply put, animal laboratories, thinking of any tools to put into the human body or new methods must be tested on animals, but Vietnam does not have any standard animal laboratories.

The second reason is the lack of investment from companies. Speaking of this, I remember my own story. I once came up with a type of pulmonary valve replacement through the skin, working with a Chinese company. The first case we did on animals but then they eliminated us from the game, and of course at that stage I lacked experience. After that, I was also angry, found another company in Thailand to find funding, and my friend funded that research, did a lot of experiments on animals but in the end failed, my friend lost 1 million USD, even went bankrupt, almost did not work in the field of medical equipment manufacturing anymore. That reality shows that investing in this field is also a very big risk. But if successful, like the Chinese heart valve sold on the world market tens of thousands of units/year, at a price of about 30,000 USD/unit, the amount of money earned after a large investment will be very large. Therefore, Vietnam is lacking two things: one is the State's lack of investment in basic science and two is the lack of companies that dare to take risks in the medical field.

I don't think I'm strong in anything, but my nature is to be eager to learn and change. That can be a strength but it can also be a weakness, being too eager will overwhelm you.

I am playful. I like natural life and exploring . Life is short so I always want to have many experiences. At work, I go to work in the morning but still like to drink wine at night. There are days when I drink wine until 11pm, go to bed and wake up at 5am to go to work. That is harmful to my health, I know that but I still can't stop.

I like drinking wine and playing sports . I used to like contact sports like football and basketball, but now I don't have the conditions to play anymore. When I have time, I try to exercise by walking. Trying to walk 10,000 steps a day is successful, but most of the time I can only keep to 6,000-7,000 steps.

The good thing is that I get to travel a lot, to experience what I like. There is probably no place in Vietnam that I haven't been to, I have been to all the farthest communes and districts, even in remote areas at the edge of the country. The bad thing is that there are things I really want to do but can't, for example, playing sports. I used to love basketball, but now if I accidentally injure my hand while playing basketball, it's like "breaking my fishing rod" (laughs). Golf is a sport that I think I also like very much, but I don't dare to pick up the club because it takes a lot of time, and while I'm playing, I'm constantly on the phone, how can I concentrate? In the medical field, doctors can't manage their own time so they are limited in many ways, not just me but all other doctors, if there is an emergency while playing, they have to run, it's unavoidable.

I didn't pay attention because I never thought about it. Being a minister or deputy minister, I definitely have to separate myself from my profession, because I have never seen a minister or deputy minister who performs surgery. But for me, professional work is my passion. My biggest dream is to complete my duties as director of two hospitals.

Thank you very much for this conversation !

Dantri.com.vn

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