My three months in Hangzhou as an intern at the Hangzhou Shi Zhong Yi Yuan was one of my most memorable life experiences.
As a teacher in Chinese Medicine, I am constantly urging my students to “go to China”. There is no substitute for this experience. I can’t even articulate all the reasons eloquently why this is so imperative, but in this post I hope to shed some light on it.
Imagine a room, around 45m2, with about 6 desks in there. About half the size of a standard office desk. Around each desk are 3 or 4 typical Chinese wooden stools – the kind a size 14 westerner could fit half of their butt on!
The outpatients clinic is a room just like this, except it is filled with people. Each doctor has their own desk, alonside them are their intern(s) – the more they have the more popular that doctor probably is.
Walking in at 8am when the hospital is just opening, it’s buzzing full of people. The doctors havent even arrived but there are people everywhere. Down the hallways and crowding around the desks. Each patient is often are accompanied by an entourage – family support for their sick mother, father or even grown up child. Often the patients would have several relatives or close friends with them.
It’s apparent that when a person is sick their community is mobilised.
The system in the hospitals at that time (ten years ago) – and still is the way in many hospitals- is a no appointment, first come, first served basis. The patients would register at the administration of the hospital, recieve a ticket then go and wait at the doctors desk to be seen. They place their patient record book on the table and before long a queue of patient record books piles up. When the doctor walks in and sees the normal 15 or so books lined up on their desk they can see today is just another ordinary, incredibly busy day.
The self-ownership of the health care record was the first amazing, unique thing that stood out to me in my first weeks of studying in China. This system seemed so simple and sensical that I wondered why we don’t do it in Australia? The answer to that one probably lies in the bureaucratic and popous traditions of western medicine (which developed in ways that take the power away from the patient and make the doctor look important and all-knowing)…but perhaps also in the underlying ownership of health that native Chinese inheritently have. This is a deep part of Chinese Medicine and it seemed that the Chinese have taken this into their management of their health care system at the root of it.
Basically each person is issued with a booklet, which added to that a swipe card around the mid 2000’s. The card and the booklet contain all their records with doctors – both western and TCM, the card could be swiped at the computer station or doctors desk and all their MRI’s, CT’s etc would come up on the screen.
This is an amazing system when you consider “doctor shopping” – one doctor can see what the others have done thus far. It almost creates a bit of professional accountablity amoung herbalists – they can see what herbs and drugs have been prescribed, tests ordered and anything else inbetween.
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| Marie and Dermatology Doctor Luo Wei Dan |
I digress from the main point but I really want to paint the picture that China is such an amazingly different place to any western country and it’s health care system is definatley a unique one. I can’t think of one western country that dosen’t have issues with it’s government issued medical services (the NHS in the UK, HMO’s in the USA and Medicare etc in Australia).
Waiting lists for routine procedures, possibly unecessary health complications created by the waiting time to simply recieve a diagnosis (not even treatment), and the cost burden to patients are all common complaints.
I’m not saying that China is perfect by any means, but it was common to see a patient present with a health problem for the first time at 8am, see the doctor, have tests ordered and completed and return with MRI or CT test results by the afternoon of that same day. These weren’t rich people – just normal everyday people. And this is with the enormous population (1.351 billion at last count – by the way there are 0.3 billion in the USA).
In China, low wages paid to health care workers certainly plays a part. But shouldn’t health care be our greatest service to people? High population always lowers costs – supply and demand.
When you go to China as a TCM intern you have the privillage to observe so much. It’s not just the hundreds of Chinese medicine (herbal), acupuncture or Tuina cases you see. I found I observed much more because of the language barrier. Your senses are awakened to what you see and feel more than what you can hear and understand in terms of language.
This amazing health care system was a massive stand out to me on my first visit to China as an intern. It’s just something different. It has it’s faults and flaws just as any other system but it’s totally different to what we experience as “hospital medicine” in Australia.