Dr. Smile Medical Group Files IPO Prospectus: Visionary Insights from Founder Dr. Qiang Zhang on the Future of Physician-Led Healthcare

Which doctors can join the Zhang Qiang Doctor Group?

How Do Physician Groups Handle Medical Disputes?

Pros and Cons of Physician Groups vs. “Flying Knife” Surgeons?

What Kind of Doctors Can Be Called “New Famous Doctors”?

Does Professional Title Significantly Impact Physicians in Physician Groups?

What Are the Advantages of Physicians Starting Their Own Businesses?

Which Doctors Are Suited to Leave the Public Healthcare System?

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Dr. Zhang Qiang Gives You the Answer

Friends who have participated in our VB group activities know that we rely on our assistant bot to engage more groups and members. During Dr. Zhang Qiang’s sharing session on Wednesday, we reminded him that the assistant was going offline, prompting him to reluctantly conclude the Q&A segment.

He also mentioned to us how much he enjoyed chatting with the group members, noting that the time flew by unnoticed and that he would be more than happy to continue the conversation for another three hours. Sunny and approachable—these are traits well known to those familiar with Dr. Zhang Qiang. After reading his extensive ten-thousand-character response below, you will genuinely feel his sincerity.

Q&A Highlights

1. There are now many physician groups within the public healthcare system. What is your view on their development?

Zhang Qiang:Currently, many physician groups are affiliated with public healthcare institutions. Physician colleagues are encouraged to explore these opportunities. Although hospital directors may issue numerous warnings, the existence of national policies indicates that such endeavors are permissible to pursue.

It is not recommended to prolong the trial period., as it is difficult to balance the interests of multi-site practice institutions and the original employer over an extended period, and challenging to allocate time among family, the original employer, and multi-site practice institutions. Therefore, physician groups within the public healthcare system face certain bottlenecks. If initial trials prove promising, physicians should transition to independent private practice as soon as possible.

2. Which doctors are eligible to join the Zhang Qiang Doctor Group? What requirements must be met?

Zhang Qiang:I believe that ordinary physicians generally need to meet four basic criteria; otherwise, they will face significant challenges and be highly prone to failure after leaving the public healthcare system.

First and foremost,It is best to have proprietary technologies.In other words, after leaving the public healthcare system, physicians must carefully consider why patients would choose them over their former colleagues. Therefore, they must possess superior clinical expertise and adhere to the high-quality, standardized treatment protocols of international hospitals to instill a greater sense of security in patients and thereby secure their viability in the market.

The second point isA Reasonable Value SystemFor instance, before leaving the public healthcare system, I served as a department director with a respectable income and stable resources, never worrying about a shortage of patients. However, driven by different professional aspirations, I resolutely chose to leave the system. If you aspire to be a physician who purely safeguards patients’ interests and wishes to earn your rightful income openly and transparently, you may consider stepping outside the public system to pursue such opportunities.

The third point isWe aim to provide patients with the most optimal treatment model,This is also a matter of values; only with the genuine intention to serve patients can one truly transcend the constraints of the system and achieve excellence. Everyone is encouraged to engage in deeper reflection on this point.

Fourth PointLearning ability. For example, when I first left the public sector, I felt highly competent, yet in reality there was a vast amount to learn; without strong learning abilities, it would be difficult to keep pace.

3. What is the biggest challenge currently facing physician groups? Where does patient acquisition rank?

Zhang Qiang:The first challenge stems from patients: how can they trust a physician team that is not affiliated with a hospital? The second issue is the lack of medical insurance coverage; in scenarios where patients must pay entirely out-of-pocket, our fees are even higher than those of public hospitals. Thirdly, many peers within the public healthcare system may misunderstand physician groups due to institutional barriers, leading to opposition or even defamation, which has severely negative repercussions. Therefore, holding this position requires physicians to possess strong mental resilience and firm convictions.

4. Top-tier healthcare comes at a significant cost. As healthcare is a public good, how do you balance the maximization of benefits for the broader patient population while realizing the value of yourself or your team? After all, achieving the latter embodies the compassionate spirit of the medical profession.

Zhang Qiang:“Whether physician groups can serve the general public in the future remains to be seen. From the perspective of current survival, we are certainly dissatisfied with the existing pricing system. If we participate in the national health insurance scheme, we risk reverting to the outdated model of subsidizing medical services through drug markups, which is neither our intention nor the goal we pursued by leaving the public healthcare system. Therefore, after establishing our independent practice, we decided to build a new value system that ensures fair compensation for physicians’ professional labor.”If we do so, we will unconsciously align ourselves with high-end healthcare. In fact, what we provide is not high-end healthcare, but rather quality healthcare as we understand it.

Over the past two years of observation, we have found thatThe general public has a very strong demand for high-quality medical care.What should we do? If we blindly cut costs to provide cheap medical care, we may end up with substandard or excessive treatment. So how can we reduce costs to make high-quality healthcare accessible to the general public? First, when our physician groups reach a certain scale, we need to standardize processes. Once these standardized procedures are widely implemented, our costs will inevitably decrease, allowing ordinary people to benefit from high-quality medical care.

Furthermore, it is crucial to understand that the high-quality medical care we provide is merely standard practice in Europe and the United States. The so-called "premium" level is not actually elevated; the medical services enjoyed by our high-spending patients are equivalent to those received by ordinary patients in Western countries.

Therefore, what we currently refer to as high-end or premium healthcare will become ordinary healthcare in ten years. Once you experience this process, you will realize that this is how medical care should be delivered; it is, in fact, the most basic requirement. Patients should always be able to schedule appointments with specialists, receive clear guidance at every step of the journey, and enjoy a seamless experience. Additionally, post-visit customer service should be available, with access to the medical team 24/7. This gives patients great peace of mind. In reality, this is simply what basic healthcare ought to look like.

So I think"We are not providing premium or high-end healthcare; we are simply delivering the standard of care that will be commonplace in ten years."However, implementing this process is not easy.

5. Is the physician group considering entering the insurance sector?

Zhang Qiang:When we reach a certain scale in the future, our physician group will also engage as an entity in insurance or evolve into a membership-based model, thereby gradually reducing the burden of medical service costs for patients. In fact, we continue to adhere to the slogan previously established,Ensuring universal access to high-quality healthcare is one of our long-term goals.If this journey were a marathon, we may have only covered one kilometer, but our direction will remain unchanged.

6. How should physician groups address medical disputes? How can physicians feel a sense of security within a physician group?

Zhang Qiang:How does our physician group currently handle medical disputes? There is one point that everyone needs to understand: when high-quality medical care is provided to patients, medical disputes are rare. We perform over 1,000 procedures annually, and to date, we have not encountered a single medical dispute.When you can spend twenty minutes carefully understanding the patient and have ample time to assess their psychological state, you will find that communication with the patient is actually very smooth.From this perspective, we are actually safer than public hospitals.

On the other hand, there is medical liability insurance."In the past, when issues arose with patients, physicians might have lacked adequate protection. Now, all our doctors carry multiple malpractice insurance policies; should any incident occur, legal and insurance support intervenes immediately, alleviating most of their concerns. Furthermore, regarding practice models, adopting a patient-centric approach significantly reduces the likelihood of medical disputes. From my personal perspective, I often felt anxious while working at public hospitals, but now I find the practice environment much more relaxed and secure."

7. Are all members of the physician team required to be experts in their respective fields? Is there a need for junior physicians?

Zhang Qiang:Currently, our physician group not only recruits senior physicians but also junior physicians; however,We tend to prefer physicians with clinical experience., this is our target physician demographic. Since physician groups currently lack a robust training system, we aim for the physicians recruited now to serve as mentors for future entrants. For physicians who have not yet transitioned out of the public healthcare system, joining a physician group will still require a period of exploration and adaptation; therefore, the experience gained by early participants is of critical importance to those who follow.

In addition, China has restrictions on professional titles for multi-site practice, so in principle,We do not accept physicians below the rank of attending physician.However, with future policy changes, all of these possibilities remain open.We are also highly willing to participate in China's medical education system.

8. What is your perspective on the career development of physicians working within China’s public healthcare system?

Zhang Qiang:The emergence of physician groups within the public healthcare system signifies the awakening of independent consciousness among Chinese doctors. From a positive perspective, it has galvanized physicians to take greater initiative in their medical practice and actively participate in healthcare reform. However, these groups face a bottleneck: as long as their contractual relationships with their original employing institutions remain unchanged, any additional activities undertaken by doctors appear to operate in a legal gray area.From the perspective of a hospital director, it would be quite difficult to gain his support for multi-site practice without an administrative mandate.

Currently, physician groups within China’s public healthcare system are a product of the country’s unique domestic environment. In contrast, physician groups abroad are typically composed of freelance physicians. At present, many Chinese doctors lack either the capability or the courage to leave the public system. Of course, in this immature environment, physicians can use this intra-system model as a way to test the waters. For example,, some of our professors are highly renowned within the public healthcare system and have an endless stream of patients; however, once they leave the system, they discover that their personal brand is remarkably fragile.In other words, while you are within the system, your brand is conferred by the institution; once you leave, you have nothing, and at that point, you will gain a completely new understanding of yourself.

Therefore, I believe that the existence of physician groups within the public healthcare system represents a courageous first step. Subsequently, they will encounter bottlenecks and must strive to devise various strategies to overcome them. This may include some physicians leaving the public system entirely to sever ties with their original institutions, thereby allowing them to pursue their ventures without constraint. Such developments are highly likely to occur.If physician groups seek market recognition or substantial growth, they should completely disengage from the public healthcare system and transition into fully independent freelance practitioners., once this mechanism is established, a new contractual relationship between the physician group and their original institution may be formed.

9. What is your perspective on the comparative advantages and disadvantages of physician groups versus “flying knife” surgeons?

Zhang Qiang:I used to be a "flying knife" doctor, practicing for over a decade. Although it was financially rewarding, it was extremely demanding. The differences between physician groups and "flying knife" practices are as follows:, the first is that "flying knife" surgeries are incidental in nature,Surgeons often travel to wherever their expertise is needed, which means that these visiting surgeons do not have close contact with the host hospital or its operating room staff, posing potential safety risks.

"Currently, physician groups sign contracts with designated hospitals. Each of our physicians works with a dedicated support team, creating such seamless integration that patients generally cannot distinguish between the two entities, reflecting a high degree of operational synergy."

The second difference lies primarily in the sources of revenue,"Red envelopes" are often inseparable from the practice of "flying knife" surgeries, serving as the primary source of income for these visiting surgeons and typically paid in cash.There are two issues at play here: one is that the income is "gray" (undeclared), and the other is the inability to pay taxes, which consequently affects physicians’ self-protection. Currently, the revenue of physician groups does not come directly from patients; the income of physicians within these groups is open and transparent, and we also ensure reasonable tax compliance.

The third difference isAfter performing surgery, visiting surgeons return to their home institutions and are often too busy to manage patients’ postoperative care., if postoperative complications arise, it is difficult for visiting surgeons to return and manage the situation. In contrast, each specialist in our physician group is supported by a dedicated team comprising relevant physicians and specialist assistants. These assistants monitor patients’ conditions around the clock, ensuring that postoperative patients can contact the relevant specialists at any time and from anywhere.

10. Based on your introduction, the focus still leans more toward low-risk surgical specialties. For high-risk surgical specialties, would physician groups operating under an asset-light model consider large-scale participation?

 Zhang Qiang:My recommendation is that, given the current immaturity of relevant laws and regulations, physician groups must exercise caution when selecting high-risk conditions for treatment. It is more appropriate to focus on common diseases and conditions requiring advanced technical expertise, as survival is the primary objective. Secondly, once private hospitals upgrade their hardware facilities and insurance reimbursement mechanisms improve, we will also undertake complex surgical procedures. Therefore, while there are no inherent bottlenecks, prudence remains essential.

11. Dr. Zhang Qiang, the VCBeat Doctor WeChat official account has recently introduced a term called “New Famous Doctors,” referring to physicians who have gained prominence in the mobile internet era. These doctors may not have strong academic credentials or hold high positions within their own institutions, yet they are highly renowned on certain online platforms. What is your perspective on these physicians? Will they significantly impact the entire healthcare industry or reshape public perception of medical services?

 Zhang Qiang:In the internet era, a new cohort of renowned physicians has indeed emerged, including myself, who have leveraged the power of the internet to some extent. However, one point warrants reminder: for teams of independently practicing physicians in this new era,A Physician’s Technical Proficiency Is Their Core Competitiveness, without a technological edge, relying solely on services or internet-based dissemination will not sustain long-term growth, nor can it indefinitely expand brand influence. In this regard, online and offline efforts should advance in tandem.

I have indeed developed new perspectives on what constitutes a renowned physician. In the past, such physicians were often evaluated by their ability to perform “flying knife” procedures (i.e., traveling to other institutions for complex surgeries), which garnered them widespread popularity and esteem, as well as admiration from peers and students. This was the conventional hallmark of a renowned physician in earlier times.

However, I believe that future renowned physicians will certainly be required to meet the following criteria:Exemplary technical expertise, lawful income, dignified practice, tax compliance in accordance with the law, and active participation in charitable activities, among others., I believe this is an obligation that renowned physicians should fulfill. Meanwhile, I hold that renowned physicians should devote part of their energy to healthcare reform, thereby fostering positive momentum. In summary, in addition to possessing advanced technical expertise, future renowned physicians should assume greater social responsibility.

12. Are there competitive and promotion mechanisms within physician groups? Do physicians with lower professional titles have opportunities for career development within these groups?

Zhang Qiang:Many people, including numerous physicians, have been inquiring about professional promotion. They believe that advancing from the associate senior title to the full senior title will lead to better career prospects.

What I want to tell everyone is,The rules of the game differ between the public and private sectors.When patients seek care at public hospitals, they are presented with a wide array of physicians to choose from. In the absence of detailed information, they often rely on professional titles as a proxy for clinical competence. However, in the private sector, professional titles carry less weight. Within physician groups, emphasis is placed squarely on technical expertise and service attitude. Consequently, patient reputation becomes paramount, rather than a sole focus on a physician’s credentials.

I myself am an example,It has been 10 years since I attained the title of Chief Physician, but after leaving the public healthcare system, this title did not bring me many patients., and my patient base has been built primarily by delivering high-quality care step by step and through word-of-mouth referrals, with little correlation to my professional title.

13. Will physician groups face the challenge of fragmented efforts and diminished effectiveness? What do you believe is the most critical priority for physician groups?

Zhang Qiang: Regarding the issue of physician groups being stretched thin by pursuing multiple objectives, I believe that in the early stages, the focus should be on clinical practice to build a strong reputation, as this is the most critical factor. Our decision to decline RMB 50 million in financing was also driven by this consideration. Had we accepted the RMB 50 million to establish a surgical center, our current efforts would likely be consumed by facility renovation and licensing procedures, causing us to miss numerous market opportunities. Therefore, we adopted an asset-light model to first establish the brand of our physician group.Then, once a brand reaches a certain level of maturity, you will find that it can be directly extended into various sectors., including driving development in insurance, day surgery, and internet-based healthcare. Therefore, these initiatives will be handled by different teams in the future.

14. What are the advantages of physicians starting their own businesses, and what is the development direction for physician groups?

Zhang Qiang: In the United States, many hospitals originated as physician groups, including the Mayo Clinic. The predecessor of the Mayo Clinic was a physician group. When such groups reached a certain scale, some physicians would take the lead in establishing hospitals.The most typical example is that in the United States, 66% of investors in ambulatory surgery centers are physician groups, while hospital investments account for less than 10%., which means that the surgical centers invested in by physician teams are actually highly competitive in the market, as they have a deeper understanding of how to ensure patient safety and how to design surgical centers.

15. What is the biggest challenge for physician groups? Patients? Physicians? Policy?

Zhang Qiang:I believe the challenges mainly stem from several aspects,One is the patient's healthcare-seeking behavior,Of course, this habit is gradually improving. For instance, we had a patient who flew from Guangzhou to Shanghai for an outpatient consultation and then flew to Beijing for surgery, as he trusted only the physician; with air travel available, he felt that receiving care in any location was essentially the same.

Additionally, there are some misconceptions among peers; many of them fail to understand these emerging developments and believe that we are making substantial profits.In reality, we feel that we are blazing a trail for them; consequently, we sometimes experience profound loneliness due to being misunderstood, while also facing numerous policy restrictions and incomplete safeguards across various domains.

"Of course, I believe that none of this constitutes the greatest challenge,"The greatest challenge is our own lack of capabilities.In other words, transitioning from entrenched legacy mindsets to a corporate group structure governed by a joint-stock board of directors presents a significant challenge. Determining how to effectively lead and organize stakeholders within this framework constitutes a major difficulty. Therefore, I believe that learning agility is crucial; we have been engaged in continuous learning, which has naturally attracted considerable attention.

From the perspective of policy challenges, current policy trends are increasingly favorable to physician groups.This is because the medical services provided by our existing public healthcare system often fail to meet the needs of the general public, leading to pronounced doctor-patient conflicts. Dissatisfaction is evident among hospital administrators and government authorities alike, indicating that our current healthcare model is flawed and requires improvement. For physician groups, our value in this field lies in how we can reinvigorate physicians’ drive to serve patients. In this regard, our direction aligns with the broader reform efforts, so I am confident that policies will continue to improve.

16. How do you plan to integrate internet thinking?

Zhang Qiang: First, the internet is an important tool in this era, capable of reshaping the landscape of many traditional industries, and the healthcare industry is no exception., so we place great emphasis on the internet. However, as an online model, the internet sometimes conflicts with healthcare practices. For instance, in offline settings, patients often seek medical care far from home rather than nearby, whereas the internet aims to provide convenience. For example, many ordinary citizens prefer to seek medical treatment in Beijing and Shanghai; what they pursue is not convenience but higher-quality medical services.

However, we cannot leverage the internet to help patients match with nearby hospitals, as patients themselves lack trust in primary care institutions. Therefore, in this regard, the internet is unable to resolve the issue, soI believe the Internet can improve physicians’ work efficiency, but it is currently unable to change the existing healthcare environment.

Medical practice is highly localized. In this regard, physicians differ significantly from lawyers and teachers. For a physician to practice, various medical devices or fixed facilities are required. Can we leverage the Internet to develop a new model? This is an area currently being explored by many.

Our physician group places greater emphasis on internet-based mobility. We will not develop traditional Hospital Information Systems (HIS), as our physicians are contracted across multiple practice sites. Given that the future of medical practice involves a mobile and relatively dispersed workforce, we are actively developing mobile platforms. Currently, we leverage third-party platforms for storing patient medical records, such as Bingli Jia (Medical Record Folder), and we also utilize Haodf.com for doctor-patient interactions. At present, we operate our own WeChat backend and proprietary telemedicine platform. In the future, we intend to conduct high-intensity consultations exclusively on our own platform.

17. Patients often lack the ability to navigate medical guidance, leaving them to rely on introductions and the hospital’s reputation. How do you enhance the convenience and efficiency of doctor-patient matching in the operation of a physician group?

 Zhang Qiang: Any physician who leaves the public system to practice independently regards the quality and safety of patient care as being as vital as their own life.This aspect may differ from physicians employed within the public healthcare system, as a single misstep could jeopardize the entire brand. Therefore, physician groups maintain stringent self-discipline in this regard.

In addition to maintaining strict self-discipline and conducting rigorous patient examinations, physician groups must also establish their own standards, including those for diagnosis and treatment.If you review the standards of our physician group, you will find that most of them are unattainable for many Grade A tertiary hospitals.. It can even be said that our standards far exceed those of typical tertiary-affiliated hospitals. We are currently studying the U.S. standards for ambulatory surgery and preparing to incorporate our comprehensive services on that basis, so as to ensure patient safety to the greatest extent possible.

18. How to establish a virtuous cycle, rather than merely draining resources from existing public hospitals?

Zhang Qiang:First, I need to clarify one point:Our patient base does not conflict with that of public hospitals., we are by no means asking public hospitals or physicians to refer patients to us, because our target patient population is clearly defined—primarily those who are dissatisfied with the practices or services offered by traditional hospitals. Of course, most patients in public hospitals may not necessarily recognize the value of our physician group’s services at present; therefore, there is no conflict between the two sides, but rather a complementary relationship.

I believe the key to attracting patients lies in whether you can provide excellent service to your first patient."From my perspective, based on over two decades of medical practice, if you provide exceptional service to the first patient—exceeding even their own expectations—they will undoubtedly bring you three to five more patients. This creates a snowball effect. In today’s internet era, information spreads even faster. Moreover, some patients hold prominent social positions; if they receive outstanding care, many will willingly help promote your services, yielding even more pronounced results. Therefore, this represents a significant opportunity for our rapid growth."

19. Which Doctors Are Suited to Leave the Public Healthcare System?

Zhang Qiang: Which doctors are suited to leave the public healthcare system? I believe this cannot be generalized, as it depends on their individual personalities and future aspirations.If you prefer stability and a guaranteed income, you can remain within the public sector. However, if you are ambitious, confident in your abilities, and unwilling to rely on collective egalitarianism, you may choose to establish your own professional brand; thus, there are no strict restrictions. Nevertheless, as previously mentioned, achieving success requires meeting certain fundamental criteria, both technically and philosophically, because the environment during the early stages of independent practice is indeed less than ideal and presents significant challenges.

20. Will physician groups expand into other fields and evolve into general practitioner groups?

Zhang Qiang:In the early stages, we took a detour. At that time, we aimed to recruit experts from all medical departments in an attempt to capture the entire healthcare market. In hindsight, this approach was somewhat immature, which contributed to our subsequent decision to withdraw from fundraising negotiations, particularly considering the human resource investments involved in the funding round.

The healthcare market is vast, and each practitioner has their own area of expertise. Therefore, we aim to make these specific departments the best in China, while entrusting other departments to other physician groups. This is a reasonable approach.I believe that as physician groups in China reach a certain level of development, resource consolidation will inevitably occur., and the combined energy will be immense; I believe that day will surely come.

21. What is your perspective on the prospects for internal medicine physicians practicing independently? Is Zhang Qiang Doctor Group currently considering exploring services in the management of chronic internal medicine diseases?

Zhang Qiang:Freelancing is not an obstacle for internists either. When I first started out, many people said that as a surgeon, I was the least suited to go independent, because performing surgeries requires anesthesiologists, scrub nurses, medical assistants, and more—how could one person possibly manage all that?

Nevertheless, we eventually succeeded. As an internist, if he has a thorough understanding of his patients and formulates comprehensive and reasonable treatment plans, patients will be willing to pay even if his diagnostic fees are set quite high.The key still depends on whether doctors can provide services that patients perceive as offering value for money,It is certainly not feasible to continue seeing one patient every five minutes, as was done in the past.

22. It has recently come to light that some hospital directors have mentioned building personal brands for physicians through their hospitals. How do you perceive the differences between in-hospital and out-of-hospital efforts in personal brand building?

Zhang Qiang:How Should Physicians Build Their Personal Brands? Whether through public hospitals or individual efforts, both approaches are viable. In fact, many public hospitals are actively engaged in brand building for their physicians.For instance, in terms of brand influence, including some of our most renowned experts in the past, their growth and fame are inseparable from the hospital. Therefore, public hospitals have their own advantages in brand building.For instance, when reporting on public hospitals, the media typically do not discuss profitability, whereas coverage of private hospitals often does; this shift in tone alters the narrative.

Public hospitals tend to highlight department heads in their promotional efforts; even when surgeries are performed by junior physicians, credit is often given to the department head if the outcomes are favorable. The brand value of medical experts is largely derived from the hospital’s reputation. For instance, when specialists at Peking Union Medical College Hospital hold clinics, scalpers drive up the prices of appointment slots significantly.But when experts leave the hospital and practice at clinics opposite Peking Union Medical College Hospital, the price they can command for their consultation slots truly reflects their value., so the true brand is his personal influence, rather than relying on the hospital.

Some hospital directors consider building personal brands for physicians. These directors are commendable, as they take into account the feelings of doctors; if excessive emphasis is placed on the hospital’s brand,If a hospital focuses solely on building its brand while neglecting its physicians, it becomes a castle in the air. Given the varying quality of doctors within hospitals, cultivating individual physician brands enables patients to identify and access competent clinicians.

23. Will physician groups consider incorporating the medical insurance mechanism?

Zhang Qiang: Although the national health insurance system represents a highly irrational pricing structure, it commands the largest patient base. Consequently, hospitals with significant heavy-asset investments often prioritize securing health insurance accreditation and leveraging supply chain advantages to offset their shortcomings as a primary survival strategy. In contrast, physician groups, by departing from the public healthcare system, aim to transform their practice models and income structures.Therefore, in cases where medical insurance coverage is unreasonable, we will forgo it and shift toward a self-pay system.However, it is quite challenging for patients to opt for self-pay services. You need to possess proprietary technologies and a unique service system so that patients will refer others to you.

24. After the doctor comes out, are the available resources reduced?

(United Family Hospital Operating Room)

Zhang Qiang:In fact, once physicians form an independent group and reconnect with various resources, you will find that the resources at your disposal are actually more abundant. The photo above shows an operating room at United Family Hospital. This operating room is equipped with various intraoperative ultrasound systems, the da Vinci Surgical System, and other advanced devices, all of which are accessible to our physician group. Furthermore, if there is a specific piece of equipment you need but the physician group does not currently possess, you can seek out and contract with hospitals that have such equipment. Therefore, in a sense, the resource pool becomes even richer. Additionally, regarding inpatient care, although the physician group does not own its own hospital, the number of inpatient beds available can be expanded indefinitely until patient demand reaches saturation.

Taking the Zhang Qiang Doctor Group as an example, as a vascular surgery team, we have our own independent ultrasound facilities in nearly every hospital. Therefore, dedicated ultrasound equipment is available in our outpatient clinics, allowing us to perform examinations and procedures on-site for patients. Among our nine corporate institutions, three hospitals are equipped with hybrid operating rooms—commonly known as hybrid ORs—which house digital subtraction angiography (DSA) systems, including CT scanners. As a result, our vascular team now has access to three hybrid operating rooms, meaning we possess significantly more resources compared to when we operated merely as a traditional department.

25. It is reported that Xu Jiayin of Evergrande is collaborating with Brigham and Women’s Hospital of Harvard University to establish hospitals in China. Dr. Zhang, do you believe that if Evergrande were to fully adopt the Brigham and Women’s Hospital model for hospital construction, patient services would be improved? Furthermore, given physician turnover within physician groups, is patient management less rigorous?

Zhang Qiang:Many large enterprises are currently seeking partnerships with Harvard and Mayo Clinic. However, I believe the timing is not yet ripe, as we lack a solid foundation. It is difficult to engage with institutions like Mayo Clinic and Harvard when basic prerequisites are not in place. Even if Mayo Clinic were to establish a clinic in China, success would be challenging to achieve because healthcare has strong local characteristics and is closely tied to lifestyle and communication habits. Therefore, while we can learn from the philosophies of Mayo Clinic and Harvard, we should not simply copy foreign models, as this would hinder sustainable progress.

This model also presents a new challenge for contemporary hospitals: how to transition from a platform that directly serves patients to one that supports physician teams. Within this support-oriented environment, physician teams can focus on delivering patient care. Ultimately, this framework should optimize the management of serious illnesses, where all outcomes and feedback directly shape physicians’ professional reputations and determine their income.

U.S. physician teams have an advantage: in addition to meeting the demand for medical services, they receive corresponding support in negotiation, finance, and legal matters. Another important aspect is that physicians form collaborative groups; if one physician goes on vacation, another will cover their responsibilities. Our physician group operates on the same principle: if there is a vacancy, other physicians will step in to cover the workload. This is the key advantage of a physician group.

In the United States, most physicians are not hospital employees; they operate as independent practitioners or join physician groups. However, there is a clear trend: following the implementation of the Affordable Care Act under President Obama, rising operational costs have led to a gradual decline in independent practice, with more physicians increasingly joining physician groups or becoming hospital employees.

Nevertheless, many countries abroad still adopt the physician group model, with hospitals serving merely as platforms. Of course, there are exceptions; for instance, the Mayo Clinic primarily employs physicians directly, yet some renowned specialists also maintain affiliations with physician groups. In China, however, a key challenge is that we have not undergone the early developmental stages experienced elsewhere, making it difficult to leapfrog directly to the Mayo Clinic model or similar structures.

26. Currently investing in private hospitals, what is Dr. Zhang's view on the development of private hospitals?

Zhang Qiang:For a private hospital, it is relatively easy to invest a certain amount of capital to acquire advanced medical equipment; however, the primary challenge lies in the shortage of medical talent. Managing such talent presents a significant hurdle. Under the current models employed by private hospitals for recruiting personnel or generating revenue, the difficulty of attracting talent will continue to increase. This is because the overall cost of physicians in China is rising. In the future, China will be more suited to a model where hospitals serve as platforms that interface with physician groups.

27. Health management is widely practiced nowadays. Do you have any plans to offer chronic disease management services in the future? If so, how do you intend to implement them?

Zhang Qiang:Regarding whether the physician group will engage in chronic disease management, there are currently no such plans. This is because chronic disease management has different requirements for physicians and employs a distinct management model compared to our surgical team. In fact, many general practitioners in the community are best suited for chronic disease management. Therefore, I believe this area should be handled by them, as they may perform better than we would.

28. Should physician groups also engage in medical scientific research? If so, how should they proceed?

Zhang Qiang:Another issue concerns the perception of scientific research within physician groups. Many people ask, “If you leave the public healthcare system, how will you conduct your research?” It is understandable that such questions arise when viewing the private sector through the lens of the public system. In reality, no one can prevent you from engaging in scientific research or publishing papers in SCI-indexed journals.

Since SCI-indexed journals do not reject manuscripts authored by physicians practicing outside the public healthcare system, there is effectively no barrier in this regard. In terms of funding, future research grants should also accommodate these physicians; for instance, the National Natural Science Foundation of China has begun to consider applications from doctors outside the traditional system. Indeed, some teams led by such physicians have already secured research grants. Furthermore, physician groups can allocate their own funds to support scientific research, so funding is not a concern.

29. What is Dr. Zhang’s view on the development of nursing staff?

Zhang Qiang:In the United States, many nurses have gradually taken over some of the tasks traditionally performed by physicians. For instance, as surgical assistants in operating rooms, nurses can perform simple procedures during laparoscopic surgeries, such as holding the endoscope or suturing the skin, which I believe is perfectly acceptable. There is also a growing trend of certified registered nurse anesthetists (CRNAs) administering anesthesia independently; in the U.S., this is permitted as long as they hold the appropriate certification. The future prospects for nursing are very promising because physician costs are high, and nurses can significantly enhance physicians' work efficiency. Therefore, I am optimistic about the future development of the nursing profession.

Nurses are the true stewards of healthcare. The quality of their stewardship directly shapes patients’ perceptions of a hospital, as patients judge the institution based on every action and behavior exhibited by the nursing staff. Therefore, it is essential to prioritize both the transformation of nurses’ professional mindsets and the institutional emphasis placed on nursing work.

30. Why was it named Dr. Zhang Qiang Doctor Group?

Zhang Qiang:Many people have asked why we chose the name “Zhang Qiang Doctor Group.” We deliberated over this for a long time. In fact, I was reluctant to put my own name front and center, as it carries significant risk; many experts might feel that if it’s named after Zhang Qiang, where does that leave them? After considerable reflection, we ultimately decided to use my name, with the English brand name “doctorsmile.” This was my genuine English name during my time in the United States, and it also appeared on my work badge. I later realized the advantage of this name: it resonates warmly with people, eliminating any sense of unfamiliarity, and brings a smile to everyone’s face upon seeing it.

Later, I began posting on Weibo. In effect, many people have gradually turned “doctorsmile” into a symbol—one that represents sunshine and positive energy, and embodies the new image of physicians. From this perspective, the name itself is not what matters most; what is crucial is whether it can convey a message and serve as a new symbol for the new generation of doctors.

Naming it the Dr. Zhang Qiang Physician Group was a natural process. In China’s current healthcare landscape, I aim to build a credible brand. By using my own name as its identifier, I will cherish this brand, much like the Mayo Clinic, which is named after Dr. Mayo.