Do All Private Hospitals Cheat?
China Medical News reporter — Jin Liang
In recent years private hospitals have multiplied around the country. Yet some have been involved in cheating patients or even gross negligence with lives, leaving a poor impression. So many feel that going to a private hospital is almost like handing one's life to a roadside quack and a band of swindlers.
Is that really so? On 30 November 2001 the First National Symposium of Private TCM Hospital Directors was held at Zhengding, Hebei. At the opening, Vice-Director Fang Shuting of the State Administration of TCM said: "Private TCM care is an important component of our country's TCM resources, a product of the market economy's growth, with its own features and strengths in management and care."
Private hospital is not a back-room shop
Cui Chun, deputy director of the Health Bureau of Dongying, Shandong, said: to guarantee quality, Dongying built a entry system for private medical institutions with a high threshold: an urban-area specialty private institution must be at least at the building standard of a second-level public hospital of the same kind, with no less than 5 million RMB registered capital. The four private TCM hospitals now operating in Dongying have won broad social recognition, and the public hospitals feel pressure and crisis.
Director Cui said: Dongying Bone-Setting Hospital is a private bone-injury specialty hospital with 12 clinical departments, 120 beds, and bed-use rate over 80%. Notably, it not only has strengths in TCM bone-setting but takes the integrated Chinese-Western road: wrist re-attachment, arm re-attachment, thumb reconstruction — major operations done independently, even exceeding the level of some local Western public hospitals. The hospital is now a designated facility for Dongying's basic medical insurance for urban workers and for traffic-accident care. Many similar examples exist.
Private hospitals don't act like 'masters'
Geng Lanshu, director of Hebei TCM Hepatology Hospital, said: we are private; we cannot set ourselves up as masters the way public hospitals do. So fine service, good outcome, low price became the private hospital's charm in competition.
Zhang Qi, deputy chief of the Medical Administration Department of the State Administration of TCM, said: at present there are about 200 private TCM hospitals nationwide. Compared with public, they have market-driven operating views, nimble mechanisms, sound resource allocation; they value talent and hospital culture; their work is full of vigor. They are also chiefly known for specialty clinics.
Hebei TCM Hepatology Hospital is a typical case. From its 1997 opening to today, the state has given no subsidy. Its grounds have grown from 12 mu to 33; a 24,000-square-meter building stands; staff has more than doubled, beds have doubled, daily outpatient volume has doubled.
For the patient's convenience the hospital takes a series of service steps: ten shuttle buses run daily between the hospital and Shijiazhuang Train Station, free; 24-hour meal orders for inpatients, delivered to the bedside; free purified water for patients; free breakfast for those needing fasting blood tests; because hepatitis patients are often irritable, soft background music plays in the corridors to ease their mood; bedding and sheets have been changed from white to other colors to ease tension; the hospital has a library, reading room, computer room — all open to patients without charge.
Many participants said: what we had thought of, they have already done.
Fang Shuting added: this symposium at Hebei TCM Hepatology Hospital may also be called an on-site meeting. The hospital has set up a model for private TCM hospitals nationwide. Its everything-centered-on-the-patient practice is worth spreading.
Private hospital directors have a belly of bitter water
Despite the development, the discrimination private TCM hospitals face has all the directors indignant. As one said vividly: "A private TCM hospital is like a tree forcing itself up through a crack in stone."
Zhang Xiaotong, director of the Beijing Cui Yueli Center for Traditional Medicine, said current medical policy treats private and public unequally. "Take the question of designated insurance hospitals. Community clinics far weaker than us are included, while we are not. The flagship of a chain pharmacy gets on the list and its branches can reimburse; private-hospital drugs, even surpassing Tongrentang in quality, get no reimbursement. Minister Zhang Wenkang has said policy must tilt toward TCM. We do not ask for a tilt — only for level ground, truly carrying out President Jiang Zemin's call to give equal weight to Chinese and Western medicine, to grow together, to complement each other. Now we cannot even qualify for a loan — it is not that I lack ability to grow; I lack the condition." Zhang called for a competition space as equal as possible for private medical institutions.
Her words drew strong echoes. Many believe private TCM hospitals' difficulty comes chiefly from administrators in some departments. Liu Xueqin, director of Taiyuan TCM Esophageal-Cancer Specialty Hospital, Shanxi, said with hurt: "Private hospitals take so much abuse. No government department gives you a straight look. Some leaders even say: 'What is there to do with you private hospitals — all just messing about!'"
Geng Lanshu also said: a private hospital's growth is not easy; there is always one or another making trouble, wanting to press you down; her hospital spends at least 400,000 RMB a year to settle these troubles.
Yin Mengfan, director of the Vitiligo Research Institute of Shanxi TCM College, said: "It is not only policy that needs fairness; the people's view too must change. Many ordinary people think private hospitals are not properly run, and some think private hospitals are out only for money and must charge high — when in fact the opposite is often true. Many private hospitals are at managerial levels not below public, with fees below state standards."
Song Hujie, director of Xi'an Brain Disease Hospital, said: many private hospitals are not behind public in care environment and service philosophy. For instance the "red envelope" — at private hospitals it absolutely does not exist; a doctor caught taking one is dismissed. "We private hospitals must stand on our own. We hope the government can create for us a fair growth environment, with fair competition among all hospitals. The most painful thing now is that we cannot do what we wish to do, cannot realize our wish."
Despite all the difficulties, participants remain confident in the future. Zhang Xiaotong said: this meeting is timely; we have gained much. Many senior TCM specialists worry about TCM's future; this meeting shows us hope of TCM's growth.
"One rat dropping ruins a pot of soup" — don't let it happen
In recent years, false medical advertising has stirred wide public anger; unlicensed practice and the manufacture-and-sale of fake-and-inferior drugs occur from time to time. Although most happens in small clinics, small outpatient sites, and unlicensed shops, private hospitals are among them — which is why many feel private hospitals are all swindlers. For this, the directors at the meeting proposed forming their own industry association, strengthening self-discipline; and called on government bodies to strengthen oversight and crack down hard on illegal medical bodies and those who harm the people — never letting one rat dropping ruin a pot of soup.
Sun Sulun, chief of the Medical Administration Department of the State Administration of TCM, in closing stressed: private TCM hospitals must both draw from all and bring out their own strengths, and scientifically evaluate their own outcomes — no cheating, for cheating cannot endure. To the directors he charged: "Private TCM hospitals must practice by law, run by law, advertise truthfully — model law-abiders."
Originally in China Medical News · Health Weekly, issue 152.