The Rise of Independent Care Escorts and Strategic Retreat of Traditional Medical Service Providers

Medical escort Lu Lu’s schedule is fully booked through mid-March. New orders for medical escort services continue to pour in from Douyin and WeChat.

Lu Lu stated,During this period, the number of orders for friends in the medical accompaniment circle has basically "exploded."Appointments for the hospital’s laboratory and diagnostic departments, which she frequently visits, are now booked out for at least ten days in advance, and the hospital has once again regained its former “wet market”-like bustle.

This scene is somewhat different from what it was a year ago. During the pandemic, many medical escorts were forced to suspend their services due to hospital access restrictions, or chose to do so voluntarily out of fear of contracting COVID-19. Hospitals became places people avoided unless absolutely necessary. Now, with the relaxation of pandemic control policies, everyone has resumed their activities, and medical escorts who have recovered from COVID-19 have quickly returned to their posts.

Lulu is one of them.

For Lu Lu, who has gradually mastered the intricacies of being a medical companion, she has clearly sensed the growing social recognition of this profession. In the past, she had to expend considerable effort explaining to outsiders what a medical companion does. Now, simply stating her identity as a medical companion is enough to be understood—this shift is the result of collective efforts by medical companions like her, who have tirelessly posted videos about their work on public platforms such as Douyin. The fruit has now ripened; all she needs to do is accept orders and prepare in advance—helping patients plan their medical visit process, accompanying them during consultations under the title of medical companion (including reasonably planning in-hospital examination routes, assisting patients with queuing to obtain diagnostic reports, picking up medications, and so on).

Coco, a medical escort nearly the same age as Lu Lu, has keenly felt the surge in demand for escort services. With his business consistently overwhelmed by orders, he established his own company and publicly recruited staff to provide medical escort services, aiming to capitalize on the still-growing market demand.

Meanwhile, some companies that had long been deeply entrenched in the healthcare services industry have chosen to “retreat” from directly providing offline, in-person medical accompaniment services—either by discontinuing their existing accompaniment business lines or by offering such services through third-party providers.

This is more or less related to the attitude of capital. When seeking projects, investors often prioritize those with established barriers to entry and tend to invest in companies that can genuinely address industry pain points. “In the case of the patient escort industry, simply helping patients move from point A to point B does not constitute a competitive barrier. This is precisely why anyone can enter this field. On the other hand, patient escort services are more akin to public welfare or social safety net provisions. While capital is not prohibited from entering this sector, it is somewhat inappropriate.” So stated Zhang Wei, founder of Shandong Yiwuyou Health Technology, a company specializing in professional triage and optimization of diagnosis and treatment processes. Zhang entered the healthcare services industry in 2009 and established his company in 2016.

On one hand, the “professionalized label” of medical companions is exploding in popularity on platforms such as Douyin, with many medical companions establishing small and micro enterprises to expand their order-taking capacity. On the other hand, healthcare service companies with years of industry experience are selectively “retreating.” This dichotomy may well define the visible landscape of the industry for a considerable period to come.

Typically, when discussing the medical escort industry, people point to the inelastic demand for healthcare services driven by an aging society, compounded by young people’s busy work schedules that leave them little time to care for elderly patients, as well as the lengthy and cumbersome nature of hospital visits—all of which have spurred the rapid emergence of professional medical escorts.

However, the demand for medical consultation and accompaniment services among the elderly population does not encompass all their needs.Among the clients served by patient escort Lu Lu, elderly individuals likely account for approximately 60–70%, while the remaining 30–40% typically consist of pregnant women or single young adults living alone in urban areas. Of course, when viewed from another classification perspective, patients seeking medical care away from their home regions also constitute a significant portion of those requiring patient escort services.

This differs somewhat from the common public perception that the primary recipients of medical accompaniment services are the elderly. While seniors do constitute the main client base for Lulu, a medical companion, these service orders are frequently placed online by their adult children who are too busy with work to take leave or live in other cities and cannot personally attend to their parents. In urban areas, however, young people living alone who seek medical accompaniment services are predominantly in their twenties and thirties. “Some young women have an aversion to hospitals and are reluctant to visit them alone; others simply do not wish to burden their friends. Some individuals require procedures such as gastroscopy, which necessitate a signature from an accompanying person, leading them to opt for medical accompaniment services,” said Lulu.

“Previously, I took on a ‘job’ from a female business owner. She found the hospital’s medical process too cumbersome and time-consuming. I helped her plan her consultation and diagnostic testing pathway, picked up her lab results, even consulted with the doctor about her diagnosis on her behalf, and collected her prescribed medications. All she did was walk around the hospital, describe her symptoms to the doctor, complete her blood tests and examinations, and then leave.”

The explosive growth in demand for medical accompaniment services is clearly not solely driven by an aging society.“Social atomization” (where individuals are as isolated as single atoms) and the “lazy economy” have further fueled this trend. With the availability of personalized medical escort services that are convenient, hassle-free, and free from the burden of social reciprocity (“renqing”), more “atomized” individuals are opting for these services.

This has further driven growth in the income of professional patient companions.Lu Lu explained that medical escort services are now mostly charged by time, with half-day rates around 150 yuan and full-day rates ranging from 300 to 500 yuan. In addition to accompanying patients during medical visits, escorts sometimes handle non-direct escort tasks for other clients, such as picking up test reports or prescriptions. The monthly take-home pay may amount to approximately 10,000 yuan. “It’s all hard-earned money,” Lu Lu said with a smile.

Whether one can achieve this level of income is also closely tied to having a sufficient volume of client orders. Lu Lu mentioned that she had previously tried ground promotion strategies. To attract “business,” she once distributed flyers near hospitals, but the results were less than ideal. Consequently, she decided to focus her efforts on Douyin (TikTok) as the key platform for building her professional image as a medical escort. Due to Douyin’s high user reach and low marketing costs, it indeed generated a steady flow of patient clients for her. Moreover, her thoughtful and sincere offline service further encouraged patients to refer other clients to her. When faced with an overwhelming number of orders, Lu Lu would refer the excess clients she could not handle to trusted contacts within her professional network; likewise, when her peers experienced similar surges in demand, they would prioritize referring clients to her.

Lu Lu also pointed out that her advantage lies in her background as a hospital nurse, which gives her a thorough understanding of relevant departments and diagnostic tests. She can even provide patient education and address some of their concerns. However, the current cohort of medical companions is of mixed quality, as many non-medical professionals are flooding into the field due to low entry barriers. With evident emotion, Lu Lu remarked, “There is no easy solution; demand is overwhelming, yet there are too few individuals with both professional expertise and a willingness to commit to this role. We can only hope that those without a medical background will gradually enhance their relevant competencies to better address patients’ questions and improve service delivery.”

“We’re not doing it anymore; it’s not profitable,” “This business is a trap,” and “Only suckers would get into this” are the complaints of a senior executive surnamed Zhang from a healthcare startup that previously offered patient accompaniment services but has since dismantled the relevant business unit. “This is a healthcare-related job, requiring practitioners to be highly professional; it is also a service-industry role, demanding meticulousness and strong psychological resilience; furthermore, it is an industry dedicated to assisting vulnerable populations, necessitating excellent communication skills and empathy,” the interviewee continued. “If someone possesses all these capabilities, why wouldn’t they pursue more rewarding opportunities?”

For healthcare service providers that had already launched patient escort services before the pandemic, this sensation is undoubtedly pronounced. The operation of patient escort services possesses inherent specificities, necessitating consideration of the following two factors:

First is regional specificity. Among patients with demand for medical accompaniment services, a significant proportion are actually those seeking medical care outside their home regions. Regions that are more suitable for launching such businesses tend to be economically developed areas with concentrated high-quality medical resources. The case of Xinran Life Health may well illustrate the regional nature of medical accompaniment services. Established in 2017, Xinran Life Health primarily serves insurance companies and provides medical assistance services for patients with severe or oncological conditions. Based in Guangzhou, the company has long served patients across South China. However, during the three years of the pandemic, epidemic prevention and control policies made it difficult for patients from other regions to seek medical care elsewhere, leading to a substantial decline in the volume of accompaniment services. As a result, its service focus shifted from covering the broader South China region to predominantly serving local patients.

Second is the patient’s willingness and ability to pay. From a certain perspective, patients’ ability to pay is often closely linked to geographic factors. For instance, the paying capacity of patients in county-level areas is generally weaker than that of patients in provincial capital cities. Zhao Lu, founder of Hefei Xiaolu Ludong Technology, which was established in 2019 and provides community public health services, pointed out, “For companies, launching medical escort services requires achieving a certain scale effect. If patients have low willingness to pay and limited financial capacity—resulting in low unit prices for medical escort orders coupled with low demand—the medical escort business cannot be sustainably operated.”

“High Input, Low Output” Deters Healthcare Service Innovation Companies from Actively Entering the Market, Leading Them to Retreat Behind the Scenes—

Xinran Life Health, which specializes in oncology patient management, previously relied on its own resources to provide medical accompaniment services. Currently, however, these services are primarily delivered by former insurance brokers. This shift is partly attributable to the transformation sought by many insurance brokers who gained extensive exposure to the healthcare sector during the pandemic. At present, Xinran Life Health leverages hospital medical resources and other assets to offer free training to these insurance brokers, now serving as medical accompanists, without taking any share of their earnings.

Hefei Xiaolu Ludong Technology provides services focused on maternal and infant health in the public health sector, and has gradually expanded into patient escort services based on customer demand. During the pandemic, its patient escort business came to a standstill due to factors such as hospital management policies. The company has since disbanded its full-time team responsible for providing escort services, including dedicated vehicle pick-up and drop-off, and now engages third-party part-time personnel to serve users with such needs.

There are two intriguing details in the above examples: First, healthcare startups have shifted from delivering services through their own teams to offering them via outsourcing. This trend, in fact, underscores the existence of demand for medical accompaniment services and the continuous growth in the number of professional medical escorts. Second, if medical accompaniment is not profitable for these startups, why do they persist in providing such services?

The answer may lie within the “ecosystem.” Although patient escort services do not generate direct revenue, they can subsequently achieve revenue conversion by maintaining user stickiness.

For instance, Xinran Life and Health, which has built an ecosystem for oncology patient management, previously offered green-channel services to help patients reduce the time spent seeking medical care. However, patients often disengaged after receiving treatment, resulting in low user stickiness. Subsequently, the company identified accompanied consultation services as a strategic entry point for retaining users. Although it does not directly share revenue with accompanied consultation specialists, the trust and rapport established between these specialists and clients enable downstream conversion opportunities for nutritional support, patient care, medical services, and related insurance products.

Dr. Sun Zhifeng, Founder and Chairman of Kangtu Wujie, also highlighted this point. Kangtu Wujie provides patients with a range of services, including private family physicians, nationwide green-channel access to medical care, tumor genetic testing, various vaccinations, medical aesthetics and plastic surgery, appointments with overseas experts, and corporate employee health management. In his view, market competition among patient companions will become increasingly fierce in the future. “Large platform-based companies with absolute resource advantages may even attract patients by offering complimentary patient companion services, thereby benefiting from their own ecosystem for managing chronic diseases, including those affecting cancer patients.”

Medical escort services serve as a key entry point for healthcare service providers to build trust with patients.

From a factual perspective, it is not only individual patient escorts and third-party medical innovation service providers that offer escort services; healthcare institutions are also actively participating in this field.

On the one hand, due to the impact of the pandemic, a large number of hospitals may face financial losses. To enhance their competitiveness, both public and private hospitals need to provide high-quality services to further achieve precise patient outreach and drive patient traffic.

For example, the Oncology Center at Foshan Fosun Chancheng Hospital is collaborating with patient escort service providers in Guangdong Province, providing them with training on medical service-related knowledge. The Oncology Center at Foshan Fosun Chancheng Hospital has established a certain reputation in the industry for its precision radiotherapy capabilities, exemplified by the use of Varian linear accelerators and Accuray CyberKnife systems. The CyberKnife is primarily indicated for solid tumors requiring high treatment precision, such as intracranial tumors, prostate cancer, pancreatic cancer, and lung cancer, enabling non-invasive tumor ablation. By gaining a better understanding of the hospital’s core strengths, patient escort service providers can more effectively deliver medical education to patients during their escort services. This subtle yet consistent health education further contributes to building the brand identity of the Oncology Center at Foshan Fosun Chancheng Hospital.

On the other hand, the introduction of policies such as the Action Plan for Promoting High-Quality Development of Public Hospitals (2021–2025) is guiding public hospitals to further improve the quality of medical services after standardizing medical management and establishing a hospital quality management and quality control network. Private hospitals are also aligning themselves with the standards set by public hospitals.

Patient escort services represent an excellent entry point. As various sectors of society recognize the demand for such services, hospitals have also clearly acknowledged this need.Some hospitals have begun to consciously leverage social resources to build their own “Patient Escort Service Platforms,” breaking down data barriers to better address issues arising during patient escort services and improve service delivery to patients.

Yiyun Ronghe, established in 2021, is a company that provides services to clients by leveraging internet-based digital healthcare technologies. Zhong Yuan, the founder of Yiyun Ronghe, keenly identified the demand for customized hospital accompaniment service platforms. One of the tertiary hospitals it serves has built a diagnosis and treatment service platform based on WeChat and mini-programs, enabling the provision of more specialized services to patients. First-time visitors can book accompaniment services through the platform, for which the hospital charges an appropriate fee and delivers professional assistance. In contrast, inpatients receive these accompaniment services free of charge.

Not coincidentally, Zhang Wei, founder of Shandong Yi Wuyou Health Technology, also pointed out that “current smart services in hospitals have not been effectively implemented; they merely address issues of recording and storage. Only by breaking down information barriers and developing digital applications can smart services and the ‘patient-centered’ philosophy be truly realized.” It is therefore unsurprising that hospitals are taking the lead in providing patient escort and caregiving services. According to him, Qilu Hospital of Shandong University had previously collaborated with a third-party company to provide inpatient escort services for some patients during the pandemic. Although all escort services were actually provided by the third-party company, the collaboration with the hospital enabled better integration of information and data, thereby better safeguarding patients’ private data while improving service quality for patients.

In fact, whether it is individual patient escorts, third-party medical service providers, or the hospital-led escort services mentioned above, none have changed the “one-on-one” service model of patient escorting, nor have they moved away from the concept of being “labor-intensive.”Amid the current technological landscape, many tech-driven companies are turning their attention to “digitalization” to address the majority of challenges patients encounter during medical accompaniment.

Nanjing Meiqiao Information Technology, with over two decades of experience in the industry, is one such company. According to Chen Wenxiong, Regional Manager for Central China at Nanjing Meiqiao Information Technology, the company aims to leverage virtual human audio-visual interaction technology to integrate the roles of doctors, nurses, and patient guides within hospitals, creating online virtual avatars. These avatars facilitate a comprehensive service workflow covering pre-diagnosis, during-diagnosis, and post-diagnosis stages through voice or touchscreen interactions within hospital settings. By conversing with these virtual humans, patients can access services such as business inquiries, triage and guidance, and in-hospital navigation. The AI virtual humans guide patients throughout their medical journey with a concierge-style service approach. Even for the small number of patients using basic mobile phones (non-smartphones), their information can be registered at the hospital’s information desk. These patients are then equipped with bone-conduction headphones and smart badges featuring the virtual human avatar, enabling continuous voice-based interaction with the AI virtual human to guide them to the right place at the right time to meet the appropriate healthcare provider.

Chen Wenxiong pointed out that, in addition to shifting away from the traditional “one-on-one” patient escort model and reducing the ratio of outpatient triage staff to achieve cost reduction and efficiency gains, a key advantage of this system is its integration with core hospital data. This enables patients to receive real-time information updates at second-level granularity, thereby facilitating more convenient access to relevant medical services. Through push notifications, the system ensures that information flows more efficiently, minimizing patient burden. Furthermore, over 80% of the services provided by the system align with the Level 3 mandatory requirements for smart healthcare services set by the National Health Commission, further supporting hospitals’ development of smart healthcare services.

The core issue hospitals address by providing medical escort services is, in essence, the resolution of multiple challenges, including the age-friendliness and convenience of healthcare services.

Users who have a demand for “medical accompaniment” services are, in fact, a rather special group: they are patients first and foremost. This also implies greater potential risks and hazards for the “medical accompaniment industry.”

This hidden danger is akin to the “bomb” that Hitchcock’s camera reveals to the audience in advance. Those caught in the situation more or less sense its presence, yet they involuntarily follow a predetermined path, step by step, until the moment the “bomb” explodes.

Some argue that medical escort services are primarily conducted within hospital premises, where emergencies rarely occur. Even if an emergency does arise, hospitals are generally well-equipped to handle it. However, a frequently overlooked point is that medical escorts do not have the legal authority to act as guardians for patients. Consequently, in the event of an emergency, such as when informed consent for surgery is required, medical escorts are often left powerless to act.

To address the aforementioned issues, medical escorts providing accompaniment services should ideally mitigate the impact of unexpected incidents by informing patients of relevant risks in advance. However, in practice, trust between medical escorts and patients is built gradually. Declaring a blanket disclaimer of liability for all risks before the service has even commenced undoubtedly serves as a strong deterrent to patients. Consequently, patients often pay little attention to potential risks when signing agreements. Some platforms proactively communicate user needs and match them with medical escorts. These escorts have signed relevant agreements with the platform. They provide the services and assume the potential risks associated with the income they earn.

Behind the risks lies the fact that the industry is still in its early stages of development, with industry-wide standards yet to be established and policy and legal frameworks remaining incomplete. Practitioners across the sector are calling for professional certification, industry norms, and policy guidance.

In fact, there may well be precedents to draw upon.

Zhao Lu from Hefei Xiaolu Ludong Technology mentioned that in May 2020, the Ministry of Human Resources and Social Security released a new position in the health sector—Community Health Assistant. Currently, they have launched pilot outpatient clinics for the Community Health Assistant position in more than thirty locations in Hefei. This profession refers to personnel who utilize health and internet knowledge and skills to engage in community health record management, health education and training, medical consultation, healthcare consulting, agency services, patient accompaniment, and public health incident handling. The definition of the position clearly involves the term "patient accompaniment."

Zhang Wei from Shandong Yiwuyou Health Technology pointed out that, in his view, medical escorts are more akin to caregivers and nursing aides in the civil affairs sector. “Their training system can draw reference from the existing training programs for nursing aides. Those willing to provide short-term care may choose to work as medical escorts, while those interested in long-term care can pursue roles as hospital companions.” He further added, “In terms of public welfare and civil affairs, medical escort services might be integrated into community-based service offerings through designated channels, becoming one of the standardized services, or potentially even part of public-interest services in the future.”

Perhaps, regardless of how this industry develops in the future, people’s needs are genuinely real, and the value and significance of “medical companions” may well lie in that simple word: “thank you.”

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Acknowledgments: (in order of appearance)
Medical Escorts Lulu and Keke (pseudonyms)
Zhang Wei, Founder of Shandong Yiwuyou Health Technology
A Senior Executive Surnamed Zhang at a Healthcare Services Startup
Qiu Xinran, Founder of Xinran Life & Health
Zhao Lu, Founder of Hefei Xiaolu Lüdong Technology
Dr. Sun Zhifeng, Founder & Chairman of Kangtu Wujie
Zhong Yuan, Founder of Yi Yun Rong He

Chen Wenxiong, Central China Regional Manager at Nanjing Meiqiao Information Technology