A couple days ago I published part one of the results from my recently finished Health Snapshot Beijing 2010 survey. I wanted to get a sense of where expats were going for healthcare, as well as how they felt about their experiences. So I asked a few questions focused on Beijing expats’ use of all clinics, both expat and local. Here are the results…
Question 5: Where do you usually get your healthcare?
This was a multiple-choice question (75 responders, 88 answers), so the pie chart’s percentages are a bit off, but I will give the exact details here. Overall, the expat clinics were easily the most popular places for healthcare, with 71% of responders choosing one of them. But a large percentage (27%) of responders went to local Chinese hospitals; this was evenly divided between their VIP departments and their regular wards. I wasn’t too surprised that 8% went to a local Traditional Chinese Medicine (“TCM”) clinic.
My impression here is that the numbers aren’t too surprising. Most/many expats have work-related health insurance which covers the expat clinics, and most people find comfort in clinics similar to what they had back at home. Plus, the language barriers at local clinics would also deter many. But at the same time, a large group (35%) have been to local clinics and TCM clinics as well, so clearly there is a big mixture. Here’s the chart:
But this begs the question — how much do people actually like their expat clinic? Let’s find out next…
Question 6: How satisfied are you with your expat clinic?
A large majority of people (63%) were either “very satisfied” or “satisfied” with their expat clinic experiences. I was actually surprised that only 9% were with their experiences. One third of responders were neutral.
I find this positive response very encouraging, both professionally for me since I work at one of these clinics, but also on a personal level as it’s quietly reassuring that an overwhelming majority of Beijingers aren’t disappointed in their health care clinics. It’s comforting to know that most of us, so far from our native lands, feel fairly safe in getting good health care during our years in Beijing. Here’s the pie chart:
But what about the 23% who do not get healthcare from expat clinics? How do they feel about their local clinics? Let’s find out…
Question 7: How satisfied are you with your visits in local hospitals?
This was a more mixed response: of those who had been to local clinics and hospitals (53 out of 75), 42% were happy with their experience, 25% were neutral, and 34% were unhappy. But the enthusiasm was muted: 7% were “very satisfied”, which is lower than the 18% who were “very satisfied” with expat clinics. And 13% were “very dissatisfied”, a bit higher than the 3% regarding their expat clinic.
The Bottom Line?
Again, these results aren’t too surprising overall. It was predictable that expats would be more satisfied at expat clinics. Still, I think the findings are reassuring for us, that the majority of Beijing expats feel they are getting good healthcare. The major follow-up question, which I did not ask, is why is this so?
I would also love to know other things, such as:
- How many people have insurance?
- How many would go to expat clinics if they could afford it? Or, the opposite — how many go to local clinics because they cannot afford expat clinics?
- What’s your main reason for going to local clinics: convenience? Finances? Philosophy?
- Is your expat clinic better or worse than your clinic back at home?
What would you want to know more about? Let me know in the comment section below.
Next Survey Post, Part 3: air pollution and food safety: major problems or massive hype?
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I was a responder on the survey. While I AM satisfied with just about everything about the small clinic my kids most often go to, and said so, personally over the years we have had very mixed (ranging from very positive to extremely negative) experiences with several of the other foreigner clinic/hospitals.
(And the funniest thing is that the positive experiences have nearly always been with the Chinese doctors there anyway- which make me wonder why we all are made to pay so much when the same local docs are “just down the road” so to speak, at bargain rates. It starts to all feel like a big money machine scam, kwim?)
Anyway, reflecting on my Overall answers vs. my Actual Experiences, I wonder how useful or accurate that polls like this really are- because they only ask global general questions.
Although I understand most people’s hesitation to advertise their personal business and medical details, I think it would be more useful to hear specific in depth stories- like case studies.
Because many people, like me, who are “satisfied” overall may at the same time have incredible stories ranging from serious incompetence to misdiagnoses and “missed” diagnoses.
I know many people who in frustration and maybe desperation, finally visited local Chinese hospitals to find out their real diagnosis – and these skilled doctors were often able to pin it down in like two minutes.
These expat patients have been deeply let down, and resent all the time they wasted and money spent, and more importantly the misplaced trust in the previous years before the crisis, too! They will never again trust the expertise of the fancy institutions and seems most will now opt for Beijing Children’s Hospital, Chaoyang hospital, specialists in Singapore or Hong Kong, even Thailand, etc.
I have heard enough stories now, that I would encourage local expat patients (parents, etc) concerned about potentially complicated medical issues to actively seek second opinions from local sources or from specialists abroad.
I cannot recount here all the stories I’ve heard nor would I publicly. But the themes are the same- health professionals not listening carefully – especially discounting, poo poohing, or not taking seriously patient/ parent suspicions regarding their or their kids’ development/health, and stories of actual injury, severe adverse reactions to medications or vaccines which doctors refused to believe, and the like.
(For instance I know one case of an infant having rare but well documented reaction after rotavirus vaccine- intussusception. Was that child given a third dose of vaccine after nearly dying and needing surgery? YES. Even though they saved his life, eventually, they missed that he was contraindicated for more of that medicine!)
It’s perhaps the missed diagnoses of babies and youngsters: autoimmune diseases, developmental delays, etc. that gnaws on me the most.
When a missed diagnosis results in a baby with brain inury, Cerebral Palsy, Autism, Developmental delay, etc. not receiving appropriate services (physical therapy, early intervention) then this is a tragedy. My third child has Down syndrome and so early intervention is something I know a lot about firsthand.
The period of infancy and toddlerhood is a unique time in brain development and small gains, good habits, and less compensatory behaviors can mean very big differences in functioning later on.
With the proper information and diagnosis, parents can maximize this time for their kids. But when doctors for YEARS say things like “first time and worried parents- geesh” or “he’s not autistic, just a little slow to talk” or “her development is fine, just on the slow end of normal” then this opportunity is missed and can NEVER be reclaimed. Lack of proper services can affect the entire rest of the life of the child. Stories such as these tug at my heart, and doctor misses here are inexcusable.
Unfortunately I have already heard many stories like this from longtime expats in Beijing.
I urge you to get educated, listen to your gut (instead of relying on the regular pediatricians so much) and take control of your family’s health situation. Because, in my experience, having had 3 babies in China, 2 of whom had developmental issues, most pediatricians are not careful about assessing even basic neurological function or checking that Primitive Reflexes are replaced properly with Postural Reflexes etc.
For parents who have concerns, there are basic infant and toddler developmental and neurological exam videos online.
http://library.med.utah.edu/pedineurologicexam/html/home_exam.html Parents of any baby who is questionable in terms of motor milestones (especially a baby who resembled the abnormal newborn at that age) should insist on a proper pediatric neurologist and get a full workup. The older baby normal neurological assessments are also very useful and shows you very clearly what to look for at each age.
Liora