Healthcare is one of the first things that a new arrival in Shanghai would probably look into. Private clinics and the VIP centers at select public hospitals draw the majority of the city's expats.

They go to these facilities for fevers, broken bones or animal bites, but for serious illnesses, it is difficult to tell how much faith they have in local hospitals.

The same goes for Ruijin Hospital's Hematology Department, even though the department is the best in the country and leads the world in treating certain hematologic diseases, according to Dr Li Junmin, the department's deputy director.

With the government's goal to turn Shanghai into a major medical center in Asia, or the world, Li said his team is working to better serve foreign patients through a platform provided by the Shanghai International Medical Center (SIMC).

"Unlike domestic patients, foreigners consider whether the medical fees will be covered by their private health insurance. They pay close attention to the amount of time that doctors spend with them. They also have higher standards for the ward environment," Li told the Global Times.

While working to cater to these needs, his team's most important job is to increase foreign patients' understanding of its expertise. "The reputation of a hospital, of a certain department or a doctor normally spreads by word of mouth," Li said. "That's why we've started working to attract foreign patients. The more they come, the more their communities will know about what we can do."

A dilemma

With some 60 years of experience, the Ruijin Hospital's Hematology Department is technologically advanced by international standards. It has advantages in the treatment of acute promyelocytic leukemia as the two drugs that are universally applied to cure the disease are closely related to the department. "We invented one of the drugs. For the other, its mechanism of action was proved here," Li said.

In addition to technological advantages, it's also much cheaper to get treated in Shanghai. "One course of treatment for this disease normally costs $100,000 abroad," the doctor said. "Here it costs only $1,000."

Although such medical services are more affordable, foreigners have had difficulty accessing them. Li cited an example of a Swedish man living in Shanghai, who was diagnosed with acute leukemia. The patient chose the VIP center at Huashan Hospital. "However, the VIP center is more of a comprehensive department that cannot deal with a disease that requires a high degree of expertise in a specific field. He then visited Ruijin Hospital. Unfortunately, due to the limited number of beds in our VIP center and the very limited coverage of international health insurance at the hospital, the patient eventually decided to return home for treatment," Li said.

The Swede's case shows there are many obstacles for expats in China's healthcare system, complicating Shanghai's goal of transforming itself into a major medical center, Li said.

Transitions on the way

The SIMC employs a multilingual medical staff and accepts a majority of international health insurance providers. So far, it has received two foreign patients in the hematology department. One of them is from Singapore and the other is from Ukraine. Both are suffering from multiple myeloma.

Li communicates with his foreign patients mainly in English and French. He said that most of the doctors in his department can speak a foreign language. But nurses at Ruijin Hospital aren't necessarily able to speak a foreign language. That's why they have referred the two foreign patients to SIMC, where nurses can speak English, French, Japanese and Korean. "Above all, the quality of medical services is a combination of the efforts from both doctors and nurses," Li said.

The Ukrainian patient sought out Li after hearing about his reputation in the field. But for the Singaporean, who works in Shanghai, he chose to get his disease treated in Shanghai based on the theory that "the number of patients that a Shanghai hematology doctor fails to save is even more than the number of hematology patients that a Singaporean doctor manages to save."

"Practicing medicine is in essence the accumulation of experience. In China, there are a large number of patients and a great variety of different cases," Li said.

According to the doctor, the occurrence rate of malignant hematologic diseases is not high: five to eight cases for every 100,000 people. But there are also some non-tumorous hematologic diseases, like thrombocytopenia, which can also be dangerous. Given that there are more than 143,000 foreigners living in the city, according to the sixth national census published in 2011, the most in the country, there are more potential patients that the city's high-end medical platform can attract.

Confident in his team's professional expertise, Li suggested that the emphasis should be on strengthening foreigners' understanding of the professionals' capabilities in treating hematologic diseases and the improvement of corresponding services, which involve better communication with these patients.

"I think it could be feasible that we will employ some younger foreign doctors who have experience studying here in China, so they can serve as a bridge between the senior Chinese doctors and the foreign patients to better convey our messages to them in a way that they feel comfortable with," Li said. "The practice though will definitely add to a hospital's operational cost."

Although many challenges might lie ahead, the doctor is confident that if things go smoothly, a change might be soon embraced within two or three years, he said.

Nurses make up a bed at the Shanghai International Medical Center.

 

Dr Li Junmin, deputy director of Ruijin Hospital's Hematology Department

Photos: Courtesy of the Shanghai International Medical Center