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Comment by adaml_623 | Hacker News Reader

"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.

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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.

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.

I attended a conference on pulmonary medicine once. There was a surgeon speaking about his trip he took to China. He had removed a tumor from a patients lung and had to carry it out of the OR theatre and physically show the family. They had paid for the procedure, travelled a long way to the hospital, they demanded to see that there was actually a tumor, and that the surgeon had actually removed it. Apparently this is common in China.

Something like that seems crazy to us, but I can sort of understand why it made sense to the family in China. China's medical system is presumably a lot less regulated, and probably full of its fair share of hucksters, snake oil salesmen, and fraudulent service providers. Demanding to see proof that a surgery was performed would be understandable in those circumstances. (An unscrupulous doctor could still fake the proof, of course.)

This is thematically, if not completely, similar to the American practice of running a battery of expensive, redundant diagnostic tests on a patient as a CYA measure. It's not enough to have a reasonable guess at a diagnosis; you need five different kinds of proof to back up your decision. You are performing not just to the standards of medicine, but to the presumed standards of insurance companies, lawyers, and WebMD self-diagnoses.

>An unscrupulous doctor could still fake the proof, of course.

Exactly, how is a family to know what is a tumor and what is just regular tissue. Heck, it could be a pig liver and not many would know the difference. Combine this with the fact that the surgeons at this talk mentioned that Chinese doctors and nurses are not well paid, you can start to see the incentive for doc's to commit fraud.

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