While others look abroad for ideas to improve China’s health care services, Dr Yang Zhen, a surgeon and deputy chief of the hospital administration office in Shanghai’s Zhongshan Hospital, looks to the past. He has been collecting books, papers and photographs documenting the history of Western medicine in modern China for 10 years and is now writing a book on the subject. An expert in dealing with hostile doctor-patient relations, he tells Zhuang Pinghui how history holds some important lessons.
Tell us more about your book and why it is worth the effort?
It’s not a serious academic book and is meant mostly for ordinary doctors, especially the young ones. History is important because medicine is not just about technology. It’s about how we understand medicine. It helps us have a clearer perspective on many discussions in the health care industry now, as the famous poem suggests “the true face of Lushan is lost to my sight, for it is right in this mountain that I reside”. I think I have an advantage in being a hospital administrator, a surgeon and amateur history buff. I am surprised at the findings during my information collecting and, from the point of hospital administration, these documents are very useful. Western medicine entered China a little short of 200 years ago and you would have thought that by now it would have evolved and updated to a high level. Instead you find many of us are foreign to history that is only six or seven decades ago. Many problems that trouble us now had solutions long ago and we are not taking advantage of it, which is worrying.
Do you have some examples on how old solutions solve new problems?
Take the example of a big controversy in January about a girl complaining about how scalpers had made it difficult to see a doctor that month. In the 1950s, almost all hospitals provided advance appointment booking. Some programmes we have been piloting in health care reform – such as allowing doctors to practise in multiple registered places or scrapping medicine surcharges so that hospitals do not profit by prescribing drugs – existed long ago. Even the [idea behind the] New Rural Cooperative Medical System – public medical insurance for rural residents introduced on a trial basis in 2002 – existed in the 1930s. In some parts of China, some farmers paid a fee to a doctor who treated both farm animals and farmers.
Do you find anything strikingly different in historical approaches to medicine?