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    Why I Am Not a Good Doctor

    Chinese hospitals are overburdened and understaffed, leaving many doctors unable to give their patients the standard of care they deserve.

    I am the dean and chief physician of a renowned obstetrics and gynecology hospital in Shanghai. As a specialist in obstetrics, it is more expensive and harder for patients to gain an appointment with me than with general practitioners. I have many titles and awards, and yet, I must admit that I’m not a good doctor.

    As dean of the hospital I’m often required to attend important administrative meetings completely unrelated to medicine. During these times, I have to ask other doctors to cover my consultations. I always feel guilty over this since many of my patients have spent a long time waiting for an appointment with me. Rest assured that if a doctor in China doesn’t answer your call, they are normally not screening you, but simply too busy.

    My consultation is in high demand and there is a long waiting list. In every famous Chinese hospital patients will wait hours for consultations that last for minutes, but brief face time with doctors are an inevitability when you deal with as many patients as we do. A woman once burst into tears upon entering my office, complaining about our time management problems. All I could do was gently comfort her. Even when keeping consultations as short as possible, it still isn’t uncommon for doctors to work through the day without a single break or meal.

    A common complaint of my patients is that they pay exorbitant rates only to receive a series of “noes” from me. Will an X-ray lead to fetal malformation during an early pregnancy? No. Is excessive bed rest needed during the final stage of prenatal development? No. Should I take progestogen to protect my fetus during a threatened abortion? No. To some, it may seem a simple, concise answer, but a “no” actually takes a lot of courage, not to mention abundant clinical experience. There are many doctors who will diagnose a mild illness as severe, often just in an attempt to make money. But it is always better to avoid a prescription or a surgery unless absolutely necessary.


    As a specialist, many of my patients come to me with particularly complex problems to diagnose. One time, I met with a patient who was having complications with her pregnancy. She had visited a number of hospitals, but they had all referred her away. The doctors who listened to her case had recommended a forced labor induction and hysterectomy, which is an operation removing the womb. Desperate, she visited me. I informed her of a risky procedure that would save both baby and womb. She accepted and the operation was a success. Later, one of my students asked why I had accepted a patient no one else would take. “If not me, then who?” I replied. Secretly, I was relieved. The pressure on a doctor when executing a risky operation is enormous.

    It is to society’s ultimate advantage that medicine continues to advance. But it is a sad reality that innovation requires guinea pigs. In developing the prenatal care sector of our hospital, we have had to introduce new technology and equipment new to China and sometimes unfamiliar to our doctors. Our hospital has taken the lead on many such trials in recent years. It goes without saying that the safety of our patients is our main priority, but there are always risks associated with new procedures. The path to innovation is full of twists and turns.

    A hospital can never completely stay away from patient complaints and disputes and as dean I must shoulder all the responsibility. Having been a doctor for more than 20 years and dean for over 10, I have been screamed at, beaten by the families of patients, and have even defended myself in court several times. But as long as I remain in this profession, I must face the music. Patient-hospital disputes are by no means a new trend.

    You can perhaps now understand why I said that I’m not a good doctor. But I’m also not a good father. My daughter, who is currently in primary school, can’t understand why her daddy has so much homework in the evenings and on weekends — homework that steals her daddy’s time away from her.

    I admit that I’m not the best doctor. Our medical staff have problems, as does the hospital, as does the world. Still, I believe that our efforts will be worth it.

    And so I carry on, content in the knowledge that I am helping society, even if that isn’t always apparently obvious.

    (Header image: Doctors and nurses place a child into bed after an ENT surgery at Shanghai International Medical Center, May 28, 2014. Sun Zhan/Sixth Tone)