Column: Need an audience? Go to the clinic!
The white-uniformed registrar at the medical clinic looked up at me from behind the desk. “What level of service do you want?” she said, pointing to a chart on the counter. The choices were 9 RMB,
7 RMB or 4 RMB. I wanted the best and happily paid her the 9 RMB for top-level service — the equivalent of a whopping $1.50.
I later learned there was an additional choice: “old, famous expert” for 51 RMB, or about $8.00.
Having worked at Essentia Health for most of the last decade, I was quite curious about the differences between the Chinese and U.S. health care systems. Thankfully, I haven’t had to learn anything the hard way. As expected, there are some drastic distinctions.
A friend and translation expert, Zhengguo, accompanied me on my latest excursion. To get an initial appointment, I had to personally go to the health system and get there early. We arrived at 8:15 a.m. after traveling two hours by bus and taxi.
It is customary to encounter long queues in a country of 1.3 billion people, as you can imagine. Sure enough, at the clinic we found a waiting line for registration and another line for the elevator. We decided it was easiest to walk up to the seventh floor waiting room. Climbing stairs was good for our health, we reasoned with a smile and a sigh.
The waiting room was adjacent to all of the examination rooms. All doors are left open and discussions between patients and physicians can be easily overheard by everyone in the area. (I’m sure I could tell some very interesting stories here if I understood more Mandarin.) It is not unusual for the current patient and the next patient to be in the room at the same time and for others who are just curious to be peering in. When it is your turn, your name is flashed on a neon light board along with your diagnosis.
The nurse encouraged Zhengguo and me to enter the room while the former patient was just finishing. During my consult with the physician, we proactively closed the door. However, five minutes later, the previous patient had one more question and so just re-entered and asked for what she needed. The vast difference in the concept of medical privacy is occasionally quite startling.
As in Duluth, the best patient care involves listening, treating the patient as an individual, using the power of caring touch, and, of course, solid medical expertise. In China, the same definition of high-quality patient care applies. My capable physician spoke as much English as he could and my friend supplied additional details in Mandarin.
In the U.S., electronic medical records are increasingly used and all information from past medical visits is readily available. At the end of an appointment, an office-visit summary is printed for the patient, complete with any specific instructions.
In China, some medical information is entered into a computer system. In addition, the patient is presented with a medical booklet. Progress notes are handwritten into the patient’s book, and the patient is expected bring this book to any future visits. Since the doctor wrote in Chinese characters, I asked Zhengguo to tell me what was written in my book. He gave it a try,
but alas, he was unable to read the doctor’s writing. Hmm…sound familiar?!
This brief description touches on just a select few differences in health systems at the micro level. There’s so much more to say. My goal will be to stay healthy long enough to write it down.
Arlene J. Anderson is a native Duluthian turned explorer and teacher in Zhuhai, China.