Shanghai’s public hospitals are responsible for providing medical care to approximately 24 million people. The leading hospitals are affiliated with tertiary institutions and graded Level 3A. Hospitals tend to specialize in particular disciplines, with doctors rapidly developing expertise with certain conditions.
What quality of care is provided?
According to a report by the Hospital Management Institute of Fudan University, released in December 2012, three of Shanghai’s public hospitals were rated among the top 10 hospitals in China: Huashan Medical Center, Ruijin Hospital and Zhongshan Hospital.
Despite the challenges and unfamiliarity, physicians and nurses are reportedly well-trained and professional, in general. However, some doctors are rumored to promote unnecessary medicines or procedures because of financial incentives from pharmaceutical companies. If in doubt of a diagnosis or proposed treatment plan, seek a second opinion elsewhere. Local hospitals are also generally best equipped to manage emergency treatment, especially in cases of trauma.
What can I expect at a local hospital?
“Public hospitals in China are crowded and chaotic,” says Dr Sisi Xu from Shanghai SKY Clinic. “It’s a complex system with little support for non-Chinese speakers. Clinics do not schedule appointments and medical personnel tend to speak limited English. Antibiotics are often administered intravenously, and basic pain relief minimal. The bedside manner of doctors differs significantly from the West too, and there is very little privacy. Expect to discuss your symptoms in front of curious bystanders,” she explains.
Navigating the system may be a challenge, especially for those without solid language skills or cultural knowledge, so consider asking a Mandarin-speaking friend to accompany you to the hospital.
How do costs compare?
Medical treatment at a local hospital is cheap by comparison to inter- national clinics, with a consultation and basic testing or medication costing as little as several hundred renminbi. Note that cash payment is expected before a patient is treated, even in emergency situations.
How to choose a local hospital
Shanghai hospitals are organized by a three-tier system:
Level 1: Primary hospital with fewer than 100 beds, and health centers that focus on the day-to-day health needs of a local community.
Level 2: Regional hospital with 101 to 500 beds, which provides inte- grated health services to several communities, and undertakes some teaching and research.
Level 3: Large city-level hospital with more than 500 beds, which pro- vides high-level medical and health services, training and research.
Hospitals are then classified as A, B or C, based on technology, management, equipment condition, and scientific research ability. Level 3A hospitals are the most authoritative.
My Chinese Hospital Experience
This past spring a slow lingering cold festered in my body for two months. Having never fully gotten rid of it through neglect I allowed it to develop into something much more serious. As the first week of May hit I was beginning to lose the energy to get out of bed. My throat glands were swelling up to the size of golf balls. It could not have been plainer that now was the opportune time for a hospital visit.
Having tried a western hospital before I decided why not try a Chinese hospital? The downside would be I’d have to have a good dictionary along. The plus side would be that I’d save money.
Arriving at Chang Hai (长海医院) Hospital near Fudan University, I had landed in unfamiliar territory. Not having the slightest idea of which department to go I went to the front desk, explained my symptoms to the nurses there. Miraculously, the nurses at the front desk told me which department to go to. By luck I had stumbled across the first step in the Chinese hospital diagnostic system.
The hospital is divided into different departments. Say you have a skin problem; you would go to the skin department. If you don’t initially know which department to go to, you first go to front desk, generally a circular desk with one or two nurses manning the table. There you can tell the nurse your symptoms and they will direct you to the first department to go to.
Once the nurses told me which department to go to, I couldn’t just simply march off to the department. First I had to pay a registration fee. I queued up in a long line to pay. But the registration line is not the last line, far from it. Once I had paid the 14 RMB registration fee, the teller handed me a queue number for the department I was going to see. Once I had hunted down the department I had to wait in line yet again until my number was called.
Once the doctor finally saw me, a ton of tests were done, and in this case, I received a muscular injection. I almost forgot, this is China, where one has to queue up for everything, hospital tests included. Fortunately, my Chinese was just at the edge of adequate, so that while taking these tests I could ask and find out what was happening to me. I have to admit; initially it was SCARY. Over time my Chinese and self confidence improved considerably. The more I understood the system the less I began to fear it and the greater sense of self-empowerment I felt.
My hospital visit was slowly coming to an end. Once all the tests were done and I waited for my results, I could go back to the doctor I initially saw (this time I did not have to wait in line) and get my final diagnosis and prescriptions. With those prescriptions I went to the main floor of the hospital, for one last queue. There I paid for my medication and waited for my name to appear on a screen. Once it had my medication were ready and I was all set to go.
Being an expat comes with certain stereotypes. One of those that is a deep mistrust in Chinese hospitals. Perhaps there is no better way to remind yourself of the country you’re living in, than full immersion. In Shanghai it can be quite easy to get caught up in the glitz and glamour of living an expat life. Let go of the stigmas associated with Chinese hospitals that you’ve been holding onto. Try it. You’ll come out learning more about the country your living in.