Crossover CCTV News

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

How many of my readers have experienced both a local Chinese hospital and an international, “expat” hospital? The differences can be quite striking, and last week I had the honor of discussing some of those differences in a lively debate on CCTV News’ Crossover program. We mostly chatted about two specific cases in China, one regarding a migrant worker who had his newly-sutured hand unsutured by the nurse because he couldn’t pay his hospital bill. The second half revolved around a recent decree in Beijing that all public hospitals limit all patient lines to less than 10 minutes of waiting.

These two hot news stories touched upon a lot of larger issues about the pressures faced by both doctors and patients at local hospitals, and it provided much context in regards to comparisons with international clinics such as my hospital, Beijing United Family.

You can view the entire 30 minute Crossover broadcast below; if you cannot see the video, please click on this link here.



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7 thoughts on “Chinese and Expat Hospitals: What's Different? Watch My CCTV Interview”

  1. Dear Dr. Saint Cyr,
    thank you for your blog;i have learnt a lot from it and almost all the time i agree with what you say.however i did find this particular broadcast kept emphasizing 2 points over and over again;1-you need to pre-pay in chinese run hospitals and 2-doctors in general give you too little time.true enough but this information is misleading without pointing out the following:chinese run hospitals are so so much cheaper than the western run hospitals in beijing and ,in my opinion, at least,the fees in western run hospitals in beijing are outrageously high ,as high as in the west (and yet they have a far lower cost structure than hospitals in the west.also if you do enough searching,in general,you can find for example doctors in chinese hospitals with far more experience thanin the western hospitals (this might be particularly important in surgery ).in fairness i must say chinese hospitals are very very difficult for a westerner to “navigate” suggestion to people who need expensive medical treatment and can’t deal with chinese hospitals here is to go to one of the international hospitals in bangkok which are like western hospitals(doctors and staff speak english) and the costs are very very low.

    1. 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…

  2. Dear Dr. Saint Cyr,
    thank you for your thoughtful reply.i do have more to say about this but i want to think about what you said some more, do a little more research and hopefully reply to your comments later this week.

    1. 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.

  3. I am a medical student in China, and i have noticed this many times that when it comes to business Chinese use “No Mercy Tools’. There have been times that i went to pharmacy myself to get all medications on my personal Expenses because i know that a worker who earns 10,000Y a year would never able to afford it and addition, they come with no insurance. Sometimes, w.r.t cases, i often prescribe the medication without entering him through the hospital data, so he could be saved for huge sum of Doctor fee and Hospital Charges. But i can’t do it for everyone, everyday 2/5 are workers being admitted to hospital. I try to help, the one who has acute need for medication or is ‘way too worst” condition.
    But the major set-back point is that those workers bring their relatives, associates and want them to be treated in same way.. .
    Doctors have regulations, but sympathy is the biggest tool a doctor uses to make patients feel better.
    I saw your interview and i am amazed that a Doctor could actually do that, in many cases, Person is not allowed to leave until he pays or he leaves with police.
    I am really ashamed by this incident.

    1. 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?

      1. Yes! i have been to International Clinics, some of our professors are doctors there , example, a Jamaican psychiatrist at SOS Beijing is our lecturer in university.
        Most of the fellows here wants to head back home. Some of us are keen to start career in Beijing but you know still we have around 2 years to start working professionally in Hospital. about family doctor, other then me some are interested in doing so maybe about 2/10. i was searching about family health medicine and thatch why i was lead to this website. Nice work, though!

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