DXY Clinic: The First Step in Building a Healthcare Ecosystem

DXY Li Tiantian

Li Tiantian, Founder of DXY and Visiting Professor at the Second Military Medical University. DXY is China’s largest academic exchange platform for the medical and pharmaceutical fields, with over 2 million registered physicians among its users. Meanwhile, DXY is committed to providing professional and trustworthy content and services to the general public in the health sector. Its offline clinic officially commenced operations in January 2016.

Founded in 2000, DXY has been a professional platform dedicated to facilitating academic exchange among physicians since its inception. Medical education extends beyond textbooks; it requires substantial learning from peers and clinical practice. Therefore, this specialized communication platform effectively meets physicians’ needs for mutual interaction and collaborative learning.

From 2000 to 2006, DXY remained a professional online academic community for physicians, attracting many doctors to engage in scholarly discussions and interactive exchanges. It was not until 2006 that we formally began exploring commercial operations. Throughout the commercialization process, we continuously experimented with various strategies and approaches, and have since achieved significant scale.

Dingxiang Yuan currently covers nearly 80% of physicians in China, a milestone achieved through gradual accumulation over the past 16 years. Furthermore, we have expanded from a single-minded online platform for academic exchange into a comprehensive service ecosystem encompassing job recruitment, professional promotion, scientific research, and medical education, aiming to provide holistic solutions that address the full spectrum of physicians’ needs.

Certainly, providing physicians with such a communication platform and offering tools related to their work, study, and daily life is closely tied to our team’s medical background. The founding team of DXY (Dingxiangyuan) primarily comes from professional backgrounds in medicine and pharmacy. Therefore, we believe we have a solid understanding of this industry and a deep insight into the needs of its users. As a result, the services we provide effectively meet their demands in these areas, which has always been a source of pride for us.

Content Is King, Professionalism First

In addition to leveraging its professional expertise to serve physicians, DXY began exploring services for the general public a year ago. This shift prompted extensive internal discussions on key strategic questions: Which angle should we take? How should we proceed? What are our objectives? After prolonged deliberation, we recognized the strong public demand for accessible medical science education. Consequently, we decided to focus on content delivery, aiming to provide the general public with professional and authoritative health-related scientific information.

Regardless of the target audience, content remains a critical factor. In the past, when we provided services to professional physicians, we often discussed: What drives physicians to actively engage and communicate within a community? Why do physicians participate in social interactions? While sharing photos or liking posts among friends and family constitutes everyday interaction, physicians in professional communities are typically strangers to one another. What provides them with sufficient motivation to interact?

Ultimately, the answer is quite simple. For highly specialized professionals like physicians, a major driver for engaging with unfamiliar peers is content—embodying the principle that “content is king.” I did not personally know any doctors from Kunming Children’s Hospital, and we were thousands of kilometers apart. However, after he posted on DXY.cn sharing his insights and experiences in treating pediatric epilepsy, I found him worth connecting with. This online connection even opened the door to potential offline meetings, where we could have brief discussions and explore opportunities for future collaboration.

Therefore, in serving professional physicians, DXY primarily focuses on delivering high-quality professional content. We position ourselves as a specialized platform, collaborating closely with physicians in content creation—inviting them to co-author and co-translate materials, and organizing the compilation of cutting-edge international information and the latest clinical practice guidelines. This enables Chinese physicians to promptly access and learn from advanced knowledge. We also encourage academic exchange among physicians through activities such as case discussions, expert lectures, Q&A sessions with department directors, and DXY’s open courses. All these initiatives are designed to provide physicians with robust professional and academic content, as only high-quality content can effectively engage and attract physician participation.

In providing services to the general public, we have largely adhered to the assessment that China lacks authoritative medical science communication articles. Recently, everyone has likely observed issues arising on internet platforms due to the commercialization of content; this is merely the visible outcome. Prior to media exposure of such incidents, their impact and damage were already substantial. We frequently note that much online content is highly exaggerated, misleading, and riddled with errors, yet it remains unchallenged and uncorrected.

Moreover, we have found that such misleading content is becoming increasingly sophisticated. While it used to be easily identifiable at a glance, it now incorporates substantial amounts of accurate information, with just a few misleading statements interspersed throughout being sufficient to mislead readers.

Therefore, we have decided to serve the general public primarily through content-based services, leveraging the strong trust relationship that DXY has built with Chinese physicians over the past sixteen years. We collaborate closely with doctors to co-create medical science popularization articles and share health-related knowledge, aiming to disseminate accurate, evidence-based medical information about diseases, medications, and overall health to the public.

The above represents some of the online initiatives undertaken by DXY, which aim to provide comprehensive services to physicians through content, tools, and support, while also meeting the public’s need for popular science education on health. However, based on our understanding of the healthcare industry, these efforts fall far short of the core of medical practice. The essence of healthcare lies in the clinical interactions that establish close relationships between physicians and patients, and core services should therefore center on diagnosis and treatment provided by physicians to patients.

I personally categorize healthcare services into two segments: peripheral and core. The peripheral segment includes payment, registration, laboratory test result inquiries, and other process-optimization services and applications. The core segment primarily encompasses the diagnostic and therapeutic activities conducted by physicians and patients.

As DXY has long been engaged in the internet industry, we position ourselves as an internet-based technology enterprise. We frequently reflect on what we can do within our service ecosystem—whether in peripheral or core areas—to meet patients’ needs.

In the peripheral sectors, we have seen many companies and suppliers already offering such services. However, in the core area of physician diagnosis and treatment, no truly reliable services have emerged, nor have any services established a viable business model. By "business model," I do not merely mean a revenue-generating mechanism; while a business model certainly encompasses service delivery and profitability, it is not limited to making money alone.

How can we truly integrate into the critical stage where genuine clinical interactions between doctors and patients take place?

The most direct approach is to start by establishing healthcare service institutions. By owning these institutions, one can leverage their platforms to pilot a model that integrates internet-based services with clinical diagnosis and treatment.

Lilac Blooms: General Practice Services

Therefore, we began preparing for the DXY Clinic. The first DXY Clinic officially opened in Hangzhou on January 18 this year. Prior to that, we had already established our “Clinic No. 0” in Fuzhou. Currently, our main locations are in Hangzhou and Fuzhou.

Our clinics in Hangzhou are primarily equipped with departments of internal medicine, surgery, gynecology, and pediatrics. In contrast, our Fuzhou clinic focuses exclusively on pediatrics. There are differences in both the number of physicians and the overall scale; the Fuzhou clinic is relatively smaller. The clinics in Hangzhou each occupy an area of approximately 800 to 1,500 square meters. The first one has already opened, renovation of the second is nearly complete, and site selection for the third has been finalized with preparations for renovation underway. The larger footprint of our Hangzhou clinics provides a broader platform that facilitates experimentation. Nevertheless, smaller operations also offer advantages, such as operational flexibility and lower costs, enabling the exploration of different service models. Therefore, we intend to pilot both approaches.

From a broader perspective, China’s hospital system, particularly the medical service delivery model centered on Grade 3A hospitals, has undergone certain new changes. The previously cited difficulties and high costs of accessing medical care were not primarily due to an absolute shortage of physicians; rather, the core issue lay in structural imbalances, with a large concentration of high-quality doctors in tertiary hospitals located in large and medium-sized cities, while primary healthcare in China remained markedly underdeveloped.

This weakness is reflected, on one hand, in the shortage of physicians; after graduation, doctors are reluctant to practice at the primary care level, preferring instead to remain in large hospitals as specialized clinicians. This constitutes the first point.

Second, the concept of general practitioners in China has only emerged in recent years. Previously, the vast majority of physicians trained in China, including myself, were specialists. Although we completed rotations across all departments during our hospital training, we ultimately specialized in a specific field; my own research and clinical focus was neurology. As a neurologist, if asked to manage cases in gynecology, gastroenterology, or pulmonology, I would need to request consultations from specialists in those respective fields, as such matters fall outside my scope of practice. This highlights China’s lack of a comprehensive general practice system and the corresponding shortage of qualified general practitioners.

Beyond this, we have also observed a demand from the patient side: patients seek high-quality medical services and reliable physicians to address their health issues, while also placing expectations on service quality and overall experience. When my own child fell ill, I took him to a public hospital, where we endured long queues, registration hassles, and intravenous drips in an admittedly suboptimal environment. I would be willing to accept slightly higher consultation fees if there were a healthcare institution offering more private appointment settings and greater convenience. However, such options are currently unavailable in China; nearby clinics simply do not provide this level of service.

In summary, we aim to penetrate the core of healthcare services. However, as no such service provider currently exists in China despite patient demand, we have chosen to enter the market through clinics. Specifically, we are leveraging Dingxiang Clinic to meet the basic medical needs of patients who prioritize quality of care, such as those suffering from common ailments like headaches, fever, colds, and coughs. Our positioning is that of a high-quality general practice service provider, akin to a family doctor model.

The Application Scenarios of Mobile Health

What exactly is the connection between this positioning and the internet? DXY has always operated within the internet industry. Now, however, it has suddenly expanded offline by opening general practice and pediatric clinics, and has begun managing chronic diseases as well as common and frequently occurring illnesses. On the surface, there seems to be no logical link between these two directions. However, from my perspective, while we have spoken extensively about internet-based healthcare and mobile health, these services—whether delivered via the internet or mobile platforms—serve more as a complementary enhancement for large hospitals. This is because their medical resources and quality of care have already reached an advanced stage.

For instance, if we rate Peking Union Medical College Hospital at 95 points for its medical services, quality of care, and diagnostic and therapeutic capabilities for complex and refractory diseases, the integration of internet-based solutions could raise that score to 96 or 97. The benefits it brings to large hospitals are evident, such as facilitated appointment registration and payment processes. However, have large hospitals truly transformed themselves through the internet? In reality, public hospitals or tertiary Grade A hospitals have not undergone fundamental changes in their original service models.

On the contrary, I believe that internet healthcare or mobile healthcare will find their most significant applications in primary care institutions, such as clinics, community health service centers, smaller secondary hospitals, primary hospitals, and grassroots hospitals. The internet has brought about tremendous changes to these medical service providers. For instance, if their services were previously rated at 30 points, the integration of internet, mobile technologies, and wearable devices could elevate their performance to 50 or 60 points. This kind of improvement is more groundbreaking.

Therefore, I personally believe that the application scenario best demonstrating the transformative innovation brought by internet technology lies in primary healthcare services, rather than in tertiary Grade A hospitals—though this statement should not be made too absolute. The enhancement of medical service efficiency through internet technology has primarily occurred at the grassroots level. This is evident from our firsthand experience at Dingxiang Clinic, where we have tangibly felt the significant convenience delivered by internet and mobile technologies.

For example, a patient receives diagnosis and treatment at a clinic but continues to experience diarrhea after returning home. In such cases, the patient can use their smartphone to take photos of their latest condition and send them to the doctor. Since the initial consultation was conducted in person at the clinic, follow-up tracking makes it much easier for the physician to assess the patient’s disease progression. Therefore, while post-consultation follow-up services may seem insignificant, they can significantly enhance the patient experience.

Therefore, our service model must not be confined to the clinic setting. In-clinic care represents only a portion of our services. We aim to leverage technology and equipment to extend our reach beyond clinical walls and into patients’ homes, thereby engaging more patients and expanding our service capacity.

I have heard many hospital directors abroad espousing similar concepts. They share the view that while patients can be discharged and leave medical institutions, we still possess the means and devices to continuously collect patient data after discharge. We can leverage this clinically significant data to provide services. However, many medical institutions in China are only capable of delivering in-hospital treatment services, and it is quite challenging for them to offer out-of-hospital services, as they are already overwhelmed with in-hospital duties. Therefore, remote management, consultation, interaction, and health education for chronic diseases are better suited for implementation at the primary care level.

Moreover, I believe that primary care represents a promising arena for internet-based and mobile healthcare services. Therefore, DXY will continue to focus on key areas such as primary care, home healthcare, and chronic disease management, striving to realize our vision. We also hope to collaborate with everyone to build this platform effectively. As for what constitutes a successful model, I believe there is ample room for discussion. Such a model cannot be achieved by one or two companies alone; it necessarily requires multi-party collaboration and mutually beneficial partnerships.

Built In-House Due to High Standards

Our decision to establish self-owned clinics is also driven by the consideration that medical services place a strong emphasis on safety and quality, fundamentally distinguishing them from industries such as food and beverage, tourism, and e-commerce. It is often said that the core of medical services can be summarized in two principles: first, medical quality; second, patient safety.

We have also found that only by establishing our own medical institutions can we effectively manage our service quality control. It is through standardized processes and clinical pathway specifications that we can regulate medical practices in accordance with high-quality standards. Secondly, we recruit physicians on a full-time basis and provide them with general practice training to meet the fundamental requirements of medical quality and patient safety. Therefore, we have chosen to build our own clinics rather than pursuing franchising or joint ventures.

Of course, as the number of clinics continues to grow in the future and more people become aware of this point, we do not rule out collaborating with some high-quality clinics. However, in the early stages, we insisted on building our own facilities because medical services have relatively high safety requirements.

Building a Platform to Connect 5P

In addition to establishing our own clinics, we have independently developed a clinic information management system, as certain needs of our clinics cannot be met by the existing management systems currently available on the market.

Our self-developed management system is currently in use at Dingxiang Clinic, and we have also invited several partners to trial our clinic management system. Based on the feedback received so far, the results are quite satisfactory. We hope to open this clinic information management system to more industry peers at an appropriate time in the future, enabling them to utilize this platform to manage their patients and business operations.

Whether DXY builds its own facilities or collaborates with external partners, even reaching 1,000 clinics would still be insufficient to meet demand. This platform requires scale. Therefore, we aim to share our expertise and build a robust platform that benefits more industry peers. With the emergence of more high-quality clinics and the participation of more professionals dedicated to primary care and family medicine, we believe we can drive transformation across the entire healthcare industry, rather than merely serving a small segment of the population in a limited number of cities.

In the future, we hope to establish ourselves as a connector. The healthcare industry is particularly unique; unlike other sectors where one or two companies can dominate the entire market, healthcare involves a wide array of stakeholders. We have summarized these into the “5 Ps.”

Patients; Physicians; Pharmaceutical Companies; Insurance Companies; Healthcare Institutions and Healthcare Service Providers.

Among these five Ps, we can only address a portion of the work. Many industry stakeholders—including healthcare institutions, pharmaceutical companies, medical device manufacturers, and insurance companies—are eager to participate, as certain services cannot be delivered without their involvement. Therefore, we hope that DXY can leverage clinics, as offline physical entities, to serve as connectors linking physicians and patients, thereby fostering closer engagement in the delivery of healthcare services.

We also hope to invite more service partners through our online platform to jointly create a new ecosystem. Within this ecosystem, each participant will fulfill their respective roles, collaborate with one another, and leverage complementary strengths, thereby forming a closed loop for healthcare services.

Dingxiang Clinic: The First Step in Building a Medical Ecosystem

Generally, there is a waiting period for inclusion in the national medical insurance program, as data accumulation is required. This period typically ranges from one to two years, reflecting specific temporal requirements. We have also noted that policies are increasingly emphasizing that private medical institutions can apply directly for medical insurance designation, even at the time of opening. However, based on our understanding of the practical implementation of these policies, a certain amount of time is still necessary. From the government’s perspective, a track record of data accumulation is prerequisite to addressing reimbursement issues. Whether we will adjust our fee structure accordingly after gaining access to the medical insurance system is still under discussion. Since securing medical insurance support requires compliance with its standards, any discrepancies ultimately necessitate strategic trade-offs.

Regarding medications and laboratory testing, our approach is to ensure only the most basic needs are met in-house. This includes essential medications and tests that require rapid turnaround times, which are handled by our clinic’s own equipment and staff. However, more complex or less commonly used medications, as well as less common diagnostic tests, are generally outsourced to third-party providers. For instance, we have partnered with Shanghai Pharmaceuticals for medication dispensing and related services. We grant Shanghai Pharmaceuticals access to our electronic prescription system, allowing them to handle medication delivery and provide physician consultations. As for laboratory testing, we perform basic tests such as complete blood count and urinalysis in-house, while all other tests are outsourced to independent third-party laboratory companies such as KingMed Diagnostics and Dian Diagnostics.

We have diverse promotional channels for patient acquisition. Currently, without comprehensive external marketing, DXY Clinic is already seeing double-digit daily patient volumes, which is a promising start and significantly exceeds our initial conservative projections. When asked how they learned about the clinic, patients cited referrals from friends, following the clinic on WeChat, or discovering it through the app, indicating that online platforms are indeed a key channel for patient acquisition.

Regarding fees, DXY Clinic currently relies on out-of-pocket payments from patients.

What is the average investment required to invest in a clinic?

When investing in a clinic, one should consider the floor area, as it correlates with the scale of operations. Our clinics in Hangzhou range from 800 to 1,500 square meters, employing over 30 doctors and nurses, and featuring 9 to 12 consultation rooms. For a clinic of this size, the initial budget should be approximately RMB 10 million.

What Levels of Physicians Are Recruited by Dingxiang Clinic? What Are the Primary Sources?

The physicians employed by DXY Clinic are primarily those with 5 to 8 years of clinical experience, holding titles mainly at the attending physician and associate senior levels.

Currently, our physicians are recruited on a full-time basis, rather than primarily as part-time staff. Although policies regarding physicians’ multi-site practice have begun to relax, their motivation and willingness to engage in such arrangements remain uncertain, as they still harbor certain concerns.

Meanwhile, they also hope to gain a deeper understanding of certain models and service workflows, so as to select suitable institutions for multi-site practice. Therefore, in the early stage, we still prioritize full-time positions.

What are the advantages of DXY Clinic compared to domestic high-end private hospitals?

How Does DXY Differ from Other High-End Private Hospitals? DXY Clinics primarily focus on basic services, such as chronic disease management and the management of common conditions. We generally do not handle complex or rare diseases, which should be managed by public hospitals.

"Given the large number of patients with chronic diseases among the general population in China, special groups such as women and children do not necessarily present highly complex conditions. Providing high-quality services to these populations is also an important direction. Therefore, we do not seek to compare ourselves with private institutions; instead, we position ourselves as a general practice clinic, a neighborhood clinic, and a family-oriented clinic, placing greater emphasis on the concept of family."

What is DXY planning to do in light of the liberalization of multi-site practice for physicians?

In the context of multi-site practice, although certain difficulties and obstacles remain evident at present, many physicians have yet to fully clarify their positions or, even after careful consideration, prefer to observe and wait. We fully understand this situation. We are committed to promoting the development of this initiative. DXY will strive to build a robust platform for these physicians, handling administrative, nursing, financial, legal, tax, and insurance matters through our dedicated teams. Physicians can thus join the platform and begin practicing with minimal logistical burden. Of course, this is a process that requires time to establish the platform properly. Once the platform is fully developed, physicians will be able to genuinely embark on the path of multi-site practice. Therefore, DXY is actively preparing for this direction.

Dingxiangyuan is currently in discussions with individual physicians and medical institutions to create more favorable conditions for multi-site practice, thereby encouraging greater physician participation. There must be room and a platform for such initiatives, and Dingxiangyuan is willing to serve as the pioneer in this endeavor. By fostering initial collaborations with select medical institutions, we can enable physicians to begin practicing at multiple sites.

What continuing education pathways does the clinic offer to its employed physicians?

Regarding continuing medical education (CME) for clinic physicians, we offer a CME service called LLLP, which stands for Life-Long Learning and Practice. We have established specific KPI requirements for each physician’s continuing education, including the number of CME credits to be earned annually, the required frequency of case discussions, participation in Journal Clubs, delivery of departmental lectures, and involvement in drafting clinical pathways for industry guidelines. These constitute our CME requirements for clinicians. I have long held the view that there are no inherently “good” doctors; rather, competent physicians are developed through rigorous training and education. Therefore, we provide high-quality academic content to facilitate their professional growth.

For DXY Clinic’s future development, is there potential for collaboration with non-local peers through models such as “white-labeling” or brand franchising? Under this arrangement, local partners would provide the medical facilities, healthcare professionals, necessary qualifications, and investment in accordance with DXY Clinic’s basic requirements, while licensing the DXY Clinic brand and system.

Regarding white-label services for peers in other regions, here is the situation: Since launching Dingxiang Clinic, we have received substantial demand in this area. Inquiries have come from within Zhejiang Province as well as from other provinces, including Sichuan, Guangdong, and Hunan, with stakeholders sequentially emailing us to propose alliance or collaborative models. From our perspective, there are two key points we would like to share:

First, we are deeply grateful for this matter; thank you all for your trust and warm welcome. However, it cannot be realized so quickly at present.

Second, we hope to take some time first to thoroughly understand our internal quality control standards, physician training programs, and the medical staff training service system. I believe that OEM services are not merely about affixing a brand label; rather, they represent a contractual partnership between two parties. This partnership should be built on a shared understanding of common interests and benefits, including mutual alignment on quality standards, safety requirements, and physician training specifications.

Will DXY Clinic offer internship opportunities to medical students in the next phase?

Therefore, it is not up to me to decide whether medical students can undertake internships here. The government has strict regulations regarding standardized residency training for resident physicians and specialized training for specialist physicians. These regulations also specify which institutions are qualified to host interns or provide standardized training. We must adhere to the relevant national requirements; otherwise, it could adversely affect the trainees’ own career development. Currently, our physician recruitment primarily targets candidates with 5 to 8 years of clinical experience.

Regarding whether recent medical school graduates are eligible to join? At present, we still hope to recruit physicians who have genuine clinical work experience. Because DXY Clinic provides direct diagnostic and treatment services to patients, it is not, by nature, a teaching institution or part of a teaching hospital. Therefore, our current recruitment prioritizes physicians with clinical experience.

Of course, there are also medical students or recently graduated doctors who express interest in visiting DXY to observe and even engage in non-clinical tasks. We welcome such initiatives and have long had plans in place to accommodate them. Indeed, some medical students and residents have volunteered with us during holidays or spare time, though they are generally not involved in direct patient care activities.

Ensuring the availability of physician resources is a prerequisite for guaranteeing medical quality and patient safety. How does DXY Clinic attract physicians to work there, and can it effectively reflect the professional value of their labor?

Throughout the delivery of clinic services, we have consistently regarded medical personnel as the core of service provision—a widely accepted common sense. In fact, not only physicians but also nurses play a crucial role in primary healthcare, with their contributions in certain aspects being no less significant than those of physicians. Therefore, we remain deeply committed to both physicians and nurses. How to recruit these professionals to join your team is a topic worthy of discussion.

However, simply recruiting physicians is not sufficient to establish a clinic; we must implement a selection process. On what basis do we screen candidates? First, we assess whether there is alignment in core values. For instance, some physicians may already be performing well at their current institutions but dislike the prevailing environment. They aspire to practice medicine in a more pure and dedicated manner, providing patients with more attentive and conscientious care. This shared value system serves as a crucial prerequisite for attracting physicians.

Secondly, in terms of compensation design, we have made every effort to ensure that our compensation package is attractive and competitive compared to their current remuneration.

Third, in addition to compensation, we have designed an equity incentive plan involving stock options, thereby enabling physicians to become partners.

The combination of these three factors should constitute a favorable proposition. Physicians will weigh the trade-offs between relinquishing their positions within the public hospital system and the benefits of joining our organization. If they find the offer acceptable, they will undoubtedly join us. Based on our experience, physicians working at Dingxiang Clinic share significant alignment with us in terms of values, setting aside the latter two factors for now.

Can DXY Chain Clinics serve as an offline experience and consultation service center for health management, followed by subsequent data collection, tracking, and management, thereby positioning itself in the direction of health management rather than solely medical care?

"We have also begun to make attempts, including the recent collaboration between DXY, ZhongAn Insurance, and Tang Daifu on chronic disease management. Currently, we are still focusing on diseases. Why?"

Since the management of chronic diseases is directly related to medical care, and chronic diseases are indeed diseases that require the assistance of doctors and nurses to address certain issues. In fact, I believe that true health management is not easy to implement; it indeed faces many challenges, especially due to resistance from traditional mindsets, which we have found to be the biggest problem upon entering this industry. People often say, "I am healthy, so why do you need to manage me?" Or they are unwilling to pay for management services, preferring free options instead.

Therefore, I believe there is still market demand for chronic disease management, and it is feasible to start with this area. However, directly implementing comprehensive health management in one step poses considerable challenges and may require a certain period of time to pilot and refine this model.

What are the differences between DXY’s and Chunyu Yisheng’s clinics? What are their respective advantages?

Dingxiangyuan Clinics currently operate primarily under a self-owned model, rather than focusing on white-labeling or franchising. This strategic choice is driven by our commitment to maintaining high-quality standards and achieving standardization in clinical workflows, quality control, and service delivery. We have evaluated various clinics across China and observed significant variability in quality within the industry. Therefore, we prefer to take a measured approach, first strengthening our own clinic platform and establishing rigorous internal standards and requirements before selecting suitable industry partners to explore collaborative models, including franchising. As previously mentioned, white-label services cannot be implemented simply by affixing a brand name; healthcare is a highly specialized service sector.

How Does Telemedicine Ensure Effectiveness?

How Can Telemedicine Ensure Quality? I have always believed that if telemedicine is to ensure quality, the initial consultation may still need to rely on in-person visits, as face-to-face communication offers the greatest assurance; however, follow-up visits and monitoring can be conducted remotely.

In fact, many international institutions conducting initial remote medical consultations require doctor-to-doctor interactions, or may invite the patient to be present, but the communication remains between doctors. This approach maximizes the avoidance of safety issues. Often, when we collect data and analyze a patient’s condition, if we are dealing with a completely unfamiliar patient whom we have never met before, conducting the initial consultation online via telemedicine lacks on-site data collection, which could lead to medical errors. Such problems, if they occur, can have particularly severe consequences.

Will Dingxiang Clinic develop specialty programs (in addition to its current pediatrics program)? For example, specialties suitable for primary care settings, such as gynecology, pain management, and proctology? We would like to know Mr. Li’s perspective and strategic considerations regarding the balance between general primary care and specialty medical services.

DXY offers certain specialty services, such as pediatrics and gynecology; however, in designing these departments, we aim to better highlight the advantages of general practice, as it serves as the platform with the closest connection to families. Yet, we must not rush. Why is that?

Because there is a shortage of general practitioners not only in China, but patients also lack the concept of general practice services. When they visit clinics, they still prefer to see specialists, such as pediatricians or proctologists. Therefore, we need to accept this process and take time to gradually change people’s medical-seeking concepts and traditional beliefs. In the early stages, we will also have specialized departments, but later on, we hope they will increasingly integrate into general practice services.

What specific problems in the current healthcare system has DXY actually resolved, particularly from the patient’s perspective?

What Real Problems Does Dingxiang Clinic Solve for Patients? I will answer this from two perspectives. First, regarding the act of seeking medical care itself: when people fall ill, their initial instinct is to visit a large hospital. However, whether it is a cold, fever, headache, or cough, we aim to manage these conditions within the community, close to home, and at the clinic level, rather than having everyone flock to major hospitals. Such overcrowding represents a waste of medical resources. Previously, patients had no alternative, as there were no trustworthy clinics nearby, forcing them to seek care at large hospitals. Dingxiang Clinic strives to change this situation and deliver value to patients.

Second, seeking medical care is also an experience. The healthcare environment, care processes, privacy protection, and doctor-patient communication all constitute part of this experience. We aim to provide a healthcare platform with a superior patient experience, and our primary contributions lie in the two aspects mentioned above.

If qualified pediatricians apply to work at your clinic, will they also need to be trained in treating adult diseases?

When training newly hired physicians, we fully take their professional specialties into account. For instance, we generally do not train pediatricians to become general practitioners for adult patients, as our medical expertise allows us to recognize the significant gaps in knowledge and skills involved. Pediatricians are assigned to continue practicing pediatrics, while gynecologists primarily focus on gynecology.

Some physicians are well-suited to provide care for adults or patients with chronic conditions, such as those who previously practiced in general internal medicine or geriatrics. We will primarily focus on gradually training these physicians to become general practitioners, rather than specializing in fields with strong subspecialty orientations, such as pediatrics and gynecology.

What are the differences between clinics and current hospitals, and what is the relationship between DXY Clinic and mobile healthcare?

Clinics and hospitals currently maintain a complementary relationship. Complex, difficult, and rare diseases still require hospital care, while common, routine, chronic, and non-life-threatening conditions can largely be managed at primary healthcare institutions. Therefore, our positioning is focused on the downstream sector and grassroots level, with an emphasis on primary care, families, and special populations—this constitutes the main distinction from hospitals. Furthermore, both parties can establish referral and training mechanisms. In fact, we have already explored such collaborations in Hangzhou with Sir Run Run Shaw Hospital and the Second Affiliated Hospital of Zhejiang University School of Medicine (Zhejiang Er Yuan), yielding highly positive results.

Dingxiang Clinic and mobile healthcare share a closely symbiotic relationship. In my view, the impact of internet-based mobile healthcare on large hospitals has been negligible to date. The true application scenarios for mobile and internet healthcare lie at the grassroots level—within primary care institutions, communities, clinics, and households. Therefore, I believe that both clinics and primary care institutions must deeply integrate internet and mobile technologies into their patient services. In fact, Dingxiang Clinic has already begun implementing such solutions, including the use of mobile devices like glucometers for remote blood glucose monitoring. In the future, we plan to extend remote monitoring to other vital indicators such as electrocardiogram (ECG), blood pressure, and blood oxygen saturation, enabling timely and effective interventions.

“Mr. Li, you once described DXY as a ‘slow’ company. Will investors push DXY to speed up? Do you still consider DXY a slow company today?”

Regarding the characterization of DXY as a "slow company," it is important to recognize that the pace of development—whether fast or slow—is, to some extent, shaped and constrained by the industry itself. Unlike sectors such as fast food, fast-moving consumer goods (FMCG), tourism, and e-commerce, which are characterized by rapid growth, frequent updates, and swift changes, the healthcare industry does not follow this trajectory. Therefore, insisting on a dichotomy of "fast" versus "slow" within the medical services sector may contravene the inherent laws of industrial development. Our priority is to ensure quality and safety. From this perspective, we take pride in being a "slow company."

What are DXY’s next strategic priorities and challenges? In your opinion, what is a difficult yet essential task that must be undertaken?

The most challenging and difficult-to-resolve aspect lies in the general public, where we need to cultivate awareness and concepts regarding health and disease. First, many individuals do not recognize that they are ill when they are; they dismiss slightly elevated blood glucose or blood pressure levels as insignificant. This is particularly true for patients with chronic diseases, who often become desensitized due to habituation and neglect their health status. On the other end of the spectrum, there is another extreme group: those who seek care at Peking Union Medical College Hospital for every minor cold or fever. Both groups are substantial in number, making it exceedingly difficult and time-consuming to change these mindsets.

DXY has also been committed to driving this transformation. On one hand, we provide health education and popularization through online platforms; on the other hand, our offline clinic services address common minor health issues, eliminating the need for patients to queue or undergo examinations at large hospitals, as these needs can be fully met by nearby community clinics. This process requires a shift in public perception, along with active dissemination and influence. Currently, our offline clinics place significant emphasis on the dissemination of health education, undertaking many initiatives that synergize with our online efforts. These include offline patient education classes, where online materials are utilized for in-person patient education, representing some of our ongoing attempts.

Is the lack of its own training base what Dingxiang Clinic is currently missing?

Regarding whether DXY also lacks a training base, this is a well-posed question, as ensuring medical quality requires sufficiently flexible training methods. This has been a key consideration in the design of our several clinics currently under construction in Hangzhou, each ranging from 800 to 1,500 square meters. The ample space not only facilitates operational efficiency but also serves an important purpose: functioning as a training center. By maintaining a certain scale, we aim to establish these Hangzhou locations as flagship sites for both service delivery and training, and then replicate this model in other clinics, including smaller ones.

How does Mr. Li view the mobile healthcare industry?

I am highly optimistic about the mobile health industry, which represents a groundbreaking breakthrough. This is particularly evident when comparing the significant differences in our service capabilities and capacity before and after the adoption of mobile health solutions. Previously, we lost contact with patients once they were discharged; unless we proactively reached out to inquire, we could not obtain their data or information, and even then, patients often provided incomplete accounts. However, with mobile health and wearable devices, we can now collect meaningful clinical data from patients. Regardless of whether they are at home or at work, I can leverage this data to provide better services. Therefore, I believe mobile health can bring substantial benefits to chronic disease management. Nevertheless, I consider its application scenarios to be more impactful at the primary care and general practice levels.

What are your expectations for the development of physician groups?

Physician groups remain a noteworthy emerging entity. From our perspective, both physician groups and hospitals are key participants in the healthcare services supply chain. We aim to collaborate with physician groups in the future, leveraging their specialized physician services and multi-site practice arrangements. We believe these services can be readily integrated into clinics, general practice, and primary care settings to better serve patients.