
Under the Knife: Why Chinese Patients are turning against their doctors - GabrielF00
http://www.newyorker.com/magazine/2014/08/25/under-the-knife
======
logicchains
I once accompanied a friend with a bad cold to a hospital in Shanghai. They
ran a blood test, and the doctor announced that she had a viral infection. He
then handed her a (fairly expensive) prescription for antibiotics. Now, as
anyone who's studied biology (or even Googled 'antibiotics') knows,
antibiotics have absolutely no effect whatsoever on viruses. I called the
doctor out on it, and he scowled at me and said something like "foreigners do
things differently".

Apparently antibiotics account for around 24% of total hospital revenue in
China[1], which may explain it somewhat.

1.[http://content.time.com/time/world/article/0,8599,2103733,00...](http://content.time.com/time/world/article/0,8599,2103733,00.html)

~~~
shabda
"Bacterial superinfection in viral respiratory disease is a clinically well
documented phenomenon."

[http://www.hksid.org/pdf/bult200305.pdf](http://www.hksid.org/pdf/bult200305.pdf)

"Respiratory viral infections may facilitate secondary bacterial infections"

[http://www.ncbi.nlm.nih.gov/pubmed/15166819](http://www.ncbi.nlm.nih.gov/pubmed/15166819)

The doctor might have had some information about his patient, which you don't?

~~~
vinceguidry
If he did, surely he would have told them about it, rather than just say,
"foreigners do it differently".

~~~
kelukelugames
My doctor friends get really annoyed when I read something on WebMD and argue
with them. 8 years of schooling makes them an expert and I'm just being a
jackass for thinking googling grants me an MD.

------
digitalengineer
So much grief but still focused: I asked Wang Dongqing whom he blamed for his
son’s (the doctor) death. “I blame the health-care system,” he said. “Li
Mengnan (the killer) was just a representative of this conflict. Incidents
like this have happened many times. How could we just blame Li?”

~~~
jjoonathan
Wow:

> When People’s Daily, a newspaper that acts as a Chinese government
> mouthpiece, posted an online questionnaire asking readers to rate their
> reaction to the murder, as a smiley face, a sad face, or an angry face,
> sixty-five per cent of readers chose the smiley face.

After having read the accounts of what their health care system is like, it's
not hard to understand this level of outrage. It sounds like many of these
doctors are exploiting the hell out of their information asymmetry in order to
defraud and extort patients who have already been driven to desperation by
their ailments. Arguably this behavior is due to the fact that the doctors are
underpaid in the first place, but I doubt anyone expects that to be much
comfort to the patients.

If Wang Dongqing was privy to his son's misgivings about the moral compromises
he and/or his peers were making then the possibility of patient retaliation
must have haunted him for some time. The fact that his son died as collateral
damage rather than as a result of a slight he personally committed really
drives home the fact that the only solution is to address the issue at the
system level :/

~~~
zo1
What? This kid murdered an innocent person in anger. It starts, and it ends
there. Whether it was collateral damage, or how angry the kid was, is
irrelevant.

It's like saying: you know, there's all these fat people that are constantly
abused and get run-around by pretty girls. They are suffering so bad, it's not
hard to understand their level of outrage when one of them raped a woman.

Seriously, violence against innocents can never be justified. No matter the
rational behind it. And by defending them and their actions, we're just giving
them credence and making them think their anger and actions are "not their
fault".

~~~
x0x0
Conflating facing a severe and painful disease [1] while being repeatedly
dicked around by the medical system through a combination of incompetence and
greed with an entitled asshole who rapes a woman because he feels like he's,
well, entitled to have sex with people he finds attractive is pretty stupid.

As was explained in the article, the murderer had endured a painful illness, a
misdiagnosis, used his grandparents' life savings and borrowed money for
treatment, traveled some distance, had treatment interrupted, was blown off
again by the medical system, and snapped. Of course it doesn't justify murder,
but it is quit different than, for example, a premeditated murder over money.

[1]
[http://en.wikipedia.org/wiki/Ankylosing_spondylitis](http://en.wikipedia.org/wiki/Ankylosing_spondylitis)

~~~
zo1
He felt entitled to retribution. The fact that he was "dicked" around by
medical individuals over a more serious matter does not nullify the
comparison, here are the details of the two scenarios:

In both scenarios the victim's were not directly to blame. In both scenarios a
larger group of people "dicked" around the aggressor. And in both scenarios
(one hypothetical) the violent actions are being downplayed, or justified
because of some sort of indirect harm towards the aggressor.

This backlash just shows how easy it is for people to conflate the issues
involved. It is in essence justifying violence against _innocent_ individuals,
and frankly, it's sickening.

" _Of course it doesn 't justify murder, but it is quit different than, for
example, a premeditated murder over money._" Murder is murder, I don't see the
distinction here. You can't go ahead and say murder isn't so bad if the
aggressor was "having a bad hair day", or any other trivial issue. If you want
to say that this individual was justified in his act of killing because he was
in danger and was forced to do so, or was defending himself, then fine that's
a different issue.

------
adaml_623
"Joe Passanante, a doctor from Chicago who did a stint at Beijing United
Family Hospital, told me that he was once performing CPR on a woman when the
parents of a girl with a fever walked into the room. “Here I am pushing on a
dead person’s chest, trying to revive her, and they’re asking me to see their
daughter,” he recalled."

It seems like a totally different world in so many ways but this quote
highlights it for me.

~~~
song
United Family Hospital is very different though from the typical public
hospital. It's a private hospital where a simple consultation with a doctor
costs about 2000 RMB (around 325 USD) and is geared towards expats with good
health insurance or rich locals.

It's worlds apart from the public hospitals they were talking earlier in the
article and is really not representative of the situation. There, the doctors
are more likely to deal with entitled customers who feel that they should be
treated with the respect their money affords them.

~~~
jimworm
Not my experience with Chinese hospitals, and I've seen several (with
consultation fees of 2 CNY - not the entitled rich crowd). Usually there are
five or six other people pushing each other to get the doctor's attention
inside the office. It's nearly impossible to be seen without some less-than-
violent strategic body positioning without eye contact. No such thing as
privacy, even in gynaecology.

------
zhte415
A general rule of thumb for an acute complaint: Go to a hospital affiliated
with a medical university. That's where the next generation of doctors are
trained by (hopefully) some of the best of the current generation. As
workhorses, they also tend to see a lot of cases in a working day (an indeed,
some of the most unusual), leading to a lot of practical experience.

~~~
epaladin
I think there's also a lot of recruitment of foreign experts for academically-
oriented institutions. I've been seeing a lot more biomedical science papers
from Chinese universities with non-Chinese names of faculty.

------
unkoman
> “Protest becomes the mechanism for providing social security and for
> distinguishing people who need help.”

Now that's one way to evaluate the health of the system. I wonder if the
baseline is measured in protests/day...

------
thaumasiotes
> Wei had only recently returned from a reëducation camp

They'll put a diaeresis in re-education but they won't print tone diacritics
in Chinese names. I'd kind of like to know how to pronounce the names.

~~~
evincarofautumn
I hope that in the next ten or twenty years it will become normal practice to
include tones in Chinese names, or at least typeset the original names
parenthetically beside the transliterations.

~~~
Terr_
Visiting Beijing a few years back, I recall a bunch of signs had a pinyin
versions of the street-name showing... but without tonal marks.

Never did figure that one out.

~~~
toxik
AFAIK it's kind of uncommon to print pinyin with tones. Especially since, when
Pinyin is used as an input method, you would write hua4 for huà.

~~~
thaumasiotes
Children's books get printed with tones. I think the lack of tones in other
contexts is down to no better reason than that keyboards don't have any
obvious way to enter them.

Using zhuyin would solve the problem neatly, but comes with its own ("made in
Taiwan") political drawbacks. It also wouldn't be an improvement in the
context of English speakers reading the new yorker.

