Physicians from China Visit Mills-Peninsula on International Health Fellowship
Two physicians from Beijing, China saw health care from a very different point of view while visiting the United States as part of an International Health Fellowship, sponsored by Health Bridge International, a non-profit organization based in the United States.
Yong Jiang, M.D., vice chair of the Department of Surgery, and Sheng Wu, M.D., attending physician of the Emergency Department at Peking University First Hospital, spent a month visiting Mills-Peninsula Medical Center, in Burlingame, Calif., to learn about the U.S. health care system. In December the physicians explored the outpatient setting at Palo Alto Medical Foundation. In January, they spent time at Mills-Peninsula in as many departments as possible and shadowed several physicians.
At the conclusion of their stay, they spoke at a briefing at Mills-Peninsula to share their thoughts about health care in China and what they have learned during their visit to the medical center.
They related that in China, one of the biggest health care challenges is the disparity between health care need and resource allocation.
“Seventy percent of the population in China is rural but they get only 30 percent of the medical resources,” Dr. Jiang said. “The cities have 30 percent of the population but get 70 percent of the medical resources. As a result, rural people flood the city hospitals.”
Another problem is the lack of an appointment system at hospitals in China.
“Patients just show up at the hospitals and take a number,” Dr. Jiang said.
The photo he shared with the audience depicted long, dense lines of people waiting, making the emergency room entrance look as crowded as an international airport closed for severe weather.
Dr. Wu said that doctors never know how many patients they will see in a day and may have only 10 minutes to spend with each person.
He also cited Chinese hospitals’ inefficient processes for transferring of patients between departments.
“We don’t have a quick way to get a heart attack patient from the Emergency Department to the cath lab,” he said. “In China it can take three hours.”
When asked what he has learned about health care in the United States that could be implemented in China, Dr. Wu said, “Everything and nothing. We have learned from your ideas, but we cannot copy them because our systems are just too different.”
One of the goals of the visit was to learn more about the patient-centered approach to care in the United States.
Mills-Peninsula Physician Services Manager Donna Everix, who coordinated all of the scheduling for the month-long visit, described a visit to the Mills-Peninsula cardiac catheterization (cath) lab.
“While visiting the cath labs, Drs. Wu and Jiang were surprised to see that we asked the patients what they wanted to do, rather than ask the family, which is how they do it in China. They are not accustomed to a patient-centric approach so seeing how we make that a priority was eye-opening to them.”
Dr. Yong Jiang described health care in China as a “ticking time bomb”:
- 350 million people smoke
- There is a huge aging population
- Rural residents lacking health care insurance often have to take out loans or sell their homes to pay for hospital care
- There is very high resistance to antibiotics and penicillin because of over prescribing and self prescribing; antibiotics are sold over the counter with sales and use regulations are not always enforced.
- There are no public health workers or community health programs.
- Philanthropy and volunteerism are very uncommon
Peking University First Hospital is quite large; three campuses house 60 wards, 36 clinical departments and 1,500 beds. Nearly 7,000 patients are treated there every day. More than 45,000 patients are admitted and an estimated 20,000 operations are performed annually. The medical campus integrates health services with teaching, research and preventive medicine. Opened in 1915, the hospital is near the old imperial city in the center of Beijing.
“Many of our physicians and staff took time to meet with Drs. Wu and Jiang and show them all of Mills-Peninsula’s wonderful programs and services,” Everix said. “They are very grateful for the time and knowledge we have shared.”
In the last days before they return home, Mills-Peninsula scheduled the doctors to meet with local representatives of the Red Cross, emergency operations at San Francisco International Airport, and the San Mateo County Department of Public Health.
“This was a great opportunity to learn from each other and we hope to have ongoing programs to share our best practices,” Dr. Jiang said. “Our goal is better health care at a lower cost and we have a long way to go.”