Yesterday, we looked at some of the banking problems in China. Today we are going to start to see a trend; institutions in China are poorly connected at best. This affects hospitals abilities to effectively treat diseases, and provide responsible treatments.
Before we start it is important to understand that China does not have family doctors, almost all of the treatment is provided in a hospital or a small clinic.
I’ve learned a lot working in a large Chinese hospital. There is no question that China’s medical facilities have improved hugely over the past thirty years. Many of the hospitals have modern equipment and well-trained doctors. The stumbling blocks we’ll be looking at today are caused by the system, and not by individuals (this article is looking at hospitals in major cities, there are far more problems in the countryside).
It starts with medical records. Each individual is responsible for keeping their test results and for making their own medical history. Because of this system, if you were in an accident while in a different city (or just a different part of your city) the new hospital would have zero access to your information. This also makes it difficult to identify epidemics, because records are so limited.
Another major challenge is unavoidable in some ways; there are too many patients and too few doctors. This huge flow of patients is only made worse by the fact that seeing a doctor is too cheap. I can see a doctor in the emergency room for the same price as a plate of fried rice in the cheapest restaurants. This means that patients show up at the first sign of a minor cold, which takes time away from seriously ill people.
My hospital serves over one million patients each year, meaning that doctors only have about 5 minutes to try to diagnose and treat each person. I have heard this complaint from the ER doctors more times than I can count.
The problem gets worse because patients demand antibiotics (usually the strongest available), and the doctors don’t have time to explain that this is useless for a viral cold. China now averages 10 antibiotic IV bags per person per year (global average is 3). The result is antibiotic resistant diseases as well as antibiotic resistant patients.
The final breakdown comes at the pharmacy. There is a regulation which requires a pharmacy to only give drugs when patients have a prescription (which seems reasonable). A doctor told me that regulations are treated more like suggestions, not laws. So even if he denied the patient antibiotics, they’d still be able to buy them.
Hospitals are key to providing the high-quality of life Chinese people are starting to demand, and China is going to need to improve their system dramatically to be considered up to global standards (even in the major cities).
Part Three looking at how difficult it is to enforce laws and regulations after they’ve been passed.
Update: This article from People’s Daily, focused on abuse of antibiotics, appeared the same day as my post.