DIAGNOSIS: Zhang Qiang, an independent medical practitioner, examines a patient at Worldpath Clinic International in Shanghai (COURTESY OF ZHANG QIANG)
Since opening his independent medical practice in Shanghai at the beginning of this year, Zhang Qiang, a cardiovascular surgeon, has adopted an entirely new lifestyle. Unlike most doctors in the country, who are employed by one public hospital at a time, he now works for several hospitals.
Zhang used to be head of the Vascular Surgery Department of East Hospital, which is affiliated with Tongji University in Shanghai. He resigned at the end of 2012 to pursue his new career path.
"I hope to set up a day-surgery platform that is up to international standards," Zhang told Beijing Review. He said that patients undergoing surgery for varicose veins usually do not have to be hospitalized. Yet in public hospitals, doctors often recommend patients to receive inpatient care, which Zhang thinks is often unnecessary and just increases the medical bills the patients have to pay. Zhang said that it would be easier to set up a day-surgery platform in private hospitals.
Currently, Zhang mainly practices at Worldpath Clinic International in Shanghai and United Family Hospital in Beijing. The former is a general medical institution jointly funded by healthcare professionals from both China and the United States, which aims to provide "expatriates and affluent families in Shanghai with the highest-quality medical services". The latter is a hospital under Chindex, a NASDAQ-listed China-U.S. joint-venture healthcare company. The hospital aspires to provide personalized medical services to patients.
Yet Zhang is not directly employed by any of these hospitals. He is actually self-employed. Rather than earning his salary from the hospitals, he gets a share of their revenue as a contractor.
Zhang has formed his own surgery team consisting of medical specialists, nurses and assistants. He pays their salary and fringe benefits with his own money, and patients can book an appointment with Zhang through his secretary. In the future, he plans to partner with a public relations company and multinational medical suppliers.
Zhang said that over the past months, the government has encouraged doctors to practice independently and in the meantime, the development of private medical institutions has given independent medical professionals more opportunities.
In China, big hospitals are suffering from a crowding epidemic. For the past few years, in order to improve the availability of medical services, the government has encouraged investment in private hospitals.
As a result, the number of private hospitals has been growing rapidly. As of the end of March, China had a total of 10,166 private hospitals, up 14.69 percent year on year, according to a bluebook on private hospitals jointly released on October 24 by the Non-Public Hospital Management Branch of the Chinese Hospital Association, the Beijing-based ChangCe Thinktank and the China Social Sciences Academic Press.
Private hospitals accounted for 43.24 percent of all medical institutions in the country, while their outpatient visits and admitted patients accounted for about 10 percent compared to public hospitals, according to the report.
In 2012, the Chinese Government outlined goals for increasing the total number of beds in private hospitals and their share of demanded services to approximately 20 percent of the total provided by all medical institutions by 2015.
Private hospitals still face bottlenecks that inhibit their growth, including shortages of outstanding doctors. Currently, some high-end private hospitals excel at providing nursing services, yet their lack of skilled doctors weakens their competitive edge, Zhang said. He believes that independent medical practitioners are going to alleviate this shortage and increase private hospital competitiveness in the market.
In response, on October 14, the State Council, China's cabinet, issued a guidance on promoting development of the health service industry. The document gave the private sector greater access to the healthcare market and simplified approval procedures for opening hospitals serving the elderly or children and those offering recuperation services. It also relaxed restrictions on the number, size, location and facilities of for-profit hospitals. The document stated that private and public hospitals should be treated equally.