China vs the US – Differences Through a Doctor’s Eyes

Dr Richard has done an interesting post on the differences between practicing medicine in the US and China, which run the gamut from divergent common ailments to wildly varying patient expectations. One worrying phenomenon the good doctor notes is the expectation among local patients that antibiotics will be doled out for any illness.

Dr Richard writes: “Last week I had another of many similar encounters: a young Chinese woman came in with typical common cold symptoms of runny nose and cough, and otherwise was fine. She made it very clear, very quickly, that she expected me to give her not just antibiotics, but IV antibiotics. Even after I explained to her that she only had a virus, she was quite flustered and still asked for the IV, telling me ‘you are very different than a local hospital.’ Ahhhhh, yes indeed…”

Over-prescription of antibiotics is a problem around the world, but is particularly chronic in China, as noted in a slightly hysterical article in the UK Telegraph earlier his month entitled “China threatens world health by unleashing waves of superbugs.” Despite the article’s over-the-top tone, it identified one of the key problems underlying China’s severely overstretched and under-resourced medical sector:

“Public health experts say the rampant over-use of antibiotics in China is primarily caused by China's under-funded healthcare system where hospitals derive up to half of their operating income from selling drugs.”

Apart from differences in patient expectations, Dr Richard also writes the types of diseases he commonly encounters in Beijing are quite different to those he regularly dealt with in the US: “I quickly noticed after coming to China (from a Sonoma county rural clinic) that the frequency and severity of chronic diseases was much lighter here. That’s for a good reason; few people with a major chronic disease would be physically qualified, much less interested, to work halfway around the world in the demanding, fast-paced business world of China. So, my Beijing clinic days are filled less with out of control diabetics and alcoholic hepatitis patients, and more with acute stomach flu and the various respiratory Beijingitis syndromes.”

Dr Richard also warms of another culturally-influenced syndrome he frequently encounters in Beijing, which he calls the 'businessman mentality': “It’s culturally accepted, if not indirectly coerced, to binge drink and smoke at business dinners — not to mention the implication that success allows you to have mistresses. I see a lot of broken marriages as well as alcoholism and chronic bronchitis in these types of expats, and I wonder if their often phenomenal business success was worth the trade-off in their physical and family health.” So expats beware – it’s not just the air that poses a threat to your wellbeing.

Incidentally, Dr Richard appeared in two segments on the Blue Ocean Network over Spring Festival, discussing issues related to Beijing pollution. Click on the links below to see the doctor in action.

http://www.bonlive.com/bontv/bontv.swf?file=http://www.bonlive.com/videoshow_xml.php?id=1965&

http://www.bonlive.com/bontv/bontv.swf?file=http://www.bonlive.com/videoshow_xml.php?id=1964&