Chinese Hospitals & Doctors – 3 Examples of Why They’re Not up to Speed
Disclaimer: This post is based on a limited number of experiences. Yet such experiences would be extremely unlikely in the States. In China, they seem commonplace.
The Shanghai Daily had an article about expats and the Chinese medical system here from Tuesday. Put simply, this article suffers from a lack of perspective. While it states that hospitals and doctors are better in Shanghai than the rest of mainland China (a statement I do not doubt), it also tries to make the case that doctors throughout China are “excellent”, as stated here:
Local hospitals are considered by many expats as not up to the Western standards; they are often dingy and with older equipment. However, most physicians are competent, if not excellent, and many expats swear by their Chinese doctors.
3 Examples Showing Why Chinese Hospitals & Doctors are Not So Great
Most Chinese physicians are competent, if not excellent? Let me give you three personal experiences (my only experiences with Chinese doctors) that show that this may not be the case:
- After getting food poisoning caused by chicken my girlfriend brought back home from her hometown on a bus, the doctor, and two of his assistants, said it was likely caused by cooking ingredients, and could not get their heads around the notion that food poisoning is almost always caused by bad meat.
- When going to get my ears inspected, they used an ultrasonic, loud device to clean the inside of my ears, which was distinctly painful. In the States they used a warm water / ear cleaning solution that they squeezed into the ear for a similar situation.
- When going for a pregnancy test, the doctors tried to get us to do an ultrasound before doing a urine test.
Three times in a Chinese hospital. Three bad experiences. Not good odds.
To top this off, as most expats who have been in China for any significant length of time know, Chinese hospitals have two cure-alls for most illnesses:
- A constant IV
- A booster shot
Seriously. Why do you need an IV if you can eat yourself? It makes no sense whatsoever.
Sorry to the expat who wrote this article for the Shanghai Daily (Jenny Hammond), but the fear that expats have for Chinese hospitals is well founded: ask a number of expats who have been to Chinese hospitals to find out why. I am sure that you will find quite a few negative or even harrowing experiences among the lot. I, for one, do not know of a single expat who “swears by their doctor”.
Here is one bad (but not unusual) experience from an expat in Suzhou: Crisis in Suzhou: On Standby
Yep.. they do have their issues. Actually though, I have had pretty good luck. Not being on an insurance package I have a needed the use of a hospital a couple of times and in general, everything turned out OK. In one case, i had a minor surgery and it turned out pretty good.
Part of the problem I think is the shear volume of people they have to work with. A couple of the doctors I met, seemed like concerned and capable. Of course, this was offset by having other hospital staff puffing cigs outside my door in the hospital.
Really cannot beat the price though.. it would cost me 10 times more back home.
Actually,I have to say the hospitals in China may do things differently but each country does things differently. I have several doctor friends who work throughout the countries and they will tell you the same thing. Part of the reason the IVs for fevers and the like are common and actually beginning to fade in many parts of the country is because of Western criticism. yes?!
Besides, Ivs expel the “evil” more quickly, more powerfully. See how it fits? Unfortunately, this practice pushed out other Chinese medicine that was equally if not more effective. As recent studies in China indicate, these antibiotics, however, have caused one third of all deafness in Chinese children. That is ALOT!!!! In some ways, let’s face it, IVs are like a fad and slowly disappearing as standard protocol.
As for western standards of cleanliness, you might be comforted by the fact that more than 99,000 people a year in the US die from drug resistant staph infections from hospitals! Think about what would happen if this were true in China.
I have studied both Chinese and Western medicine and medical anthropology, so I can speak from both sides. Although the methods may seem strange to you, realize that whichever treatment modality is used,the doctors are genuinely concerned about you. Considering the sheer numbers they serve, they do an amazing job. So, too, realize that through the 1980s any doctor that needed more training or was severely lacking in skill were assigned to big cities until they coud prove themselves. This, perhaps, is why Shanghai is saying it has the best doctors. So, too, the history of Shanghai plays a significant role. Shanghai was the financial capital, the port the Brits demanded open after the Opium war and was effectively ruled by the Brits, US, France, Germany and Shanghai. Do you see how western criticism has influenced or made the Chinese defensive?
Also consider that dollars spent on equipment and western medicine greaty limits the amount of people the medical system can and does serve. This is a factor and question every government must answer. Comparatively, the US is the lowest ranking healthcare of developed nations and ranks 46th in the world even though it is second in spending. The important point is that you were seen and treated successfully, were you not?
Feel free to write me anytime. I was a triple major and have spent more years than I care to admit studying China history, philosophy, culture, medicine and language but it has served me well. China is life long learning, but you know that. Namaste, 湘君
I liked your medical anthropology comments Debra/湘君. I also have degrees in Chinese and Western medicine, and agree that each system of medicine has its place. But regardless of the treatment modality, there are seriously unacceptable conditions in some hospitals here. Last time I went to a local ER to visit an employee, I sat for two hours and never saw anyone wash their hands while moving between the 6 beds. Not that it would have helped – there was no soap in the dispensers. My employee was stuck next to a patient who was wheezing/drooling blood-flecked saliva into his oxygen mask. Then he’d take it off during his coughing spasms and wipe his face off on his bed sheet. His drunk buddies showed up with snacks and kind of laid across the sheet for a while to hug him, then got up and started offering snacks to everyone. Later an old lady came in w severe abdominal pain, they striped her down in front of everyone, put a gown on her, and laid her in a newly-emptied bed. But nobody had changed the sheets. The doctor came in and asked what the problem was, patient groaned out the problem, doctor said “ok, wait a while”. No charting, notes, directions to nurse. I was curious so followed him over to the adjoining staff room where he lounged back and started small-talking with a co-worker. I walked back to my employee’s bed. Old lady said, “I have to vomit”. Nurse “wait wait, we don’t have a bedpan”. Family member grabbed a plastic grocery bag from the respiratory patient’s buddies, old lady vomited in the bag, nurse came over to take the bag and it dripped while she walked away. Nobody cleaned it up. Doctor still hadn’t returned 30 minutes later when we left. Really wrong in all sorts of ways.
“Although the methods may seem strange to you, realize that whichever treatment modality is used,the doctors are genuinely concerned about you…Considering the sheer numbers they serve, they do an amazing job.” In China I routinely see inappropriate expensive meds for inappropriate lengths of time, have botched bargain-basement surgeries, financial exploitation of the patient, etc. Who knows if it’s b/c of poor training, financial motivation, or lack of genuine concern? Except for the old zhongyi who do the 10 kuai/treatment, I’d say ALL doctors (regardless of country) are genuinely concerned about the patient’s money, SOME doctors are genuinely concerned about the patient, and FEW doctors are capable of doing an amazing job.
My local employees occasionally ask for help with medical crises. A common scam here is for the hospital to only accept the patient if they’ve paid a deposit up front. One employee with a heart condition paid about RMB 30,000 to be admitted. The hospital then began treatment and would not release him (“it’s too dangerous for you to leave”) until his money ran out a few weeks later, at which time they declared “you’re finally ok now, but you’ll probably have to come back again”. They refused to give a specific diagnosis or provide a copy of his medical records. The next time he returned to the same hospital, but only had RMB 2000. They said OK. I go to hospital and it’s a dump. I ask for him to be transferred to a different hospital. They refuse and say “too dangerous, we have to keep him here indefinitely”. I grab the EKG out of chart and demand to discuss the diagnosis and treatment plan with the cardiologist. 2 hrs later they decide that the cardiologist is too busy and that it “probably is OK” to go to a different hospital. Take the ~70? kuai ambulance to the other hospital. Since it’s 3am, he stays until the morning, gets diagnosis, is released and w no problems at follow-up.
“As for western standards of cleanliness, you might be comforted by the fact that more than 99,000 people a year in the US die from drug resistant staph infections from hospitals!” Not sure what numbers you’re referring to, but US deaths from MRSA were estimated at ~19,000 in 2005, (total life-threatening infxn from MRSA ~94,000) (http://www.cdc.gov/od/oc/media/pressrel/2007/r071016.htm). China Daily reported that patients have a 10% chance of leaving the hospital with a new infection, and half of the 5 million such cases last year were MRSA (probably non-life threatening)(http://afp.google.com/article/ALeqM5hfQIWU4O51OmqWN0gSdDubJ0FQaw). MRSA is becoming a huge problem all over the world. It’s encouraging that China is working to curb its rapidly growing rate of drug resistant hospital acquired infections (ex: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1502134).