Home Zhou Shenglai: It's Time for Hospitals, Doctors, and the Internet to Unite

Zhou Shenglai: It's Time for Hospitals, Doctors, and the Internet to Unite

Dec 03, 2015 22:35 CST Updated 22:35

Highlights


1. If the environment and society have changed, but you remain unchanged—clinging to your so-called success model of yesterday and operating on inertia by continuing to replicate your past—then your failure tomorrow is inevitable.


2. In reality, mobile internet technology does not need to replace physicians or render them obsolete; rather, it requires effective collaboration with physicians and hospitals.

3. Healthcare is not equivalent to medicine; the greatest distinction between healthcare and medicine lies in the fact that healthcare is an art of practice grounded in science.

4. Physicians are both scientists and artists.

5. Within the information flow, particular attention must be paid to the circulation of health information data and the value generated during this process.

6. The value and role of physician groups, which I have summarized into three major functions: liberating productivity, developing productivity, and optimizing productivity.

7. Multi-site practice for physicians is not the optimal system; the ideal model is for physicians to operate as independent practitioners.

8. The greatest value of a physician group, which must be kept in mind, is its asset-light business model. In other words, your most valuable assets are the physicians’ own experience and knowledge, making it an organization built on intellectual capital.

9. Three Major Characteristics of Healthcare Service Institutions: Capital-Intensive, Technology-Intensive, and Labor-Intensive. Therefore, the service framework must be primarily structured around intellectual capital combined with financial capital.

10. Post-hospital disease management services are designed to cultivate loyal users, while pre-hospital health management services aim to identify and secure target customers in advance, nurturing potential clients.

11. Non-medical personnel engaged in internet healthcare can collaborate with hospital physicians to deliver an integrated service spanning pre-hospital, in-hospital, and post-hospital care, which represents the most promising prospect for the healthcare industry.

The Three Major Topics Discussed Today: First,Medical + Internet + Mobile, secondlyHospital + Clinic + Physician Group, thirdly,Pre-hospital + In-hospital + Post-hospital, first we discuss the first major topic: healthcare + internet + mobile.


——————Healthcare + Internet + Mobile——————


# Facing the Impact of the Internet, Hospital Doctors Must Change


I have observed that members of our group fall into two categories: those with a medical background and those without. I will first share my core perspective with our physician colleagues. This is a viewpoint I have frequently presented to hospital directors, physicians, and nurses at recent internal healthcare industry seminars, and it is also a statement I often make:Yesterday's Success Model Is the Cause of Tomorrow's Failure, so the core message of this statement is to remind our hospital presidents, department heads, and physicians that we must also adapt when the environment and society change.


If the environment changes and society evolves, yet you remain unchanged—clinging to what you deemed a successful model yesterday and operating on inertia by merely replicating your past today—you are destined to fail tomorrow.Many people believe that doctors and hospitals are the most conservative institutions. Our doctors and hospitals have long been accustomed to responding to all changes with constancy. Regardless of which dynasty or who ascends the throne, people will always need medical care. Therefore, no matter the era, I continue to practice medicine in the same way and provide patient care as I always have.


In particular, there is insufficient understanding of mobile internet technology. Many people, including numerous hospital directors, believe that, at the end of the day, mobile internet is merely a tool. The most important aspect of a tool lies in its user and how it is utilized. This view is not incorrect; it is a technology, belonging to the realm of “technique” or “methodology.” However,Technological innovation will exert a disruptive impact on human perceptions and even the entire social system and structure.


The emergence of mobile internet technology has upended the organizational philosophies and service models across all aspects of human life. As every industry undergoes transformation, physicians, hospitals, and their leaders and managers must timely assess the situation, adapt to societal changes, adjust accordingly, and actively embrace the mobile internet era.


In the past, no matter how skilled physicians were, they had to see patients one by one; a specialist could see at most thirty patients in a morning. With the advent of mobile internet technology, however, the reach of each physician—especially specialists—has expanded, enabling them to realize greater professional value. This is just one small example; there are many more.


I will not dwell tonight on the impact of mobile internet on physicians and hospitals. For those interested in further study, I will share a post later that covers a topic I presented during an internal hospital seminar: three key propositions—how physicians should practice, how departments should be managed, and how hospitals should be operated—in the era of mobile internet.


Next, I would like to share some of my personal insights and perspectives with colleagues in the mobile health sector who do not have a medical background. By engaging in mobile health services, you have chosen a sunrise industry—a strategically sound decision. However, certain issues warrant attention during practical implementation.


The Internet Cannot Replace Hospitals and Doctors: They Are in a Collaborative Relationship


As professionals in the mobile internet sector, in addition to mastering mobile internet technologies, it is essential to understand the unique dynamics of the healthcare industry. You do not need to study medicine from scratch or acquire medical knowledge to the same extent as physicians; however, you must understand the professional characteristics of doctors and the distinctive attributes of the healthcare industry. Failure to do so may lead to practices that contradict or even conflict with the industry’s core values and service models. Some statements may be deemed inappropriate and inconsistent with the principles governing the healthcare sector. For instance, claiming that “doctors will be unemployed in 30 years” is neither scientifically sound nor rigorous.


In fact, mobile internet technology does not need to replace physicians or cause them to lose their jobs; rather, it requires effective collaboration with physicians and hospitals. Thus, non-medical professionals working in the mobile internet healthcare services industry,The most critical aspect is to thoroughly grasp the unique attributes of the medical profession, while also understanding the characteristics of the healthcare industry.. The healthcare industry is the most unique among all sectors, primarily characterized by three key features. Hospitals are the only organizations in the world that simultaneously integrate capital intensity, technology intensity, and labor intensity. Therefore, for such an institution, having capital alone is insufficient, having technology alone is inadequate, and having personnel alone is not enough; it must be a comprehensive integration of these three core elements.


Furthermore, there must be a comprehensive understanding of the medical profession. What is the role of physicians? What lies at the core of healthcare? Many controversies in our society stem fundamentally from a lack of adequate, scientific understanding of healthcare. What exactly is healthcare? Healthcare is not synonymous with medical science. The most significant distinction between healthcare and medical science is that healthcare is an art of practice grounded in science. Consequently, many current online diagnosis and treatment systems mistakenly believe that establishing an expert database enables them to diagnose patients and replace physicians and hospitals. In reality,What can be replaced is medical knowledge; what cannot be replaced is practical clinical experience.


Therefore, a good physician must possess not only rich, systematic, and comprehensive medical scientific knowledge and skills, but also unique practical experience honed through decades of clinical practice. Thus, a good physician is both a scientist and an artist. A crucial aspect of our mobile internet services isClarify what you can replace doctors with, what you cannot replace, and what you can cooperate with doctors on.. We can categorize the clinical services provided by medical experts into standardized service time, which can be substituted by others, and personalized service time, which is unique to the expert and cannot be replaced.


Only in this way can we leverage the advantages of mobile internet—a high-tech innovation—to facilitate public access to medical care, making the healthcare experience more comfortable, efficient, and convenient. This approach better demonstrates the value of physicians, enhances their effectiveness, and enables them to address the needs of a larger population. Simultaneously, it allows for greater realization of the professional value of medical experts. Consequently, doctors will be more willing to collaborate with professionals from other sectors to deliver mobile internet-based healthcare services. A critical success factor is the close collaboration between experts from both the medical and technological fields; only through such integrated cooperation can the industry thrive, avoiding any disconnect between clinical practice and technology implementation.


Mobile Internet Healthcare Is Not Equal to “Internet + Healthcare”


Regarding the first major issue, I would like to address the third point: mobile internet healthcare is not synonymous with “Internet Plus” healthcare. The industry cannot be successfully developed simply by combining individuals from medical backgrounds with those from the internet sector. It requires physicians to learn and understand new technologies, concepts, and methodologies of the internet, while professionals in the mobile internet industry must also study, learn, and research the unique characteristics of physicians and the healthcare sector. Only by leveraging this synergy to achieve an effect greater than the sum of its parts can mobile internet healthcare services be delivered effectively. I believe the most critical factor is for all stakeholders to conduct thorough and serious research.The Four Quadrants of the Healthcare Industry


mmexport1449153194545


To facilitate a comprehensive understanding of the mobile internet healthcare services industry, we provide an analytical framework based on a two-dimensional coordinate system. The vertical axis represents the cost of personalized customization in healthcare services, rated on a scale from 0 to 10. The horizontal axis indicates the technological complexity of healthcare services, also rated on a scale from 0 to 10. A score of 5 serves as the dividing line for both axes.


In this way, we can divide the chart into four quadrants. The first quadrant, located in the upper-right corner, represents the highest level of personalization and customization (scoring 5 to 10) as well as the highest degree of technical complexity (also scoring 5 to 10). This quadrant is typically where medical experts leverage their unique and specialized expertise to make their impact.


The second quadrant is located in the bottom-right corner of our chart, indicating a personalization level ranging from 0 to 5, which signifies low customization and, consequently, high standardization. However, its technical complexity scores between 5 and 10, reflecting high technological sophistication. Thus, the second quadrant represents a domain characterized by high technical complexity and high standardization, but low customization. This sector tends to be prioritized during the industrialized production phase, with numerous such examples already emerging during the era of mass industrial production.


In other words, in the era of mobile internet, new business models will emerge in Quadrant II, which is characterized by high technological complexity and a high degree of standardization. For instance, third-party clinical laboratories can be established in community shopping malls rather than within hospitals, representing another transformation brought about by the mobile internet era.


The third quadrant, located in the upper left, is characterized by a high degree of customization and low technical complexity. The fourth quadrant, situated in the lower left, features a low degree of customization (i.e., a high degree of standardization) and low technical complexity. In fact, the fourth quadrant has been thoroughly explored during the industrial era. Examples include fast food and the production of hospital consumables, which have already been well established.


The third quadrant is characterized by a high degree of personalization and low technical complexity. I believe this is the area where mobile internet healthcare services should make the most significant investments, given its low risk, broad audience reach, and alignment with the growing demand for personalized solutions in the mobile internet era. For instance, in the past, if I fell ill and needed laboratory tests at a hospital, I was required to fast and hold my first morning urine for testing, or even provide a stool sample, which was quite cumbersome. Now, in the age of mobile internet, these tests can be conducted entirely at home, allowing for self-testing in the bathroom right after waking up in the morning.


Currently, many third-party testing institutions abroad are integrating non-invasive and non-traumatic home-based tests with internet connectivity, while collaborating with physicians and hospitals. This represents an excellent entry point. Through this four-quadrant framework, we can clearly distinguish which aspects of mobile internet healthcare services can replace traditional physician- and hospital-delivered care, which must remain exclusively under their purview, and which require collaboration with hospitals and physicians. In this way, we have technically resolved the issue of delineation and clarified why the concept of “Healthcare + Internet + Mobile” places particular emphasis on “Mobile.”


Health Data Streams Will Generate Enormous Value


The most significant difference between the mobile internet era and the traditional internet lies in its mobility, which essentially pertains to the issue of flow. We are all familiar with logistics and human flow; China’s human flow is arguably the largest in the world, with the annual Spring Festival travel rush serving as a prime example. Today’s airports resemble train stations of the past, illustrating the consequences generated by the movement of human flow.


So the next step isInformation Flow, within the information flow, the circulation of health information data and the value generated during this process warrant particular attention. Since healthcare needs are constant, the defining characteristic of medical services in the mobile internet era is their focus on this data flow.


The value generated by big data, particularly in relation to healthcare and human health, represents our most significant resource and the next major goldmine to be tapped in mobile internet medical services.


This is our healthcare + internet + mobile.The core focus should be on issues related to mobility.Due to time constraints, I cannot elaborate on this issue in detail here. I will share a post with you later, which is the keynote speech I delivered at the Tsinghua University Medical and Health Big Data Forum on January 16th this year. You can review it for more details. Now, let’s move on to discuss the second question.


——————Hospitals + Clinics + Physician Groups——————


The second issue concerns the “Hospital + Clinic + Physician Group” model. Hospitals and clinics are familiar concepts, serving as the primary healthcare settings for the Chinese public. In contrast, physician groups are a relatively new phenomenon in China, having emerged only in the past one to two years. While this concept is novel domestically, it is well-established internationally. In other developed Western countries, physician groups have long existed as organizational structures for medical practice, functioning as key entities that provide healthcare services and facilitate patient access to medical care.


The Role of Physician Groups


I personally strongly support and advocate for the development of physician groups. Although they are still in their infancy in China and many new challenges have emerged, they will undoubtedly become a significant trend in the future. A greater variety of physician group models will emerge, working alongside traditional hospitals and private physician clinics to form a comprehensive, scientifically structured, and mutually supportive professional system of healthcare institutions and practitioners.


The greatest advantage of physician groups isTransformed the rigid institutional and operational mechanisms of China’s current healthcare service providers. The value and role of physician groups, I have summarized into three major functions:Liberating, Developing, and Optimizing Productive Forces


Liberating Productivity


First, unleashing productivity means liberating physicians from the rigid, planned-economy framework of traditional public hospitals. Cultivating a competent physician is exceptionally challenging; yet, if they practice solely within a single public hospital, their full potential and value cannot be realized. For instance, Professor Gu Chengxiong from Anzhen Hospital is a top-tier expert in coronary artery bypass grafting (CABG) in China. However, he performs no more than 300 surgeries per year at Anzhen Hospital, whereas his capacity could allow for 600 to even 900 procedures. Without alternative practice models, this represents a significant waste of human resources.


With the implementation of multi-site practice for physicians, we can potentially add another one to two hundred cases through their second and third professional engagements. However, multi-site practice is not the optimal system; the ideal model is independent practice for physicians. Historically, physicians are members of society who should be legally authorized to practice medicine wherever they go. Their medical license should not be displayed on the walls of hospitals or clinics, but rather metaphorically "affixed to their foreheads." Only by establishing such a social management system can we maximize the value of physicians. The emergence of physician groups has broken through the constraints of the old system, liberating physicians, particularly senior specialists.


This is the first value, known as liberating productivity.


Developing Productive Forces


With the proliferation of physician groups, we will see a rise in privately run medical institutions, bolstered by greater support from emerging healthcare professionals. This is because the primary obstacle facing China’s private healthcare sector has been a shortage of human resources. Many physicians have been unable to practice in private hospitals or other non-public medical institutions. However, with the advent of physician groups, these entities will increasingly enter into contractual agreements with hospitals—not only public hospitals but, more significantly, private ones. In the future, Public-Private Partnership (PPP) models will become a highly prevalent framework for such collaborations. Consequently, privately run medical institutions will no longer need to worry about physician shortages, as physician groups will serve as their strong backing.


Optimize Productivity


Third, why can physician groups optimize productivity? Why establish the Zhang Qiang Physician Group and various other physician groups? Because this model must generate greater social value than previous forms to demonstrate its validity and alignment with development trends. It must achieve a synergistic effect where the whole is greater than the sum of its parts, which is precisely what the organizational structure of a physician group aims to accomplish.Production efficiency must be significantly improved., which is the very value proposition of physician groups.


Where Does the Productivity Optimization of Physician Groups Manifest?I believe it breaks through the rigid systems inherent in traditional hospitals and the small-scale, private clinic model rooted in a subsistence economy. While both of these legacy models have their merits, they also have their own shortcomings. Physician groups serve as a connecting link that bridges these two organizational structures. They leverage the flexibility of independent practice characteristic of general practitioners and TCM physicians operating in clinic settings, while also harnessing the collaborative, team-based, and intensive production mode seen in specialized hospital groups. After all, no matter how skilled a physician is, they cannot complete medical procedures without the support of anesthesiologists and ICU nurses.


What Is the Value of Physician Groups?


Some physician groups have secured investment and are building their own hospitals and clinics. But is this truly viable? It’s not that it can’t be done; however, that does not represent the greatest value of a physician group. The greatest value of a physician group—keep this in mind—is calledAsset-Light Business Model, which means that your most valuable assets are the doctors' own experience and knowledge, making you an institution formed by knowledge capitalists.


In other words, as a physician group, it is essential to clearly understand your unique strengths and distinctive advantages, as well as your shortcomings. Therefore, physician groups can neither replace hospitals nor substitute for private practices; they are undoubtedlyPhysician groups must connect with hospitals on one hand and private clinics on the other.. This also includes general practitioners and traditional Chinese medicine clinics, which are government-run and public. Moreover, physician groups must clearly understand the benefits they offer to these two types of institutions and their distinct competitive advantages in order to operate successfully.


We must keep in mind the three major characteristics of healthcare service institutions: capital-intensive, technology-intensive, and labor-intensive. Therefore, services must be,Knowledge + Capitala primary framework structure. From the perspective of privately-run healthcare, capital is not scarce, but knowledge-based capital is. This knowledge-based capital includes both experts with extensive clinical experience and those well-versed in the management, operation, and administration of medical services—what we refer to as experts in hospital professionalization. Therefore, the three core elements of a hospital are technology, service, and management, all of which are indispensable. Currently, the dissatisfaction with our public hospitals stems from their low levels of service, technology, and management.


Why Do the Challenges of Healthcare Reform Emerge in Public Hospitals? The Biggest Problem Facing Public Hospitals Today, Which I Summarize asFirst-rate technology, second-rate service, third-rate managementThe key constraint on the development of China’s healthcare industry lies in the outdated management systems and operational mechanisms of public hospitals. Therefore, our physician groups must outperform both public hospitals and private clinics in terms of management and service quality to demonstrate their value. The greatest asset of a physician group is its intellectual capital—namely, its expertise in clinical technology and management. Hence, we must innovate in these areas and absolutely avoid replicating obsolete management systems, operational mechanisms, and service models from the past.Therefore, I believe that the reform and innovation of healthcare services must be an integrated approach encompassing three major innovations: the system, the mechanisms, and the service model, rather than focusing solely on technology., especially regarding our current approaches to medical service delivery and management standards, we must address these gaps.


Accelerate the Development of Private Healthcare


One final point regarding the second-to-last major issue: whenever we speak of private healthcare provision, we tend to focus exclusively on establishing hospitals, which is a misconception. Private healthcare provision should not only be reflected in the establishment of hospitals but also in clinics, and even more importantly, in new types of physician groups that leverage mobile internet platforms as their foundational infrastructure.


From the perspective of China’s overall medical service landscape, public hospitals provide more than 90% of all medical services, whether in outpatient care or inpatient surgeries, while privately run medical institutions account for less than 10%. Therefore, some leaders and experts have boldly predicted that by 2020, the share of privately run medical institutions should reach 20%. In my view, this target is far from sufficient; the proportion is too low. We should accelerate our efforts to strive for a share of 50% or even over 60%.


Because, whether viewed from the perspective of the contemporary world or through the lens of history, medical services provided by private healthcare institutions account for more than 60% of overall healthcare services. Taking Taiwan, China, as an example, the share of private healthcare in Taiwan exceeds 80% of total medical services. This means that the key to the next stage of China’s healthcare reform lies in strengthening the development of private healthcare. Of course,It is not only about establishing for-profit specialized hospitals, but also about developing general practice clinics offering both Western and traditional Chinese medicine., as well as various forms of physician groups. Only when these three business models form a tripartite balance can they constitute a modern healthcare service structure, compensating for the rigid medical services provided solely by public hospitals.


——————Pre-hospital + In-hospital + Post-hospital——————


Shifting Public Needs: Disease Prevention Becomes Increasingly Important


The third major issue concerns future medical services. I would like to emphasize that doctors, hospitals, and all professionals engaged in the internet healthcare industry should not focus solely on in-hospital care. It is a common misconception that mobile internet healthcare services primarily address the difficulty of accessing medical care; this view is incorrect. With social development and progress, the public’s demands for medical care, physicians, and hospitals have long since evolved. During the era of the planned economy, when living standards were relatively low, the public’s expectation of doctors and hospitals was simply to save lives and heal the wounded. Consequently, people only thought of doctors and hospitals when facing life-threatening conditions. Thus, the mission of healthcare at that time was strictly centered on emergency lifesaving and trauma care.


Since the reform and opening-up, the Chinese people have become more affluent, leading to a demand for high-quality medical care and pharmaceuticals. When falling ill, patients seek out the best doctors and hospitals in China, sparing no expense. This has given rise to robust, high-end healthcare demands. Currently, many citizens travel abroad for medical treatment, prompting the emergence of numerous companies catering to this need—this constitutes the second stage. In the third stage, the Chinese public’s higher-level aspiration is to avoid illness, reduce its frequency, delay its onset, and prevent severe diseases. This is because health represents both the most fundamental and the ultimate highest-level human need, as everyone wishes to live a long and healthy life.


Therefore, large hospitals and prominent physicians are locked in fierce competition within the "red ocean" of complex, rare, and critical conditions, vying for a share of the government’s limited healthcare insurance funds. Meanwhile, at the other end, the strong and rigid demand from the general public for longevity, reduced suffering, disease prevention, fewer illnesses, delayed onset of disease, and avoidance of severe illnesses remains unmet. If hospitals and doctors do not address this need, who will? Zhang Wuben stepped in to fill this gap. Thus, the prevalence of Zhang Wuben in China should not be blamed on the public's ignorance, but rather on professionals in our healthcare service industry. Therefore, during the 14 years since my return to China, I have advocated that our doctors and hospitals should not only apply their medical knowledge and skills to treat diseases but also prioritize disease prevention.Medical knowledge can both treat and prevent diseases.


Transforming Healthcare Models: Cultivating Potential Users in the Pre-Hospital Setting


In particular, as the disease spectrum shifts, our healthcare service models must also evolve. In the past, patients predominantly suffered from acute and severe conditions; a single course of treatment often led to recovery, while failure to respond typically resulted in mortality. Today, however, the majority of cases involve chronic diseases, which are often lifelong conditions that cannot be completely cured. Consequently, chronic diseases require continuous management. For this reason, I have been advocating that hospitals assume responsibility for the post-discharge care of chronic disease patients, providing them with ongoing medical services. This approach not only helps alleviate the difficulty of accessing healthcare but also consolidates the therapeutic outcomes achieved during hospitalization. Otherwise, if hospitals simply discharge patients after treatment without follow-up—remaining unaware of medication adherence or its effectiveness until relapse occurs—the practice is clearly unreasonable.


Therefore, we observe that many patients across various hospitals experience second or even third strokes. This is related not only to the patients themselves but also to the healthcare service models of hospitals. Hence, we advocate that hospitals should first extend their in-hospital medical services to the post-discharge phase, managing chronic disease patients who have received treatment in the hospital to prevent recurrence. We refer to this service model asDisease Management Model


Furthermore, physicians in our hospital should not wait for patients to develop overt disease before initiating treatment. For instance, once diabetes is diagnosed, the condition is typically lifelong. Prior to the onset of diabetes, patients undergo a prolonged pathological process, with a phase of rapid progression occurring near the clinical threshold. Intervention during this critical window yields the greatest therapeutic benefit, and current medical laboratory testing capabilities are fully adequate to support such early detection and intervention.


Therefore, our hospital must not only provide treatment services for diabetes but also offer medical services for diabetes prevention. Through health screenings and physical examinations, we can identify individuals at high risk for diabetes and manage them proactively, thereby preventing the onset of the disease. As diabetes is often referred to as a lifestyle-related disease, it is entirely possible, using current methods and approaches, to prevent high-risk individuals from developing diabetes or to delay its onset. We refer to this service asHealth Management Services, thereby extending the passive, fragmented medical services currently offered within the hospital to both ends of the care continuum: one end focuses on pre-hospital health management services, while the other emphasizes post-discharge disease management services. Post-discharge disease management serves to cultivate loyal users, whereas pre-hospital health management aims to identify and secure target customers in advance, nurturing potential clients.


Internet Healthcare Must Collaborate with Hospitals to Deliver Integrated Services


By integrating pre-hospital health management services, in-hospital diagnostic and therapeutic services, and post-hospital disease management services, we provide the general public with a seamless, continuous healthcare system that offers lifelong health protection—from womb to tomb. This constitutes a true medical service system aligned with the needs of the modern population, fulfilling integrated medical care across three distinct levels.Once an integrated healthcare service system spanning pre-hospital, in-hospital, and post-hospital care is recognized, a retrospective look at the internet and mobile technologies reveals that mobile internet is an indispensable tool and method for all physicians and hospitals.


Furthermore, for non-medical professionals engaged in mobile internet healthcare services, recognizing this issue reveals a vast blue ocean—or untapped frontier—yet to be explored. There is no need to engage in cutthroat competition with hospitals for business, nor is it necessary to vie for market share through so-called appointment registration services. Instead, you will find that it is entirely feasible to collaborate with hospital physicians to deliver an integrated service spanning pre-hospital, in-hospital, and post-hospital care. This represents the most promising future for the healthcare industry.


——————Q&A Highlights——————


1. Professor Zhou, how do you view the issue of overtreatment, and how can physician groups address this problem?


Zhou Shenglai: Overtreatment is a critical issue that urgently requires governance, but relying solely on physician groups is insufficient. While physician groups may perform better than public hospitals in curbing overtreatment—since they prioritize patient and family satisfaction and reputation rather than leveraging institutional dominance or exploiting their market position—they are not a panacea. Addressing overtreatment fundamentally depends on the national health insurance system, as demonstrated by successful models in advanced countries worldwide. Therefore, I believe overtreatment is not an incurable ailment; it is entirely solvable and can be managed effectively.


2. In the context of the internet, a new cohort of renowned physicians has emerged. They enjoy high reputations on platforms such as Weibo, WeChat, and Haodf.com, yet they hold neither senior professional titles nor significant academic standing at their primary practice institutions. How should we interpret their career development? Do they represent a future trend in the medical profession?


Zhou Shenglai: This is actually understandable. Those who have truly made up their minds to leave are physicians who believe they possess significant capabilities but cannot fully realize their value within the current system. In contrast, experts who are thriving within the existing framework are reluctant to give up the benefits it affords them in order to embark on new entrepreneurial ventures. Therefore, this point should be understood by all. Furthermore, what defines a “good doctor”? No one is born a good doctor; every seasoned physician has started out as a junior or young doctor. Thus, the public should view these physicians who have left the traditional system with a balanced and fair perspective.


Both Dr. Yu Ying and Dr. Zhang Qiang serve as excellent examples. During her tenure at Peking Union Medical College Hospital, Dr. Yu Ying’s talents were not fully visible; yet she is, in fact, a highly thoughtful and capable individual. It was only when China’s current social and institutional mechanisms provided her with a better platform that her true value could be realized. Similarly, despite his extensive experience working at Shanghai Oriental Hospital and Zhejiang Sir Run Run Shaw Hospital, Dr. Zhang Qiang was unable to fully achieve his professional aspirations. However, the Zhang Qiang Doctor Group has enabled him to unleash 100% of his potential and value. This, I believe, underscores the inherent value of physician groups.


3. Professor Zhou, what impacts do you believe physicians’ multi-site practice will have on hospitals?


Zhou Shenglai: The practice of physicians holding multiple practicing licenses does indeed pose a challenge to hospitals. Both hospital presidents and department heads are accustomed to managing staff as traditional institutional employees and are not yet familiar with collaborating with experts outside the established system. In the future, hospital physicians will inevitably be categorized into two groups: full-time physicians and part-time physicians. This includes not only those whose personnel files are managed by the hospital but also contractual physician-experts. Currently, hospitals already employ contractual staff, primarily nurses and junior physicians. The future trend will see leading specialists also collaborating with hospitals through contractual arrangements.


In my view, neither hospital presidents nor hospitals should stand in the way of physicians practicing at multiple sites or engaging in independent practice. As society advances, hospitals will inevitably adapt their management models to accommodate full-time physicians, contracted doctors, and collaborating experts alike. I believe hospital presidents are generally reasonable and understanding, as many leaders of major hospitals are themselves medical experts. Therefore, on December 12 this year, at the annual conference of the Disease Health Management Professional Committee of the Harbin Industry Association, we will bring together 100 presidents from Grade A tertiary hospitals across 100 cities to form the “Health Knowledge Capitalists Entrepreneurship and Innovation Mentor Group.” One of our key objectives is to support physician-led entrepreneurship and innovation, thereby driving an overall increase in productivity.

▶VCBeat Medical Innovation: Dean's Perspectives Series