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China's five-star clinics offer
health for wealth
By Matt Young
BEIJING - In the event of a medical
emergency, Chinese can dial 120 - or, for a lucky
few, the concierge.
Notorious for lagging behind
international standards, elite healthcare has gone
high-end on the mainland, most visibly in the form
of private clinics in luxury hotels. The St Regis
is the latest to offer both butler, and clinical,
services. In June, United Family Hospitals and
Clinics expanded its Chinese facilities - already
marked by deluxe decor - into the Hotel St Regis,
Beijing. "Do you know that hotel?" asked United
Family Hospitals' public 
relations manager Lily Sun, seated near a clinic
bed draped in a golden sheet, an ornate
flower-filled vase nearby. "It's a very good one,
[isn't it]?"
Not far away from St Regis,
the Swissotel Beijing has its own 700-square-meter
healthcare center, known as the Hong Kong
International Medical Clinic, Beijing. Along with
minibar peanuts and spirits, payments for health
services can be charged to Swissotel room
accounts. "We use alcohol swabs just like outside
of China," said the clinic's marketing manager
Jennifer Jiao, demonstrating this emerging
industry's eagerness not only to impress
international clients with ambience, but to
reassure them that the essence of quality care has
arrived too. Hong Kong International boasts that
it was the first international-standard clinic in
China, launching in 1993. But it only became a
profit venture and expanded from 130 square meters
to 700 square meters in the Swissotel in 2000,
Jiao said. About 80% of its clients are foreign,
she added.
Before 2000, with a few
exceptions, all healthcare institutions were
non-profit by law in China, according to The
ChinaCare Group, a healthcare consulting
organization headquartered in Beijing. The
Healthcare Reform Act in 2000 legalized for-profit
hospitals and clinics, opening up a potentially
vast medical marketplace in a country of 1.3
billion people. Today, there are a half-dozen
private, international clinics in Beijing that
have opened their doors to the 150,000-170,000
expatriates living there, said David Wood,
president of The ChinaCare Group. Similar numbers
of clinics have taken root in Hong Kong and
Shanghai, he said. Considering the fast growth of
suburbs lined with expatriate villas, bedroom
communities outside the city could be the next
fertile ground for international clinic
germination, he said.
But for the average
Chinese citizen, a visit to the doctor still is
anything but a sumptuous experience. The lucky 15%
of the Chinese population that has medical
insurance, which is funded by the government, can
only use it at public hospitals, Wood said. A 1999
study by the World Health Organization ranked
China only 132 out of 191 countries for overall
healthcare achievement. Chinese hospital space per
bed averages 93 square meters, just half that of
the 186 square-meter international standard,
according to ChinaCare, which also noted that
Chinese hospitals generally aren't clean and are
rundown.
But that's clearly not the case
for St Regis, which opened in June with 700 square
meters for immigration checkups, Sun said. Elegant
family medicine and dental facilities will open
there in August. United Family Hospitals, which
originally opened in 1997, provides a cornucopia
of healthcare, from emergency services (it has its
own emergency hotline and ambulance) to cosmetic
surgery (with a plastic surgery facility in
development). About 80% of its patients are
foreign. Last November, United Family Hospitals
also opened up its "SRC clinic" in Shanghai, Sun
said. SRC is short for Shanghai Racquet Club,
which is right next door. "In China some rich
people - they are very rich - don't care about
money issues. They want to spend money on much
better services. This part of our business is
growing."
But not without growing pains.
Maryland-based Chindex International Inc, the
parent company of United Family Hospitals, lost
$5.7 million, or $1.06 per share, for the 2004
fiscal year. That was mainly because of expenses
related to hospital expansions in Shanghai and
Beijing, said Roberta Lipson, president and CEO of
Chindex. The company also lost $2 million in
fiscal year 2003 because of a delayed hospital
opening in Shanghai, attributable to the SARS
epidemic, Lipson said. Revenues did, however,
exceed $100 million for the first time in the
recent fiscal year, she added.
It's
certainly not cheap, or easy, to start up a new
international clinic in China. It took nearly two
years to recruit doctors from overseas for a new
Shanghai facility, said Sun. "A lot of
international enterprises - when they start their
businesses in China - become very localized
because that will lower their costs," Sun said.
"For this enterprise it's very different because
our customers are international, so we have to
have an international team to serve the customer.
Even if the HR cost is quite high, we have to
absorb that."
It's hard to get a read on
exactly how other private Chinese clinics are
doing financially because they do not have to
disclose their earnings, unlike Chindex, which is
publicly traded. Wood, whose organization consults
for international clinics, preferred not to
comment on the financial health of specific
institutions. But he said some seemed to be
teetering on the edge of bankruptcy.
Basic service the main
draw
While supplying superior service might
be difficult, demand for it appears to be high.
It's not even the trappings of luxury that the
wealthy are interested in, but the basics of
superior service: an attentive staff and direct
billing to insurance companies, both of which are
relatively new features in China.
After
relocating to Beijing five years ago, US citizen
Timothy Manchester, 54, found United Family
Hospitals because his insurance company had direct
billing services set up with them. Seated in a
waiting room with plenty of space to stretch out,
unlike in the vast majority of Chinese hospitals,
Manchester praised the clinic's service. "You go
200 miles that way and you're in Czechoslovakia,
300 miles [the other] way and you're in Africa,"
he said, likening healthcare in other areas of
China to that of developing nations. "But this
place saved my life." Not long ago, Manchester
said he arrived feeling ill at United Family
Hospitals, and physicians quickly discovered that
he had a life-threatening illness called
asymptomatic pneumonia. "If I [had] sat at home 24
hours longer, I would have died," Manchester said.
Personalized attention may have been what stood
between him and the Grim Reaper.
At the
main United Family hospital in Beijing, which
consists of four posh floors, the staff attends to
only 300 clinical visits per day, Sun said. "In
the general local hospital, every day they will
have 5,000 clinical visits, so you can see the
difference," she said. United Family Hospitals'
management is looking to certify its top-notch
service, aiming to soon be the first hospital
group in China to garner Joint Commission
International Accreditation. An accreditation
survey is scheduled in August, according to a
press release.
The staff at Vista Clinic,
located near the prominent Kerry Center Hotel,
Beijing, also knows the importance of Western
medical service. Besides doctors, it recently
hired an American nurse as a consultant to teach
its Chinese nurses bedside manners that indulge
the mostly foreign clientele. "Western bedside
manners [are] important," said Stephen Brinkop,
marketing manager for Vista Clinic. "If you go to
a Chinese clinic, you miss that kind of care. You
miss the good words, you miss the explanations.
Even if you go to a specialist, they do their job
and do it well, but they wouldn't explain much to
you. They wouldn't show their care." Clients have
been increasing by about 20% year-by-year at Vista
Clinic, Brinkop said. But revenue at the clinic,
which was built four years ago, has been flatter
because of expenses.
Beijing Intech Eye
Hospital caters to high society too. On May 1, it
opened new VIP facilities for premium customers,
mainly foreigners. The head ophthalmologist, who
has a passion for architecture and design, helped
to create facilities reminiscent of a museum or
gallery. A single leather loveseat seemed to
invite clients to recline and admire the glossy
hardwood gates enclosing the examination rooms.
"We don't have a very good location, so
that's a disadvantage," said Intech marketing
manager Tony Zhan, perhaps hinting at the
mud-ravaged streets outside. "So we need to do
better in service." Zhan said ophthalmologists
there are focused on safety over speed of recovery
when it comes to laser eye surgery, which is a
notion not always embraced even in the US. For
instance, the clinic advocates laser-assisted
sub-epithelial keratectomy (LASEK) for the
correction of nearsightedness and astigmatism, as
opposed to the laser-assisted in situ
keratomileusis (LASIK) vision correction procedure
more popular in the US. LASEK is considered by
many ophthalmologists to be safer because it
treats only the outermost surface of the eye,
rather than cutting into a more inner layer like
LASIK. Despite its safety profile, LASEK's
recovery time is slower than LASIK, making many
American surgeons loath to embrace the procedure
in their instant-gratification society.
Intech may be safe and serene and
technically savvy (it will soon have an LCD screen
for interactive eye-lessons), but it has only
recently achieved another benchmark. "This coffee
machine actually just came in here two or three
weeks ago," Zhan said. (It's still not
Starbucks-quality.) As for bedside manner, the
staff is still working on this aspect of health
care. "We don't have very good smiles sometimes,"
Zhan admitted.
Prices at international
clinics often are more than what a local could
afford, but less than an American patient would
pay in the US. The cost of an Intech refractive
eye procedure for the VIP crowd still isn't much
more than one for locals by Western standards.
It's $900 for a standard LASEK procedure that
corrects both eyes (the most popular option with
Chinese patients), and $1,100 for a VIP LASEK. The
VIP procedure includes surgery by the most
experienced doctor on staff and an upgrade to
custom LASEK, which takes into account an
individual eye's "fingerprint" and can yield
better visual results. In the US, surgeons usually
charge between $1,500 and $2,500 per eye for
LASEK, according to a 2004 survey by the American
Society of Cataract & Refractive Surgery.
One thing Zhan wanted to make clear: "We
don't... price by face - expatriate or Chinese. We
just say that for laser surgery with a different
doctor, we charge a different price." Despite the
increasing presence of international clinics in
Beijing, foreigners traveling there specifically
for medical services - ie, medical tourists - are
still few. For cheap, quality refractive surgery,
Zhan urged Americans to spare themselves the
20-some hour flight to China and hop the border to
Canada. "A lot of Americans fly to Vancouver to do
the surgery," he noted. "It's a very good deal."
On the other hand, Brinkop said that if a
tourist gets food poisoning and winds up in Vista
Clinic, sometimes he or she is impressed enough to
ask for further services, like dental care. "You
don't call them patients anymore, you call them
clients or customers. You provide a medical
newsletter. We have regular seminars and do
first-aid [classes]. School classes come here to
visit a dentist, learn about dentistry and get a
dental check at the same time. We do a lot more
here than [physicians usually do abroad] I think.
We are active at all angles, at all points,
creating a very strong link with the community."
In addition to being able to watch a DVD during a
teeth cleaning, patients should know they're being
brushed with good hands at Vista Clinic, Brinkop
said. "Now, especially after SARS, you have people
from the Health Ministry coming in at any time [to
check things]," he observed. "They can come at
three in the morning or six in the afternoon,
rushing through the rooms and checking stuff out."
Foreigners should be wary that some
Chinese clinics have a modern appearance but are
poor in quality, warned Brinkop. "There is a rise
in places trying to copy this [international]
scheme," Brinkop said. "For example, you see all
this dentistry here - like mushrooms. There is no
hotel, no mall without a dentist. It looks very
neat. But [service] doesn't get up to standard
with these clinics. That's why they come up and
[then] they vanish."
Matt Young
is a Washington, DC-based freelancer and a staff
writer for EyeWorld Magazine and EyeWorld
Asia-Pacific Magazine.
(Copyright 2005
Asia Times Online Ltd. All rights reserved. Please
contact us for information on sales, syndication and republishing.) |
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