Chinese and Expat Hospitals: What's Different? Watch My CCTV Interview

Hi Allan,

Thanks for the comments, you obviously have a lot of experience with local hospitals…but you really don’t get at the heart of the matter when you keep saying that “chinese hospitals are so so much cheaper”. You make it sound like a GOOD thing! It is absolutely not a good thing that your chinese doctor costs 20 kuai per visit; NO ONE in the Chinese healthcare system is happy with that, and especially the doctors, who clearly are overworked and underpaid. An astonishing 96% of Chinese doctors feel they are not compensated correctly — and they are correct to feel that way; they are not properly rewarded for their years of training and sacrifice.

And you certainly don’t mention how the Chinese clinic may be “cheap” but what about the quality of care? For example, you don’t mention how an extraordinary percentage of patients receive unneeded procedures and medicines, especially IV antibiotics. Yes, I do agree that experience is important and you do want your surgeons to have many years of experience. But honestly, we’re not really talking about surgeries, we’re talking about the 95% of patient experiences in hospitals, which are outpatient consults with doctors for medical issues. And again, there is absolutely no way that a patient is getting adequate care in a 5-minute visit. My clinic spends 30 minutes per patient, which is an extraordinary amount of time — but you also have plenty of time to really understand a patient’s history and risk factors, and offer them advice and treatment to prevent chronic disease.

Many people spend lots of money on non-essential but “high value” items such as iPods, Starbucks coffee, BMW cars. So why on earth, when it comes to your most invaluable asset — your health — would you not want the same highest value for a truly essential service such as your health? You think you’re saving money at a local hospital, but are you really? Did you not probably just spend hundreds more on medicines and tests than you would have at an international clinic? And did you walk out of your local hospital feeling like the doctor actually listened to you and gave you the best evidence-based treatment? Did you actually feel relaxed and your privacy respected?

The key here is VALUE — and that definitely does not only mean how much you paid…

I welcome a robust debate about this! The issue of pricing of international clinics is always a major issue here and worthy of an honest, open discussion.

If I may clarify my position a bit more: I do feel that every person has a right to health care, and I do feel this is a fundamental human right that should be paid for by a national government. I don’t think anyone should ever be excluded from proper healthcare simply by money. I think the ideal system is mostly along the UK system, which covers all their citizens under a single-payer system. I also think their emphasis on using primary care family doctors as the initial gatekeepers for all illnesses is a wonderfully cost effective and efficient way to manage health, especially regarding preventing and managing chronic diseases.

That’s one reason I’m such a big proponent of international clinics; in general, we are all staffed by primary care doctors, and we are providing a service that doesn’t even really exist in China — primary, preventive health care, using international standards of care. The Ministry of Health has dropped by my hospital many times to examine our system and is using our model of primary care to extend to the entire country.

In an ideal China, a person walks into a local clinic and pays a minimum copay, has a 15 minute appointment (or longer) with a Chinese board-certified primary care doctor, and gets evidence-based care, including education on preventing chronic disease. This is going to take many years to accomplish here, but the international clinics are leading the way as role models.

This again brings up the idea of VALUE, of “getting what you pay for”. Yes, you pay a premium for my clinic — but you get more time with a doctor than at any other clinic in China, in a clean and relaxed hospital chain that is the only foreign-owned hospital accredited by the world’s leading agency to guarantee proper standards, the Joint Commission International (JCI). That accreditation is very expensive to earn and to maintain, but that’s what ensures patient safety, privacy, and proper standards of care.

That also means that in your “expensive” visit to our clinics, we will actually be honest with you and not try to sell you unneeded meds or tests, since we do not get paid extra for services.

Thanks for your comments! Have you ever been to an international clinic? I’m curious what your medical student classmates think — what specialty do they plan? Does anyone want to be a family doctor? Do people want to work at an international clinic?