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Losing patience with our patients

(Global Times)

09:01, August 17, 2011


Huang, a 78-year-old man, recently underwent major heart surgery at a local Tier-Three hospital famous for its skilled doctors and experience in performing heart surgery.

When Huang still didn't regain consciousness due to ICU psychosis - a condition in which patients experience delirium - he was asked to leave the hospital with management claiming his "clinical indexes" indicated he was well enough to be transferred to a Tier-Two hospital for a recovery that would take another couple of weeks.

The hospital administration said that it had already been "lenient" in agreeing to keep this man for almost three weeks, while other patients who had undergone the same operation were usually discharged within one to two weeks after undergoing surgery.

Hospitals in Shanghai are generally divided into three categories: community-level hospitals; district-level general hospitals that are labeled Tier-Two hospitals; and large, Tier-Three hospitals that boast the city's most experienced doctors and advanced equipment.

Normally, community-level or Tier-Two hospitals are the best option for patients who only need a prescription or who have a minor ailment such as a fever or a toothache. However many residents do not trust these lower tier hospitals. This mentality has resulted in routine crowds found in the city's few Tier-Three hospitals.

It's understandable that when a doctor needs to see 70 patients a day, he can only spend several minutes with each one. But when patients are suffering serious problems it is different. It sometimes takes weeks or even months for a patient to recover. But it appears that large hospitals show no concern for this.

The two-week limit is obviously unfair for seriously ill patients. When Huang was asked to transfer to a lower-level hospital, no hospital was willing to accept him. The explanations those hospitals offered varied: some said they had no experience in taking care of a patient who had just undergone a heart surgery; others said they couldn't admit him because his surgery wasn't carried out by them.

Without personal connections, it appears that no medical organization in the city is willing to accept a patient like Huang. In this case, his final admission to a Tier-Two hospital was facilitated by guanxi between doctors from the Tier-Three and Tier-Two hospitals.

But after a week of treatment at the Tier-Two hospital, his condition took a turn for the worse. As relatives of the patient exerted pressure on the doctor at the previous Tier-Three hospital, Huang was finally re-admitted to the renowned hospital. He is still in the ICU today, but making good progress.

Because of the imbalance between the large number of patients and limited resources in the best hospitals, it's understandable that they seek ways to increase their turnover rate.

On one hand, a higher turnover rate is surely good news to patients who have been anxiously queuing up outside hospitals. But on the other hand, money is undoubtedly the major reason behind it.

Current practices need to be re-examined. Doctors should comprehensively evaluate a patient's condition to see if he or she is well enough for a gradual recovery at home. Kicking them out to a lower-level hospital is rarely a good solution and, in most cases, merely causes more pain and worry to both families and hospitals.

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