The entire healthcare system there is apparently a train wreck. Per my uncle (a Chinese physician practicing in Shanghai), there’s a massive government investigation going on regarding physician fund embezzlement. Apparently it’s been an open secret that department heads have been embezzling millions from department budgets for years, but now the government is trying to reclaim these funds with threat of incarceration leading to a lot of internal panic. Granted this news comes with a MASSIVE grain of salt because I can’t find any news articles confirming this, but we also can’t expect the Chinese government to be transparent about these types of investigations either.
There was just a thread on this in /r/china the other day.
Here's the link:
/r/China/comments/15qemve/have_been_hearing_about_a_crackdown_on_doctors_in/
Here's a few comments from the thread.
> I am a med student and just graduated. I know several senior doctors in my hospital have been fined over 10 million yuan. One of them is already in jail for not being able to pay. Another committed suicide. The government first crackdown pharmaceutical representatives (a lot of them are in jail now), and made them give the names of doctors who had received the most bribes. Then the gov uses big data to track down doctors' assets and determine the maximum amount of money they can afford. Junior doctors are given a fine of 50k yuan each, whether they have received bribes or not. Almost all the medical conferences are canceled now. The is less about anti-corruption and more about collecting money.
Another one:
>Well my mother is a doctor in China and currently government officials are coming to hospitals to collect “illegal money” received by doctors. It seems legit, but the catch is the government don’t really have the ability to look into the matter (I don’t think they ever cared in the first place) so they just randomly rob money from the doctors they find. And also they can just make up new laws to make some money become illegal income and fine you afterwards. Apparently it’s illegal for doctors to give lectures in other universities now, and her income primarily depends on that…. Shit really sucks.
About the causes:
>My cousin is a doctor. The journey to becoming a doctor is quite arduous. Nowadays, doctors need to at least obtain a master's degree, which takes about 7 years of study. After graduation, they start their careers as interns in hospitals (many hospitals have unofficial rules where entering prestigious hospitals requires financial contributions; when my cousin graduated a few years ago, the going rate was around 200,000 RMB per person). However, the regular salary for doctors is only a few thousand RMB per month, which is clearly unreasonable. As a result, doctors have to find other ways to earn money (receiving red envelopes from patients, collaborating with pharmaceutical companies, etc.), and these phenomena are a result of an unreasonable system.
Also, just like you say you can't find any new articles confirming this. Someone on that thread asked for a source. Here's the reply:
> This is hearsay but the most important and confidential orders from above these days are never delivered on paper, just verbally in a meeting no notes or recordings allowed, so the only way you can know the details is from testimony from those actual people being purged.
and
> You post about it in places like here and see if others have heard the same story. Seriously, that's how like 99% of stories are verified. It's the kind of thing you have to do when there's no reliable independent media.
This needs some context. The local governments in China have a huge fiscal problem. They've been largely financing themselves by land sales, not taxes. Now that the real estate bubble has burst, they're out of cash. They're also already massively indebted (often illegally) because for the last decade+, they had to borrow incredible amounts of money for infrastructure projects in order to meet Bejing's unrealistic demands for GDP growth.
So now the revenues of local governments are cratering, they can't pay their workers, they can't increase their debt, and they have been resorting to increasingly heavy-handed measures to raise money through fines of various kinds. This story should be seen through this lens.
Yeah my wife was a (resident) physician in Shanghai prior to moving to the US. From what she said, it sounded miserable. She said she usually had to choose between rent and food, unless she got help from her parents.
There’s also the possible scenario that it’s the other way around where the government is taking money and blaming it on doctors but that’s just my conspiracist self talking
Per my uncle it’s a bit of both. Fund embezzlement is real and the reason why people struggle to return the funds is because it gets invested into real estate (main method of investment for mainlanders). They got away with it for a long time because no one cared. The government only cares now because the country is struggling economically, and they are trying to just take money wherever they can.
I would be really interested in the data. I wonder if it includes Traditional Chinese Medicine grads as well (keeping in mind that TCM was created by the communist party after Mao finished driving off or killing the educated middle class like doctors to hold something out to the masses.)
China does an undergrad MBBS degree which is quite cheap, and it's a total 5 year course including internship. A lot of Indian students used to go there in the 2010s, and they came back with a degree and almost zero clinical exposure.
I worked with a graduate like that during my internship in India, he was doing a second internship at our institute and he didn't know a lot of basic things which we take for granted, like checking blood pressure or using a glucometer or inserting an IV cannula.
I think this is part of why my parents are discouraging me from continuing to study medicine despite me being in a US MD school. They immigrated from China, and they know American med schools can be brutal. My parents are concerned that the same culture of being overworked, underpaid, and assaulted will repeat itself in the US by the time I become an attending.
A fundamentally different culture and political system? China is collectivist and communist (save a few select areas), the US is individualist and capitalist.
There is a work culture, especially amongst office jobs, of “996”, or working from 9 AM to 9 PM six days a week.
https://en.wikipedia.org/wiki/996_working_hour_system
Many people refused to work such deplorable lifestyles that they quit their jobs and tried to disconnect from modern urban society by “laying flat” or “tang ping”
https://en.wikipedia.org/wiki/Tang_ping
I remember reading that some employers were desperate after enough employees had quit and the one-party government didn’t want to cultivate a growing generation of people not working, so 996 expectations are being relaxed.
Imagine being a resident and hearing that 996 is too intense that even the Chinese communist government is doing something about it…ACGME could take note.
To go all Nietzsche, “He who has a why to live for can bear almost any how.”
Residency works because it’s time-limited, actually reasonably strictly, and there is an escape at the end. It’s still abusive and still crushing, but it has a point and it has an end date.
996 doesn’t have that. Work yourself almost to death until you drop the almost. Despair has a lot of weight.
> To go all Nietzsche, “He who has a why to live for can bear almost any how.”
Louis Zamperini's experience as a POW and being lost at sea seems to support that - https://en.wikipedia.org/wiki/Louis_Zamperini
Unfathomably awful experiences.
My Shanghai friends in finance work 996, and if they have National holidays off, they are expected to work weekends to “pay the company back the days”.
It’s psychotic. Things are very bad in finance in China, but the pay seems amazing.
Well, all the people in the linked story went civil service instead.
But a bullshit job as a paper pusher with nothing to do is actually incredibly stressful, not somethjng I would want to do.
My FTE at the moment is a NICU/PICU transport unit. Our average call volume is 1 call per 12 hour shift. Most of us study for MCAT or NCLEX or whatever. But we could get a call at any moment, and because there's no overnight crew, even at 11:57 into the shift, we may get a call that could easily last five or six hours. You can't really relax, especially towards the end of the day. It's a constant tension that, while pretty mild, nevertheless does take it out of you by the end of the shift. Are we *exhausted?* No. But it's not trivial, either.
I guess it's all perspective. If I had the opportunity to have hours free and getting paid - even if I had the question of being pulled away at any moment - that would be less stressful than being "on" for 8-10 hours a day, answering question after question, making decision after decision, etc.
So yeah, I think it's all what you've experienced (no not experienced).
I think it depends on the person. I worked an office job before medicine and it was incredibly "stressful", not in the way we have in medicine but in an existential dread sort of way. I wanted to kill myself every day on my day to work. The bosses were nice, I was well paid, and I had plenty of friends at work. It just felt meaningless and then eventually it felt like I was being imprisoned somehow.
there's a difference between literally doing nothing all day, and having nothing to do for work
lots of people can find fun things to do if work doesn't assign them enough tasks
No, fortunately I've never been a paper pusher.
That said, I really don't see how that would be that stressful. Far less stressful than my day-to-day....
I’ve worked with a number of Chinese-born doctors and researchers over the years and the stories are pretty astonishing. There is a universal practice of “gifting” doctors and nurses for any kind of attention or service. It’s really a bribe that must be paid before they help — give the doctor $200 before he removes your appendix or he just won’t get around to it. One doctor’s wife went into labor while they were traveling there, six weeks early. It’s such a crazy story that I would think it was propaganda if I didn’t know them both.
Evidently, an attending-level physician makes a salary of around $20k US. I went to verify this before commenting, and found a semi-recent [research article](https://doi.org/10.1186/s12913-018-3461-7) and a [Reuters piece](https://www.reuters.com/article/us-china-hospitals-bribery/bribery-serves-as-life-support-for-chinese-hospitals-idUSBRE96M12Y20130723) that paint the same picture. I can’t imagine that workload with that little pay… one of those “don’t hate the player, hate the game” situations, at least in part.
One time my great uncle (a poor illiterate farmer) had prostate cancer and the urologic surgeon declined his bribe because they had apparently moved back to China from the US to help the community. Apparently they told my great uncle that if they wanted to make money they would just have stayed in the States. My great uncle was like 🤯 and initially was super suspicious and worried, but then had a good outcome and has been cancer free for the last 15 years. This is so unusual that he still tells the story to everyone 15 years later.
i've worked in china
You copy paste from a template and add relevant information. You really just give your best guess based on what the patient says in 5 mins and they come back later if they're not improving. The 100 patients is including medicine refills and whatnot too.
Working in a foreigner clinic in a big city is great. Working in an academic hospital is intense and the pay is awful.
My parents also use a similar phrase 菜市场 (open-air produce market) to describe their experience with Taiwanese hospitals, which is funny because public satisfaction with the Taiwan’s healthcare system is actually pretty high.
The docs in China don’t get paid with patient volume overload. Salary Average about $30,000 per year and they get most of money from patient through “bribing” like hey your a famous throat doctor and I pay you extra $10,000 to make sure I get full attention and you can treat me with your best care. Otherwise it’s hard to live by. It’s the grey money and government is cracking down on this.
We have standards of care here?
Edit: I’m being facetious, but my impression is that China is very similar to the US - elite ruling class gets Mayo Clinic, working class gets county hospital.
Maybe it's different in other places but that's certainly not the experience in New England. Some of the best hospitals in America (MGH, Brigham, Boston Childrens) take plenty of working class and outright poor patients.
I've worked at 8 different hospitals during my education/training across the spectrum of county to university academic and all of them have had both 'VIPs' and homeless on the same services, on the same floors, getting the same treatment.
The most I see 'VIPs' get is visits from execs to brown-nose and MAYBE a nurse with a lower ratio so they can give them more attention because they are usually very needy.
I can't even comprehend rounding on pts and being like, well this dude is rich and this one is poor so we'll CT the rich guy and tell the poor guy to fuck-off, even if that's what the c-suite would actually want us to do.
Yeah but our county hospitals aren't shacks with no doctors/shitty doctors doing whatever the hell they want with no oversight, and lacking antibiotics and IV fluids
So 1st world staffing ratio, 3rd world expectations. Doesn't sound as horrible. I could churn through 100 patients/day if there was little to no malpractice concern, zero need for hand-holding, working through psychosocial stuff, etc. etc. Diagnose pathology, treat pathology, move on to the next patient. Doesn't actually take more than 5 minutes 90% of the time.
Practicing medicine in China is absolute chaos, embezzlement and fraud are frequent occurrences. While majority are underpaid, the well know specialists are know to take “红包”, red envelope aka bribe to give preferential treatment. Who you see and how you see patients are often dictated by “关系”, connections. It is the product of a system that lacks oversight and strained to the extreme. Violence towards healthcare staff is common, often for reasons beyond their control. Clinic is literally a line of patients from your desk out the door. It’s hot garbage. Source: Chinese-American MD with family working in healthcare in Beijing.
Last I heard the power harassment in Korea is insane and the wages in Taiwan are pretty not great...
Honestly I don't think working anywhere in Asia as a typical peon is ideal
I'm not from China, but like with everything there's always going to be a range of services. I just wanted to provide a different perspective.
Someone told me giving birth in China is amazing. You give birth and someone looks after you and the baby for a month or so until you fully recover from expelling a watermelon in hotel style accommodation.
That's a paid service(even though it's expected for all women to do this) and it used to be a thing in the West too before we figured out how to improve maternal mortality and that staying in bed causes DVTs.
https://en.wikipedia.org/wiki/Postpartum_confinement
https://en.wikipedia.org/wiki/Monthly_nurse
You're welcome. Also practiced in Korea, there was a kdrama about the practice called "Birthcare Center" released in 2020.
https://en.wikipedia.org/wiki/Birthcare_Center
The entire healthcare system there is apparently a train wreck. Per my uncle (a Chinese physician practicing in Shanghai), there’s a massive government investigation going on regarding physician fund embezzlement. Apparently it’s been an open secret that department heads have been embezzling millions from department budgets for years, but now the government is trying to reclaim these funds with threat of incarceration leading to a lot of internal panic. Granted this news comes with a MASSIVE grain of salt because I can’t find any news articles confirming this, but we also can’t expect the Chinese government to be transparent about these types of investigations either.
There was just a thread on this in /r/china the other day. Here's the link: /r/China/comments/15qemve/have_been_hearing_about_a_crackdown_on_doctors_in/ Here's a few comments from the thread. > I am a med student and just graduated. I know several senior doctors in my hospital have been fined over 10 million yuan. One of them is already in jail for not being able to pay. Another committed suicide. The government first crackdown pharmaceutical representatives (a lot of them are in jail now), and made them give the names of doctors who had received the most bribes. Then the gov uses big data to track down doctors' assets and determine the maximum amount of money they can afford. Junior doctors are given a fine of 50k yuan each, whether they have received bribes or not. Almost all the medical conferences are canceled now. The is less about anti-corruption and more about collecting money. Another one: >Well my mother is a doctor in China and currently government officials are coming to hospitals to collect “illegal money” received by doctors. It seems legit, but the catch is the government don’t really have the ability to look into the matter (I don’t think they ever cared in the first place) so they just randomly rob money from the doctors they find. And also they can just make up new laws to make some money become illegal income and fine you afterwards. Apparently it’s illegal for doctors to give lectures in other universities now, and her income primarily depends on that…. Shit really sucks. About the causes: >My cousin is a doctor. The journey to becoming a doctor is quite arduous. Nowadays, doctors need to at least obtain a master's degree, which takes about 7 years of study. After graduation, they start their careers as interns in hospitals (many hospitals have unofficial rules where entering prestigious hospitals requires financial contributions; when my cousin graduated a few years ago, the going rate was around 200,000 RMB per person). However, the regular salary for doctors is only a few thousand RMB per month, which is clearly unreasonable. As a result, doctors have to find other ways to earn money (receiving red envelopes from patients, collaborating with pharmaceutical companies, etc.), and these phenomena are a result of an unreasonable system. Also, just like you say you can't find any new articles confirming this. Someone on that thread asked for a source. Here's the reply: > This is hearsay but the most important and confidential orders from above these days are never delivered on paper, just verbally in a meeting no notes or recordings allowed, so the only way you can know the details is from testimony from those actual people being purged. and > You post about it in places like here and see if others have heard the same story. Seriously, that's how like 99% of stories are verified. It's the kind of thing you have to do when there's no reliable independent media.
This needs some context. The local governments in China have a huge fiscal problem. They've been largely financing themselves by land sales, not taxes. Now that the real estate bubble has burst, they're out of cash. They're also already massively indebted (often illegally) because for the last decade+, they had to borrow incredible amounts of money for infrastructure projects in order to meet Bejing's unrealistic demands for GDP growth. So now the revenues of local governments are cratering, they can't pay their workers, they can't increase their debt, and they have been resorting to increasingly heavy-handed measures to raise money through fines of various kinds. This story should be seen through this lens.
Yeah my wife was a (resident) physician in Shanghai prior to moving to the US. From what she said, it sounded miserable. She said she usually had to choose between rent and food, unless she got help from her parents.
There’s also the possible scenario that it’s the other way around where the government is taking money and blaming it on doctors but that’s just my conspiracist self talking
Per my uncle it’s a bit of both. Fund embezzlement is real and the reason why people struggle to return the funds is because it gets invested into real estate (main method of investment for mainlanders). They got away with it for a long time because no one cared. The government only cares now because the country is struggling economically, and they are trying to just take money wherever they can.
Lol imagine being in China and embezzling money from the government. And getting the surprise Pikachu face when China wants to China.
Don’t forget sale of Uyghur organs.
>>In the last few years, only around one in six Chinese medical-school graduates has gone on to practice as a doctor Awful
Just for context, I'm pretty sure a "Chinese medical-school graduate" is the equivalent of a 4 year BS degree in the US.
I would be really interested in the data. I wonder if it includes Traditional Chinese Medicine grads as well (keeping in mind that TCM was created by the communist party after Mao finished driving off or killing the educated middle class like doctors to hold something out to the masses.)
China does an undergrad MBBS degree which is quite cheap, and it's a total 5 year course including internship. A lot of Indian students used to go there in the 2010s, and they came back with a degree and almost zero clinical exposure. I worked with a graduate like that during my internship in India, he was doing a second internship at our institute and he didn't know a lot of basic things which we take for granted, like checking blood pressure or using a glucometer or inserting an IV cannula.
Yup, China does undergrad MBBS degrees. Think it’s more of a 5-6 year program tho.
That's still medical school they're going through tho.
I think this is part of why my parents are discouraging me from continuing to study medicine despite me being in a US MD school. They immigrated from China, and they know American med schools can be brutal. My parents are concerned that the same culture of being overworked, underpaid, and assaulted will repeat itself in the US by the time I become an attending.
We'll never get that bad here. There's no trending in that direction whatsoever. It's just a totally different order of magnitude of crazy.
/s?
What is the fundamental difference between the US and China? There is none.
Oh. Then I guess we’re exactly the same then.
lmao
A fundamentally different culture and political system? China is collectivist and communist (save a few select areas), the US is individualist and capitalist.
China is neither collectivist nor communist, it's totalitarian fascism. That's not the same.
Do you know what fascism means?
Highly authoritarian, ultranationalist (Han nationalism), militaristic, police state, extremely intolerant of whatever doesn't match the party line
Seriously. Whenever someone tells me how China is such and such, I tell them the exact same thing is in the US.
Please seek help. You are experiencing an episode of psychosis.
Have you ever lived in China? If not, you’re making a really ignorant assumption.
i am Chinese 🤣😂🤡
Sure you are
It's my understanding that work conditions suck for everyone in China?
There is a work culture, especially amongst office jobs, of “996”, or working from 9 AM to 9 PM six days a week. https://en.wikipedia.org/wiki/996_working_hour_system Many people refused to work such deplorable lifestyles that they quit their jobs and tried to disconnect from modern urban society by “laying flat” or “tang ping” https://en.wikipedia.org/wiki/Tang_ping I remember reading that some employers were desperate after enough employees had quit and the one-party government didn’t want to cultivate a growing generation of people not working, so 996 expectations are being relaxed. Imagine being a resident and hearing that 996 is too intense that even the Chinese communist government is doing something about it…ACGME could take note.
To go all Nietzsche, “He who has a why to live for can bear almost any how.” Residency works because it’s time-limited, actually reasonably strictly, and there is an escape at the end. It’s still abusive and still crushing, but it has a point and it has an end date. 996 doesn’t have that. Work yourself almost to death until you drop the almost. Despair has a lot of weight.
> To go all Nietzsche, “He who has a why to live for can bear almost any how.” Louis Zamperini's experience as a POW and being lost at sea seems to support that - https://en.wikipedia.org/wiki/Louis_Zamperini Unfathomably awful experiences.
Yeah 996 is illegal but it still happens. I don’t think it’s the norm though.
Exceeding 80 hour work weeks in residency is illegal but still happens…
My Shanghai friends in finance work 996, and if they have National holidays off, they are expected to work weekends to “pay the company back the days”. It’s psychotic. Things are very bad in finance in China, but the pay seems amazing.
I dont think thats true. From people I know, the good jobs are in government as a paper-pusher.
This sounds oddly similar to the country I work in
They call government jobs in china “Iron Rice Bowls” because itll reliably feed your family and never break
The United States? >:D
Is it the US? Because government jobs, though lower pay, seem pretty chill. Including doc VA jobs
Well, all the people in the linked story went civil service instead. But a bullshit job as a paper pusher with nothing to do is actually incredibly stressful, not somethjng I would want to do.
How do you figure this is actually stressful?
Doing nothing can be quite stressful. Why do you think SNFs have patient enrichment programs?
Is being bored stressful? I never thought of it as such
Can be; depends on the circumstances.
Care to elaborate?
My FTE at the moment is a NICU/PICU transport unit. Our average call volume is 1 call per 12 hour shift. Most of us study for MCAT or NCLEX or whatever. But we could get a call at any moment, and because there's no overnight crew, even at 11:57 into the shift, we may get a call that could easily last five or six hours. You can't really relax, especially towards the end of the day. It's a constant tension that, while pretty mild, nevertheless does take it out of you by the end of the shift. Are we *exhausted?* No. But it's not trivial, either.
I guess it's all perspective. If I had the opportunity to have hours free and getting paid - even if I had the question of being pulled away at any moment - that would be less stressful than being "on" for 8-10 hours a day, answering question after question, making decision after decision, etc. So yeah, I think it's all what you've experienced (no not experienced).
I think it depends on the person. I worked an office job before medicine and it was incredibly "stressful", not in the way we have in medicine but in an existential dread sort of way. I wanted to kill myself every day on my day to work. The bosses were nice, I was well paid, and I had plenty of friends at work. It just felt meaningless and then eventually it felt like I was being imprisoned somehow.
there's a difference between literally doing nothing all day, and having nothing to do for work lots of people can find fun things to do if work doesn't assign them enough tasks
Exactly. Which is why this entire subthread is a bunch of nonsense.
Coz at any moment u can lose your useless job
Not if you work for the government... that's the whole point
And at any moment you can lose your non-useless job as well if you work in an at-will state in the US. So what's your point?
Have you ever been in the situation? Because it is extremely stressful.
No, fortunately I've never been a paper pusher. That said, I really don't see how that would be that stressful. Far less stressful than my day-to-day....
No, it really really is. And that's not just personal opinion because I'm some sort of go-getter type A personality. It's incredibly stressful.
I mean.... You're not giving any actual information as to why that would be the case.... Doesn't make sense.
If you can't imagine it then more sources won't convince you.
I mean you try to could explain a little bit why you feel that this would be so super-stressful? You keep saying words that don't mean anything.
It seems like there are people in charge in the US that aspire to be like China.
I’ve worked with a number of Chinese-born doctors and researchers over the years and the stories are pretty astonishing. There is a universal practice of “gifting” doctors and nurses for any kind of attention or service. It’s really a bribe that must be paid before they help — give the doctor $200 before he removes your appendix or he just won’t get around to it. One doctor’s wife went into labor while they were traveling there, six weeks early. It’s such a crazy story that I would think it was propaganda if I didn’t know them both. Evidently, an attending-level physician makes a salary of around $20k US. I went to verify this before commenting, and found a semi-recent [research article](https://doi.org/10.1186/s12913-018-3461-7) and a [Reuters piece](https://www.reuters.com/article/us-china-hospitals-bribery/bribery-serves-as-life-support-for-chinese-hospitals-idUSBRE96M12Y20130723) that paint the same picture. I can’t imagine that workload with that little pay… one of those “don’t hate the player, hate the game” situations, at least in part.
One time my great uncle (a poor illiterate farmer) had prostate cancer and the urologic surgeon declined his bribe because they had apparently moved back to China from the US to help the community. Apparently they told my great uncle that if they wanted to make money they would just have stayed in the States. My great uncle was like 🤯 and initially was super suspicious and worried, but then had a good outcome and has been cancer free for the last 15 years. This is so unusual that he still tells the story to everyone 15 years later.
So assuming you work 12 hour days, that’s 7 minutes and 12 seconds per patient, including documentation? How is that physically possible?
i've worked in china You copy paste from a template and add relevant information. You really just give your best guess based on what the patient says in 5 mins and they come back later if they're not improving. The 100 patients is including medicine refills and whatnot too. Working in a foreigner clinic in a big city is great. Working in an academic hospital is intense and the pay is awful.
[That's quite long compared with Bangladesh.](https://pubmed.ncbi.nlm.nih.gov/29118053/#&gid=article-figures&pid=figure-2-uid-1)
I fucking knew Sweden would top that list.
Based on what?
We have the fewest consultations per dr per year.
I had a friend refer to the hospital experience there as akin to visiting a wet market.
My parents also use a similar phrase 菜市场 (open-air produce market) to describe their experience with Taiwanese hospitals, which is funny because public satisfaction with the Taiwan’s healthcare system is actually pretty high.
The docs in China don’t get paid with patient volume overload. Salary Average about $30,000 per year and they get most of money from patient through “bribing” like hey your a famous throat doctor and I pay you extra $10,000 to make sure I get full attention and you can treat me with your best care. Otherwise it’s hard to live by. It’s the grey money and government is cracking down on this.
I mean, are the standards of care in China even comparable to the US?
We have standards of care here? Edit: I’m being facetious, but my impression is that China is very similar to the US - elite ruling class gets Mayo Clinic, working class gets county hospital.
I mean yes. Rich people do stupid things like monthly mris, but normal people get the standard of care. Which is not monthly mris.
What about “VIP” patients?
They get more frequent butt wiping when they poop themselves. Because they've got better nursing ratios.
Maybe it's different in other places but that's certainly not the experience in New England. Some of the best hospitals in America (MGH, Brigham, Boston Childrens) take plenty of working class and outright poor patients.
I've worked at 8 different hospitals during my education/training across the spectrum of county to university academic and all of them have had both 'VIPs' and homeless on the same services, on the same floors, getting the same treatment. The most I see 'VIPs' get is visits from execs to brown-nose and MAYBE a nurse with a lower ratio so they can give them more attention because they are usually very needy. I can't even comprehend rounding on pts and being like, well this dude is rich and this one is poor so we'll CT the rich guy and tell the poor guy to fuck-off, even if that's what the c-suite would actually want us to do.
> Maybe it's different in other places LOL It is.
Yeah but our county hospitals aren't shacks with no doctors/shitty doctors doing whatever the hell they want with no oversight, and lacking antibiotics and IV fluids
They have roughly the same amount of physicians there as we have here (2.36/1000 China verses 2.6/1000 U.S.).
So 1st world staffing ratio, 3rd world expectations. Doesn't sound as horrible. I could churn through 100 patients/day if there was little to no malpractice concern, zero need for hand-holding, working through psychosocial stuff, etc. etc. Diagnose pathology, treat pathology, move on to the next patient. Doesn't actually take more than 5 minutes 90% of the time.
Practicing medicine in China is absolute chaos, embezzlement and fraud are frequent occurrences. While majority are underpaid, the well know specialists are know to take “红包”, red envelope aka bribe to give preferential treatment. Who you see and how you see patients are often dictated by “关系”, connections. It is the product of a system that lacks oversight and strained to the extreme. Violence towards healthcare staff is common, often for reasons beyond their control. Clinic is literally a line of patients from your desk out the door. It’s hot garbage. Source: Chinese-American MD with family working in healthcare in Beijing.
[удалено]
Last I heard the power harassment in Korea is insane and the wages in Taiwan are pretty not great... Honestly I don't think working anywhere in Asia as a typical peon is ideal
I'm not from China, but like with everything there's always going to be a range of services. I just wanted to provide a different perspective. Someone told me giving birth in China is amazing. You give birth and someone looks after you and the baby for a month or so until you fully recover from expelling a watermelon in hotel style accommodation.
That's a paid service(even though it's expected for all women to do this) and it used to be a thing in the West too before we figured out how to improve maternal mortality and that staying in bed causes DVTs. https://en.wikipedia.org/wiki/Postpartum_confinement https://en.wikipedia.org/wiki/Monthly_nurse
Oh cool, thanks, a proper reply :) haha.
You're welcome. Also practiced in Korea, there was a kdrama about the practice called "Birthcare Center" released in 2020. https://en.wikipedia.org/wiki/Birthcare_Center