Doctors in China - the dark side

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Guangzhou Writer

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Doctors in China - the dark side
« on: May 04, 2013, 06:47:24 AM »
Some people have been very grateful that they had traveler's or other health insurance prior to coming to China that provided for them to see the much more expensive, Western-trained doctors, or allowed them to leave China for treatments. Here are some of my experiences that reveal a few of the problems with the health care system in China.

The cases of needing to leave mainland China for a serious health problem or operation are I'm sure less common, but you can consider the risk vs. cost. Personally, I wouldn't let a Chinese doctor (practicing Western medicine) touch me if I weren't forced to (visa medical exam) or dying, but I'm a little more doctor phobic than most people. I'm also much more health conscious and observant of doctors and I've observed and taught English to doctors here. I've also taken several friends, both foreign and Chinese, to doctors here over the years. One horror story after another. A Boy Scout with First Aid training and a pocket knife would have done a better job.

For example, I took a girl who'd crashed her bike and hit her head, splitting her upper lip. It's a common injury that's pretty easily repaired by anyone with a little experience sewing. This was an unmarried girl in her early 20's and they let a new student do the sewing. It's fine to let people learn, but that's the wrong situation. It didn't look well at all, and no one examined her or inquired about her head injury.

Imagine walking into the emergency room of a prominent hospital in a major city complaining of crashing your bike and having a head injury, you have a big goose egg on your forehead, and no one even examines it or asks if you're dizzy. These "doctors" are mostly worthless, IMO.

I know I sound a bit extreme, but I think it's because I know how to give some treatments and can tell the difference between a person who cares about another's body and health and someone who does not.

Chinese docs of Western medicine generally only have about 3 minutes to examine a patient, and that is usually done with a patient in a chair, the doctor in a chair at a desk facing away from the patient, and the doctor basically using a chart in order to match symptoms gathered by his assistant to a few standard medicines that might work. Next!

You also have to understand the fundamental corruption in the Chinese medical system. The most clear example is that Chinese surgeons require that their patients give them a 20% or greater cash gratuity in a red envelope prior to the operation. If you don't do it, they will do something to make you regret it.

One of my American colleagues had a small cyst behind his shoulder and went to get it fixed, but I didn't know about it until afterward. We were playing basketball outside, he took off his shirt and I exclaimed, "WTF happened to your shoulder?" He said, "What do you mean? I just got a cyst removed." I'm not kidding here, it looked like a can opener had been used for the incision. There was so much scar tissue that it still looked like there was a small cyst. I asked him, "Did you give the doc some hong bao before the operation?" He said, "No, what's that?" I said, "You mean your Chinese friends who took you to the hospital didn't tell you about that?" He said, "No. What is it?" I told him about it.

Can you imagine what they would do if they were operating somewhere near your organ and they thought your gratuity was too small? I know local Chinese that have high moral standards who work in hospitals. They come home depressed and distraught just from what they see the doctors do to people who don't pay the hong bao (red envelope) gratuity.

I simply can not contemplate the revulsion of allowing a Chinese doctor to actually operate on me or anyone I care about. I'm sure some of them, somewhere, in some far away galaxy, might be conscientious enough to properly handle a human body, but I haven't observed it yet in any doctor. I've only seen one blind masseur in all these years who had any gentleness and skill, after trying lots of massages over the years from invitations by locals to accompany them. These doctors and masseurs wouldn't compare well next to a first day massage therapy student in the worst school in the USA. Probably sounds like I'm exaggerating, but I know this topic well.

But, if you like being touched as if you were a damaged car fender and the doctor were a talking hammer who knocked out dents because they had nothing better to do, not because they even enjoyed hitting things, then by all means...

Re: Doctors in China - the dark side
« Reply #1 on: May 04, 2013, 05:11:38 PM »
A few of my colleagues had to go to the hospital for various things.  A few things to note:

- In Chongqing, doctors still smoke inside.  Sometimes while visiting you.
- Nurses don't change bedsheets.  Even if they're covered in someone else's blood.
- Charts are a mere formality for nurses.  Doctors shouldn't have to read.
- Neon green IVs are perfectly normal.
- If you are expected to stay overnight, fork out the money for a private room, otherwise your visitors contract severe acute pneumonia and have to come back as a patient.  (WAIT!  I think this is a part of their money making scheme.)
- Shared rooms are full of prolonged "Aiyohh"s.

I told my friends that if I ever get sick enough to be hospitalized in China, they are to make sure I am flown to Hong Kong for decent medical care.  Legitimate doctor training and licensing?!  Why I never.

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Borkya

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Re: Doctors in China - the dark side
« Reply #2 on: May 04, 2013, 05:20:20 PM »
I've had a few small biopsy's done in china. While I will admit they used thread twice as thick as my american doctor (and therefore leaving a bigger scar) it was clean and efficient.

But then again I go to a private hospital and they have an international clinic and the nurses help you with everything. My minor surgery was done in the general area with a doctor that couldn't speak english, but the english speaking nurses explain it to you and stuff beforehand and walk you to the room.

But your right otherwise. I am shocked at the level of 'service' I've heard about. I had a poor student who just had lung surgery. For 2 days he had a tube sticking out of his chest (why I'm not quite sure) and they didn't give him ANY pain medicine. He is a strong, kind of manly guy and he even admitted to me he wanted to burst out crying because of the pain. At night they gave him 2 pills (I'm guessing the equivalent to aspirin)  to try to ease the pain and help him sleep. It made me so mad that they weren't doing anything to help this boy feel better.

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Guangzhou Writer

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Re: Doctors in China - the dark side
« Reply #3 on: May 04, 2013, 06:04:05 PM »
Glad to hear that you had a good experience, Borkya. It's good to have a variety of reports if you want to make a judgment about the need for special insurance or knowing in advance where the good doctors are in your city.

Perhaps your friend with the chest tube gave a small hong bao? Seriously, that could be the reason.

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piglet

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Re: Doctors in China - the dark side
« Reply #4 on: May 06, 2013, 02:35:51 AM »
I have been 3 times to the Taiwanese owned hospital here where the Docs actually speak a bit of English and explain to you what they are doing. It was great,and I can honestly say "almost" on a par with treatment back home and much quicker and cheaper.
Once was a skin biopsy and the two other times much minor things but they don't seem to have normal docs here only hospitals.Wasn't going near the No 2 Hospital here which others told me to go to,simply because I prefer to be able to communicate with the docs and have them tell me what they are doing.
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Guangzhou Writer

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Re: Doctors in China - the dark side
« Reply #5 on: May 06, 2013, 02:40:51 AM »
That's great, piglet. How was the price for English speaking medical care?

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piglet

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Re: Doctors in China - the dark side
« Reply #6 on: May 06, 2013, 02:52:06 AM »
very reasonable.The last time I went I saw a gastro chappy had an examination and got 3 kinds of pills and paid 160 RMB total.They jumped me ahead of the Chinese so I only waited 10 mins
For people who like peace and quiet - a phoneless cord

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Guangzhou Writer

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Re: Doctors in China - the dark side
« Reply #7 on: May 06, 2013, 03:08:03 AM »
A bona fide success story. Cool.

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A-Train

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Re: Doctors in China - the dark side
« Reply #8 on: May 06, 2013, 03:16:47 AM »
very reasonable.The last time I went I saw a gastro chappy had an examination and got 3 kinds of pills and paid 160 RMB total.They jumped me ahead of the Chinese so I only waited 10 mins

Are you sure this happened in China? Was there a grey-haired man behind a curtain?
"The young do not know enough to be prudent, and therefore attempt the impossible and achieve it, generation after generation.

Pearl S. Buck

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piglet

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Re: Doctors in China - the dark side
« Reply #9 on: May 06, 2013, 07:01:33 PM »
Black haired man,nurse in pink smiling and mucking about with various files,bed behind curtain for exmination,and nice organized waiting room with NUMBERS... no shoving  bjbjbjbjbj
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randyjac

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Re: Doctors in China - the dark side
« Reply #10 on: May 07, 2013, 01:49:18 AM »
In my experience, one can find excellent doctors in China, but the problem lies in the infrastructure. Skilled technicians and caregivers below the rank of doctor do not exist in large numbers.
The experience of a colleague years ago in Wuhan serves as a case in point. He needed arthroscopic knee surgery. He researched the matter carefully and found a qualified doctor in Wuhan (at a military hospital). The surgery seemed to go fine, and then he entered a phase of physical rehabilitation. Long story short, he received bum advice from the physical therapist, overdid his exercise, and blew out the knee. In the aftermath, he endured a horrible period of inconvenience, remedial treatment, and second-guessing that lasted for months.
Whether in China or elsewhere, do your best to stay away from hospitals. Dangerous places, people die there. 

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CaseyOrourke

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Re: Doctors in China - the dark side
« Reply #11 on: May 17, 2013, 12:50:17 AM »
It so happens that the family of one of Mrs. Casey's students in Yanji are doctors.  We all have become extremely close friends and they consider us like family  The father is a dentist.  We helped him translate his portion of a joint research project he is conducting with an American teaching hospital.  The mother is an emergency room technician and the grandfather is a pediatrician. Both parents work at Yanbian University Hospital and grandpa has a private practice.  Also Mrs. Casey's brother is a Dr of TCM who has treated me a few times with acupuncture.

The father does all our dental work for free. When Mrs. Casey was still pregnant, the mother hooked us up with one of the top OB-Gyn's in Yanji to monitor the pregnancy and also deliver the baby.  When she went in for delivery, we did up the red envelope for the dr. but she refused it because first we were foreigners, but also because she was doing it as a personal favor for the our friend. 

When the mother found out we had paid the hospital both a deposit to reserve her room, afterward when we checked out and Grandfather's staff had billed us for our visit, she went and got the money back for us.  When Mrs. Casey asked why, I said that in the US, professional ethics does not allow doctors to charge other doctors or their family, so maybe it is the same in China and we have been included in that group.

As far as a Chinese hospital, it has been my impression that unless you have family to take care of you, the care you get from the hospital is minimal.  They won't even feed you.  When Mrs. Casey was brought back from recovery, her brother and I were the ones who had to move her from the gurney to her bed while the attendants just watched.

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A-Train

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Re: Doctors in China - the dark side
« Reply #12 on: May 17, 2013, 06:36:46 AM »

As far as a Chinese hospital, it has been my impression that unless you have family to take care of you, the care you get from the hospital is minimal.  They won't even feed you.  When Mrs. Casey was brought back from recovery, her brother and I were the ones who had to move her from the gurney to her bed while the attendants just watched.

It's also been my personal experience.  I think they're too busy performing personal favors for the well-connected.
"The young do not know enough to be prudent, and therefore attempt the impossible and achieve it, generation after generation.

Pearl S. Buck

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Guangzhou Writer

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Re: Doctors in China - the dark side
« Reply #13 on: May 18, 2013, 03:13:31 AM »
An American friend of mine with a local, Cantonese wife reported to me having very good experiences at two hospitals in Guangzhou. The first was a military hospital near the China Hotel, but I don't know the exact name. Separated by a couple of years, he twice had a full series of tests and blood work done for 700 RMB that probably would have cost that much or more in USD back home. He was very pleased with the service, although that's barely even inpatient.

The second time they found some problems because he was having stomach pain and sent him to Zhong Shan Hospital, which seems to be widely acknowledged as the best in GZ. There the docs diagnosed a stomach ulcer and liver problems, did MRI and a CAT (he told me) and he was completely satisfied with everything. A good experience for him and no problems with the docs or nurses.

Although the problems were caught before surgery was needed and this was not even an overnight stay, he said they were all pro's and there was no lack of information through his local wife/interpreter, although that information filter could be masking gaps in what a person might want to know if they were better informed.

Sounds more and more like in China it really pays to know the tip, top, best hospital in town, as well as being connected in some way.

Re: Doctors in China - the dark side
« Reply #14 on: May 20, 2013, 03:37:23 PM »
Sounds more and more like in China it really pays to know the tip, top, best hospital in town, as well as being connected in some way.

Ugh, I cannot agree with this statement. In my experience, reputation doesn't necessarily = quality of care. I'd had a wart I'd wanted removed and my co-workers recommended Xiehe hospital, the best hospital in Beijing. After waiting in line from 6AM for a number (and the security guards trying to sell the 5rmb "gua hao" to see the doctor for upwards of 200rmb) when I reached the gate I was told that there were no more numbers to see a dermatologist or any other kind of normal doctor that day. I was confused, and the security guard said I could see some other kind of doctor- which I didn't understand but just took the number. As I walked into the hospital, the guard followed me and when I joined my husband the guard began making threats toward my him and told my husband to leave me alone. The guard told my husband if he didn't let me see the doctor unaccompanied, he would kill him. And that was my experience at the best hospital in the country.

I went to a smaller hospital that specialized in bone care and had everything taken care of within a half hour without waiting at all.