Spring Rain Doctor Presses On: Business Model Evolution and Resilience After Founder's Passing

Although Zhang Rui, the founder of Chunyu Doctor, passed away not long ago—a great loss to the entrepreneurial community—the team at Chunyu Doctor continues to forge ahead through ongoing exploration.

Founded in 2011, Chunyu Doctor is a pioneer in China’s internet healthcare industry. In an era where the internet has permeated every sector, the development of internet healthcare in China has been far from smooth, and a mature business model has yet to emerge.

Due to the significant differences between China’s healthcare system and those abroad, Chunyu Doctor has been unable to take the shortcut of directly replicating successful foreign models, as many other internet companies have done. It can be said that Chunyu Doctor, together with its competitors, has pioneered a path in China’s internet healthcare sector that did not previously exist.

Chunyu Doctor’s business model comprises three phases: “selling questions,” “selling doctors,” and “selling insurance.”

“Selling Answers” refers to Chunyu’s service model of providing healthcare-related responses to user inquiries. In the early stages of its mobile platform launch, Chunyu Doctor primarily offered two services: “self-diagnosis” and “light consultation,” with both the software and services provided free of charge. To date, “Selling Answers” has remained Chunyu Doctor’s core business model throughout its development.

In its early days, Chunyu positioned its product as pre-consultation services, with core functionalities centered on “self-diagnosis + medical consultation.” Chunyu aimed to address the long-unmet user demand for “doctor-patient communication” by “selling questions,” and attempted to achieve profitability through a “freemium” model.

Self-diagnosis refers to users querying their symptoms via the Chunyu app and performing a preliminary self-assessment based on the results, typically for mild or common conditions. When experiencing discomfort, users can access the Chunyu “Self-Diagnosis” platform, select their corresponding symptoms, and follow the prompts provided by Chunyu to conduct a self-assessment. If multiple symptoms are present simultaneously, users may further refine their self-assessment through the multi-symptom query feature. For complex or severe conditions, Chunyu will advise users to seek medical attention at a hospital.

Light Consultation refers to the service where users consult doctors online via the Chunyu platform based on their symptoms. Chunyu recommends the inquiries to contracted physicians in relevant departments on its platform according to the specific content of the questions. The assigned physicians then conduct further questioning based on the patient’s description to reach a final diagnosis. Patients can submit inquiries via voice, text, or images, and doctors can respond using the same three methods. Light Consultation primarily targets common and mild conditions. For complex or refractory cases, the consulting physicians will advise users to seek in-person medical care at a hospital.

Chunyu Doctor’s free lightweight consultation service operates on a crowdsourcing model. Users submit questions through the Chunyu platform, where artificial intelligence identifies the relevant medical specialties and routes the inquiries to online physicians in those departments. Similar to the Didi Chuxing model, when multiple qualified physicians are available, they compete to answer the questions on a first-come, first-served basis. Meanwhile, Chunyu’s backend employs a suite of algorithms that adjust physician rankings based on their professional levels, historical response records, and user feedback.

During the initial phase of its operations, Chunyu Yisheng’s light consultation service adopted a free-of-charge model. Upon launch, each user was allowed one question per day, with physicians providing text-based responses within one hour; users could then ask follow-up questions. Subsequently, as the number of contracted physicians increased, Chunyu Yisheng gradually lifted the cap on online consultations.

In April 2012, Chunyu launched the Doctoral Clinic project. This initiative was primarily designed to attract young physicians holding doctoral degrees. Due to their youth and limited years of practice, these doctors often earn relatively modest incomes at hospitals; thus, they are inclined to join Chunyu’s platform to generate supplemental income by answering patients’ inquiries. Meanwhile, their doctoral credentials make them more readily accepted by users.

The Doctor’s Clinic project primarily offers two services: first, online lightweight medical consultations via the Chunyu Yisheng mobile application; second, users can schedule appointments for real-time telephone consultations with doctors, with each 15-minute session priced at RMB 60. Physicians contracted by the Doctor’s Clinic must hold a Medical Doctorate (MD) degree or possess a senior professional title of Associate Chief Physician or above.

In August 2012, Chunyu introduced a user-determined pricing system. Within the traditional hospital system, the price of each medical service is approved and fixed, and registration fees for doctors are set according to their professional ranks. Under Chunyu’s user-determined pricing model, across all available departments, users can choose a payment amount ranging from free to RMB 25 based on their expectations for the quality and timeliness of medical services. Doctors then decide whether to provide the corresponding services after reviewing the user’s request and offered price. Once a doctor accepts the user’s offer and delivers the service, Chunyu remits the balance of the user’s payment, after deducting operational costs, to the doctor. Additionally, users may pay a specified fee to consult designated doctors via text-and-image messages or phone calls; in such cases, the entire fee goes directly to the doctor, with Chunyu taking no profit from these transactions.

The “selling questions” business model has significantly boosted both the user base and the number of contracted physicians for Chunyu Doctor. However, its path to commercialization has been far from smooth, facing challenges in securing payment from both users and social insurance programs. Chinese consumers are not accustomed to paying for services. Since “selling questions” entered the market with a free-of-charge model, it is difficult to gain widespread acceptance among users who have become accustomed to free services once fees are introduced. Furthermore, under China’s existing medical insurance system, it is nearly impossible for social insurance to cover the costs of online consultations.

Zhang Rui found that users were willing to frequently use Chunyu for online consultations when the service was free, but under a fully paid model, only 10% of users might continue using Chunyu’s “Light Consultation” service. Under these circumstances, Chunyu Doctor decided to improve its business model, aiming to attract users to pay by leveraging doctors’ professional knowledge and expertise. This business model is referred to as “Selling Doctors.”

This ecosystem incorporates e-commerce models, physician-guided medication services, private doctors, and a hospital network. Chunyu Doctor is building its own hospital network. The Chunyu Hospital Network is structured as a four-tier pyramid (see Figure 2). At the base of the pyramid are Chunyu Doctor’s online services, including mobile and web platforms. These online channels serve as user acquisition engines for Chunyu, forming the foundation of the hospital network. They address daily health consultations and general health concerns while simultaneously enabling Chunyu to collect vast amounts of data.

The second tier from the bottom is Chunyu Clinic, which operates on a crowdsourced partnership model to revitalize existing offline resources. The clinics address users’ diagnostic needs for common illnesses, while major examinations and surgeries are referred to the third tier, Chunyu Hospital. By the end of 2015, two funds were supporting Chunyu Doctor in making healthcare investments; consequently, Chunyu established a number of Chunyu Hospitals through holding or equity stakes. Chunyu Hospitals manage not only common diseases but also high-end, complex, and critical conditions. At the apex of the pyramid is Chunyu International Medical Care, which collaborates with renowned international physicians and prestigious hospitals to tackle rare and complicated cases. With higher fees, this tier targets high-net-worth individuals and corporate clients. 

“Selling problems” is hardly profitable; doctors rely on platform subsidies to boost their income, while “selling doctors” is excessively cash-burning. So, who should ultimately foot the bill for internet healthcare?

The primary payer for internet healthcare enterprises should not be patients, nor doctors, but rather insurance providers. Can China’s internet healthcare sector integrate with insurance? Does this present an opportunity for Chunyu Yisheng? Accordingly, Chunyu Yisheng entered the third stage of its business model evolution: “selling insurance.”