Wednesday, 5 December 2012

Western expats find Chinese doctors unsympathetic

Tessa Thorniley found pre-natal care to be brusque and costly
A British woman living in China has described how she found pre-natal care high on cost, low on compassion
When she went to hospital for  investigations to see whether she is expecting a second child, Tessa Thorniley learned that Chinese doctors do not consider it their job to spare your discomfort or stress – they simply present the medical facts as they see them.
"A few weeks ago, suspecting that I might be pregnant, I visited one of the doctors at a well-known foreigner-friendly private clinic in Beijing.
I say “suspecting” because I was not sure whether to trust the China-brand test kit I had purchased for the equivalent of £2 from a medical stand in a shopping mall, or my translation of its instructions.
At this very early stage, the doctor I sat down with, a Chinese Ob-gyn who attended the top medical school in the country and had also studied at Yale Medical school, suggested that we try a scan. This a good money spinner for the clinics, as it costs anywhere between CNY 370 (£37) and CNY 1700 (£170) per scan – and what woman faced with the chance to see the first movements of her tiny baby would turn it down, especially when it is covered on insurance.
I was not remotely surprised when the radiologist said that she couldn't find a heartbeat. She suggested that there was a sack, which could indicate a pregnancy at around six weeks, but she could not see anything inside.
I returned to the doctor's room for his verdict. He sat me down, stared down at me and said: "It's probably a miscarriage. There is no heartbeat. You should go away and we'll check again in 10 days.”
Ten whole days not knowing if I had a baby growing inside or I had already miscarried. I was shocked. Couldn't he do a test, a blood test, another pregnancy test? Something?
"No", he said firmly. "If you have miscarried, the pregnancy hormones might still show up. A test won't determine whether you are still pregnant. You have to come back."
With that, he closed my file. Our little discussion had cost RMB 700 (£70).
I left feeling down and angry. Why didn't he simply say that they couldn't see a heartbeat and leave it at that? Why put me through unnecessary stress by suggesting I might have miscarried? Wasn't it far more likely that the foetus was too small to be picked up by the monitor?
On my way home, I thought about the doctor's response and decided that it was very typical of everything I have read and experienced of Chinese doctors. It is not that Chinese medics don't know their medicine - they do – but, when it comes to bedside manner, they have a very different approach to overseas doctors. It is not their job to spare your discomfort or stress; it is their job to present the medical facts as they see them.
One of my friends, a pregnant mother who goes to the same clinic, suggested incompetence might to blame for the prognosis, because the radiologist had failed to read the scanner properly. My friend had also been told that she had probably miscarried at an early stage in her pregnancy, and she had ended up flying to her doctor in Japan for confirmation that she was, indeed, pregnant.
I also considered going elsewhere for a second opinion, but I decided against it, as I was convinced that scanning for a heartbeat at six weeks was a waste of time.
Then, gradually, day by day following the appointment, I felt worse and worse physically, with nausea and overwhelming tiredness, which filled me with hope.
It has now been 13 weeks, and I have had three scans, the last one showing a fine looking, somersaulting foetus.
I have racked up over a £1,000 of medical bills, including CNY 580 (£58) for an HIV test - standard procedure, but a costly one; CNY 435 (£45) to tell me my blood type (which I already knew); and a charge of CNY 675 (£68) for something entitled “Established Patient Detailed”.
I have also switched doctors, in favour of the head of department, when I can get an appointment with him, who trained at Charing Cross hospital medical school in Hammersmith, and is rather more sympathetic in his dealings with patients.
As this baby is my second, my husband and I have considered finding out the sex. But it turns out that the rules have changed since the last time I was expecting, and doctors are no longer permitted to tell anyone - foreign nationals included - the sex of their child before birth.
There are obvious reasons for this rule inside China. Sex-selective abortion, while illegal, is so widespread that it has contributed to the country's skewed sex ratio of 108 men for every 100 women, as reported by the UN. Estimates suggest that by 2020, there will be 30 million more men than women reaching adulthood and entering China's mating market.
But it makes no sense to apply this rule to foreign couples. It is not as if our China-born babies have the option of becoming citizens of China, should we want that for them, so they will never be part of the statistical problem.
Of course, since finding out the official rules, I have also uncovered the unofficial solution.
I have been reliably informed that, although doctors will not tell you the sex of your child, should you ask, most helpful radiologists will circle the relevant portion of their screen and suggest you look closely for the presence or absence of certain parts.
Read more: Daily Telegraph

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