Feature: Gong Xiaoming, a Chinese freelance doctor's odyssey
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E-mail Xinhua, June 26, 2017
by Xinhua writer Yuan Quan
BEJING, June 26 (Xinhua) -- Gynecologist Gong Xiaoming has a prescription for what ails China's health service: Set doctors free.
A specialist in uterine fibroids, he has worked with the prestigious Peking Union College Hospital for 15 years. Scalpers once sold his consultation bookings for 3,000 yuan (586 U.S. dollars), 400 times the official price.
"I should be proud," says Gong, 45. But in the winter of 2011, he was told a patient had queued overnight for a consultation ticket in temperatures of minus 4 degrees centigrade. "I was shocked," Gong recalls. "How Chinese patients suffer to see doctors?"
China's medical resources are extremely unbalanced, with 80 percent of patients in rural areas, but most quality hospitals concentrated in big cities like Beijing and Shanghai. Last year, an estimated 7 million patients of Beijing hospitals came from neighboring Hebei Province.
Gong admires how good medical staff in the United States and Europe can work for more than one hospital, either public or private. Moreover, thanks to the hierarchical medical system, patients can receive high-quality services at clinics nearby.
In 2013, Gong quit the public hospital system, working as a contract doctor in several Shanghai and Shenzhen hospitals. In 2016, uniting about a hundred leading doctors nationwide, Gong set up China's first gynecologist group, named "Woyi", which means "a fertile ground for doctors".
Such initiatives focusing on freelance physicians and doctor groups have come under the spotlight on Monday, China's National Doctor's Day, marked annually on June 26.
THINK FOR PATIENTS
At school he was shy and unsociable, but he was the top scorer in the national college entrance examination of his hometown in Zhejiang Province. He followed his father's recommendation to study clinical medicine at university.
He started as a general practitioner, but was frustrated at dealing with so many terminal patients. Gong loved to solve problems. He became a surgeon before moving into gynecology.
Gong earned a reputation from a five-hour operation to save a young woman's uterus by removing 419 fibroid tumors one by one. Other doctors had suggested a hysterectomy.
"I think about each patient's future," says Gong.
He works now in private hospitals where a consultation usually costs 420 yuan, about 60 times of the official fee when he worked in public hospitals.
Some criticized Gong for "only working for the rich," but he says doctors at private hospitals save patients hours of queuing, and more importantly, give more time to each consultation - at least 15 minutes.
Gong says allowing doctors to register at more than one hospital gives patients more access to treatment, and helps underpaid doctors to earn more.
Gong admits he had no idea how much a consultation should cost at first: "We left the decision to the market."
He raises the example of a female doctor, who often works late because her consultations last longer than others. She has many patients, though her consultation fee has risen from 450 to 800 yuan.
"Doctors and patients both benefit," Gong says.
A LONELY PIONEER
Since 2009 government regulations have allowed doctors to register at more than one hospital. Last October, the government released the "Healthy China 2030" blueprint to "explore the practice of freelance physicians and doctor groups."
New regulations in March also supported doctors in running their own clinics. But Gong has long been a lonely pioneer.
Official data shows that about 3,000 doctors had applied for more registrations, less than 5 percent of the total in Beijing by 2016. In Jiangsu, about 1,000 doctors have applied since 2010.
Those who hesitate to break away fear the loss of patients, because top public hospitals always have thousands more than private ones.
Last year, two ophthalmologists made headlines after being fired from a leading Beijing public hospital for "stealing patients".
"Chinese people prefer to judge doctors by the hospitals they work for," Gong says. "They trust public hospitals and trust their medical staff. So freelance doctors, who have been stereotyped as quacks in the past, have to compete in the market."
INTERNET MEDICINE
Doctors must offer excellent service to please their patients, he says.
In 2000, he set up the "China Obstetrics and Gynecology" website. At first he just shared research and essays from abroad.
But after he uploaded a video about a new method to treat postpartum bleeding, he received a message: "I saved a uterus today after learning the treatment through your video online. Thank you."
Gong realized the huge power of the Internet.
He wrote an article on Weibo in 2012, saying that many women were diagnosed or even prescribed treatments for "cervical erosion", which, he believes, is not a real condition.
He hoped the article could raise public awareness about overtreatment. It was soon reposted 33,000 times, with more than 4,000 comments. A microblogger replied, "Hail to the doctor with a conscience."
He has millions of followers on WeChat and other online clinics, sharing medical science and advice. He also offers two pregnancy apps.
Almost 90 percent of his patients come to him through the Internet.
GRASSROOTS TREATMENT
Some predict China will have more freelance doctors in the next 15 years. But Gong says there is a long way to go. "Few people would pay more to see a doctor at a private hospital."
The government is stepping up efforts to improve medical services.
During the 13th Five-Year Plan period, medical consultations through family doctors will be encouraged, and the government will pilot the hierarchical medical system in 85 percent of regions around China. Medical competence at grassroots level will be enhanced with more resources for lower tier institutions.
Gong and his team have begun working with public hospitals in second and third tier cities, seeing patients and conducting surgery at hospitals in Hebei and Zhejiang provinces.
Gao Xia, vice president of Hebei's Zhang Jiakou Women and Children Hospital, says Gong's service not only attracts more patients, but helps train the local staff: "Patients do not need to go to Beijing to see good doctors."
Every month, Gong flies to two or three cities. Though life is busier, he feels freer.
"I will keep working hard to make China's health care better." Enditem
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