The parents of Wei Zexi, a computer science major at Xidian University in Shaanxi province who died of a rare form of cancer, wait outside a funeral home in Xianyang, Shaanxi, on April 13. Photo: China Daily
A private hospital union in China has faced criticism and scrutiny after the death of 21-year-old college student Wei Zexi who had received an experimental cancer treatment from a department of the No 2 Hospital of the Beijing Armed Police Corps. But the department that administered the treatment is found to have been outsourced to a private hospital chain, which reportedly controls 80% of all Chinese mainland private hospitals.
The chain is known as “Putian-system” because the principal owners or investors behind the profit-driven institutions hail from the city of Putianin southeast China’s Fujian province, a place known in the 1980s to produce traditional medicines to cure sexually transmitted diseases.
Amid a growing public outcry against private hospitals that charge exorbitant prices for treatments and medicines, sino-us.com talked with several Putian system insiders to learn their side of the story.
Despite the recent spate of negative news, Doctor Peng (pseudonym) said she loves her work at a private maternity hospital in Putian system. “To work as a doctor here, I’m just supposed to improve on my medical skills. There is nothing else,” she told Sino-US.
In Peng’s view, the best part about the Putian system is that it promotes an operation style that frees medical practitioners from encouraging sales of treatments or medicines, which removes the source of potential patient-hospital disputes. Actually, the private hospitals in China are known to have strong sales teams, and some of them were exposed by the media for running online, print or TV advertisements advocating treatments or medicines later proven to be discredited.
Doctor Peng revealed that the private hospitals, all of which are under the umbrella of a chamber of commerce organization, Putian (Chinese) Health Industry Association, strive to offer a respectable position to medical practitioners.
According to Peng who has worked in a big public hospital for many years, in most public hospitals in China, medical workers are poorly paid and under pressure to urge for payments in arrears from their patients who’re financially insolvent.
“As a doctor, I tended to consider only the medical conditions of my patients instead of whether or not they could afford my treatment. While, in situations when patients didn’t have enough money to pay,doctors like me would get deductions on our salaries to compensate for the loss,” she added, “It’s unfair but it’s a norm in China’s public hospitals.”
After getting into a Putian private hospital, Peng doesn’t need to worry about these issues anymore. “I’m now paid several times more than I was. Anxieties about financial constraints that used to haunt my family are gone. Now, I could put my whole heart into practicing medicine and doing research.”
It is agreed by many industry insiders that guided by the “Putian idea” of separating doctors from sales initiatives,disputes between patients and their doctors have been considerably decreased. And patients who have chosen the private hospitals that boast separate customer service departments also feel satisfied with the arrangement.
In the in-patient department of a Putian union maternity hospital, sino-us.com interviewed some patients who’re expecting babies.
A lady surnamed Lu told sino-us.com she thinks giving birth here would be more convenient because of all the comfort the private hospital could provide and she has faith in her doctor, who’s a famous obstetrician in China.
Meanwhile, Lu confirmed the medical expenses here are not affordable for all people. “A natural labor would cost over 70,000yuan (or USD 10,469) compared with 8,000 yuan (or USD 1,196) in public hospitals, while caesarean birth would be charged over 100,000 yuan (or USD 14,956) instead of around 20,000 yuan (or USD 2,991).”
A big shareholder of the Putian system who don't want to be named told sino-us.com that the management system that his hospitals are applying has proven for many years to be quite effective in avoiding disputes.
However, the Wei case indicates either the so-called Putian operation failed to work in case of dubious treatment or not all Putian hospitals are freeing their medical practitioners from selling medicines or treatments.
On June 17, over 300 patients who had received the controversial immunotherapy at the No 2 Hospital of the Beijing Armed Police Corps gathered at the hospital’s front door to hold a protest. Several protesters told sino-us.com that the objective of the protest was to get back what they had paid for the failed therapy which usually costs between tens of thousands to hundreds of thousands of yuan.
In the afternoon, several representatives of the group were received by the National Health and Family Planning Commission, the executive agency authorized by the State Council to verify medical information. Now, searches of medical keywords on baidu website prompt a disclaimer that all medical information promoted through the Internet should not be presumed as authentic and it is suggested people double check through the National Health and Family Planning Commission’s official website.
One representative interviewed by the medical information officials told sino-us.com that the government agency has discredited immunotherapy because the technology was not previously approved or affirmed to be reliable. As for the appeal of the protestors for a refund, medical officials suggested they negotiate with the responsible hospital.
On June 15, Beijing police intervened and deployed officers at the hospital aiming to maintain stability. Such action is rarely seen at public hospitals without a military background.
In China, patient-hospital disputes leading to violent clashes are not uncommon, while in most cases, local police stations don’t take action until the situation becomes violent. The widespread delay in police actions has been criticized by the media as indifference,which can have fatal consequences.
When the national regulators and police departments intervened, a Putian boss hiding behind the chaos confessed that he and his partners now feel extremely anxious about the current situation.
In fact, many Putian bosses running healthcare institutions mentioned frankly in the past that their first bucket of gold came from seemingly shady business. “I became a poster boy when I was 16. Those suffering from sexually transmitted infections were enticed by the advertisement posters and sought me out for treatment,” Zheng Zhi (pseudonym) told sino-us.com, “That’s how I became rich.”
According to the health industry baron, back then, the medicines he acquired from a family of medical practitioners in his hometown Putian were effective for sexually transmitted diseases.
“It is not like we’re selling fake medicines. Our business secret was that we obtained the family recipe at a lower price and sold it out at a much higher price.
The business finally made Zheng rich and brought him enough money to open a real hospital. Now, as a pioneer in the Chinese mainland running private medical centers, Zheng owns dozens of medical equipment companies, private hospitals and joint ventures with public hospitals. The headquarters of his company got listed on the Nasdaq in 2012.
Zheng claimed he had studied hospital administration in Western countries like the US for many years and brought home with himself professional management teams to provide solutions for his Chinese operations. He believes more efficient administrative methods should be applied to state-owned or private hospitals in China to deal with the country’s now common disputes between patients and hospitals.
Although Zheng made it clear his group aims to manage more private and public institutions, as an industry insider,he is well aware of the series of government measures rolled out by the State Council in 2015 to ban public hospitals to outsource departments. The Baidu medical information ranking is actually regarded by bosses like Zheng as a counter measure.
On June 28, 2014, the private hospitals with Putian sponsors joined to set up the Putian (Chinese) Health Industry Association, a union that included over 8,500 hospitals totaling over a million employees and covering almost all Putian system medical services and equipment providers.
On April 4, 2015, the association initiated a high-profile boycott targeting Baidu because they believed the search engine was charging exorbitantly for their medical promotions. However, the issue is reported to have been resolved peacefully. Until the death of 21-year-old Wei, the Putian system together with its long-time cooperation partner Baidu is once again in the media and public spotlight, although this time, they are both accused to be the culprits of Wei’s tragic death.
(The article is translated and edited by Rebecca Lin.)