Entering a Chinese hospital is entering a money-making machine designed to extract money from the sick. They see your illness as nothing more than an opportunity to make money. Treatment is directed according to how much they can profit rather than how useful (or even harmful) it is for the patient. For practically any illness, no matter how minor, the doctor will prescribe around five different medicines including antibiotics. If your symptoms are more than mild, they will try to put you on a drip. A minor ailment can turn into an expensive and time consuming misadventure. This madness is due to the Chinese medical system and the ridiculously low consultation fees doctors are paid due to government controls. Doctors are typically paid less than 1 USD per consultation, barely even a living and not enough to support a family in modern China. So doctors need to make money through kickbacks, usually taking the form of superfluous antibiotics, IV’s and diagnostics. It is overt corruption and few Chinese people seem to question it. Therefore, it’s not about to change anytime soon, and if you’re living in China you need to know how to deal with it. Here I’ll explain how to see a doctor without getting cheated.
When you see a doctor in China, you first register and pay a small fee. You then proceed to the appropriate department and may need to register again (paying another small fee); each department wants a piece of the registration action! The registration fee is minimal and it’s nothing to worry about. I had an ear problem recently, and paid 4RMB at the main counter and then 7RMB at the ENT department. That’s a total of 11RMB (less than 2USD). After paying the registration fees, you can see the doctor and then walk out of the hospital without paying anymore more if you choose. Most people do not understand this, and think they must follow the instructions the doctor gives them.
During the consultation, the doctor will write in your medical record booklet. The booklet contains valuable information such as your medical diagnosis and recommended course of treatment. You are able to take this booklet home with you, a very basic but efficient system where you have full control over your medical records! After the doctor writes in your booklet, he’ll start tapping away on the computer and then printing out page after page of prescriptions. In the normal course of events, you take these prescriptions to the cashier and pay in full. Some of those prescriptions may be for additional diagnostics or an IV drip. After you have paid, you proceed to the appropriate treatment room in the case of diagnostics or direct the hospital pharmacy if it’s just medicine. Here is one of the tricks. Unlike in western countries, you cannot go to the pharmacy of your choice; you must pay for your medicines directly through the hospital. Perfect for receiving kickbacks! This is why I do not recommend you follow the normal course of events!
Instead of following the process above, here is what I recommend. After the doctor prints out the countless scripts and instructs you do go to the cashier, you instead use your dictionary to find out what each of these medicines actually are and use websites such as www.nlm.nih.gov to research them. Take note of whether any of these medicines are banned in countries such as America, or whether you’ve been prescribed any strange but expensive Chinese medicines. After that, you may proceed to the cashier and show them only the prescriptions that you want, or find a pharmacy outside of the hospital and show the prescriptions to them. In a nutshell, when you go to the doctor in China, the diagnostic information he writes in the book can be useful, but use very careful discretion before filling any of the scripts.
If the doctor tells you do go on an IV drip, you probably don’t need it! Chinese hospitals have large IV rooms literally full of people on drips. The trick is that they charge over 120RMB to put you on a drip (in contrast to the 4RMB consultation fee). A drip serves as a relatively convenient and safe way to extract extra money out of you. It shocked me that some friends here hate going to the hospital because the doctor always puts them on drips. Little do they know that just because the doctor writes the prescription does not mean they have to follow through with it! To avoid going on the IV drip is as simple as not giving the prescription to the cashier.
When I first went to hospital in China, I was foolish enough to just trust the doctor and did end up on an IV drip for antibiotics. The doctor told me to come back the next day to have the drip again. When I went back I saw another doctor who was very honest. She told me the drip was a waste of time and that I could take the same antibiotic in tablet form much more conveniently (and cheaply as 12RMB a box!). So why did the first doctor insist that I take the antibiotic via IV, day after day, when it’s readily available in tablet form for a moderate, non-urgent illness? So he could get kickbacks. I learned my lesson and I would not go on a drip again unless I was actually dehydrated or did need an urgent infusion of antibiotics into my blood stream.
The situation in Chinese hospitals is not about to change anytime soon – there are too many powerful interests involved. Pharmaceutical companies are making a fortune from excessively prescribing medicine and low salaries of doctors enables the state to keep their costs down. If you don’t want to deal with it, buy insurance and go to expensive international hospitals.