Tuina, chi and professional queuing: at the TCM hospital

 At 0830hrs we left the hotel and set off to the TCM hospital. En route our tour guide explained certain aspects of the Chinese Health Care system including the following:

 

·      The health care system integrates western and TCM There is no free health care provided in China.

·      Health care is accessed via a TCM hospital, Western hospitals that have TCM doctors or TCM clinics. Patients usually choose hospitals as they perceive clinicians there to be  better .

·      The Chinese Government  incentivises use of neighbourhood clinics by offering higher discounts (30%) compared to hospitals (10%).

·      Patients prefer to have consultations in the morning as they believe clinicians have less chi ( energy) later in the day.

·      Patients pay others to queue early for them as there is no appointment system.

·      Xi Juan TCM hospital has 750 beds. Paediatrics constitutes 40% of its workload.  I was struck immediately by three things:

 

1)            A prominently displayed board in the reception area which showed a range of consultation fees graded according to the seniority of available clinicians.

2)            Several health promotion posters on the wall of the                 reception and corridors.

3)            In TCM 40% of therapeutic options were physical - acupuncture or Tuina - 60% herbal. Surgical operations play little part in TCM.

 

We visited four departments:

·      The Department of Herbal Medicine and Pharmacy. Here we learnt how prescriptions were written, prepared, labelled and dispensed. All of these were done ‘in house’ using such ingredients as sea dragons, ginseng and deer horn. The hospital has its own herbal gardens  so as to assure quality.

·      The Department of Dermatology.  Here a TCM trained consultant discussed a patient with a generalised itchy red rash (erythroderma).  She advised that the patient be admitted for blood tests, skin biopsies, etc. The patient had previously unsuccessfully tried Western medicine.

·      At the Department of Acupuncture a 75 year old emeritus professor of TCM acupuncture was demonstrating to the trainees acupuncture techniques on a patient suffering with muscle dystrophy and another suffering with Bell’s palsy which apparently is a common affliction of the Chinese.

·      At the Department of Tuina it was explained to us that clinicians needed at least 3 years training to acquire skills in Tuina techniques, and so this physical therapy discipline was not to be confused with high street massage. TCM Tuina techniques were used mainly for musculoskeletal conditions, though we also saw it being applied to treat a toddler with constipation. The Tuina Professor also explained the restorative value of exercise, as well as certain breathing techniques.

Finally, we passed by a TCM research department which is actively involved in researching, archiving and promoting good practice in TCM.

My personal reflection is that this visit was a worthwhile and highly recommended aspect of our Study Tour of integrated healthcare in China.

Thereafter the rest of the day’s activities included visits to the 2008 Olympic Stadium and a Buddhist Temple. In the evening we attended a breathtaking acrobatic show.