VB Group Interview No.14 | Gong Xiaoming: How Doctors Grow in the Internet+ Era

[Guest Introduction]Dr. Gong Xiaoming, the first freelance practitioner in obstetrics and gynecology in China, holds a Medical Doctorate from Peking Union Medical College. He is the founder of China OB-GYN Network and Fengxinzi. In 2013, he was named one of the Ten Most Influential Doctors on Sina Weibo. With his Weibo follower count now reaching 740,000, he has become a veritable “big V” (verified influencer) in the medical community. As WeChat gradually gained popularity across China’s social networks, Dr. Gong became the first professional doctor in the country to launch an official WeChat public account, leveraging the platform to disseminate educational content on obstetrics and gynecology to his followers.

Topic Sharing
I graduated from Peking Union Medical College. From 1998 to 2013, I worked at Peking Union Medical College Hospital for approximately 15 years. Subsequently, I served at Shanghai First Maternity and Infant Health Hospital for one and a half years. Since February of this year, I have been working as a freelancer. As early as 2013, while still at Peking Union Medical College Hospital, I began practicing at multiple institutions. During my tenure at Shanghai First Maternity and Infant Health Hospital, I focused primarily on multi-site practice. I am an obstetrician-gynecologist with a strong interest in the integration of healthcare informatics and internet-based medical services.

Healthcare Should Be Left to the Market
Many people have asked me why I left Peking Union Medical College Hospital (PUMCH). This decision was closely tied to my personal reflections on healthcare. In 2012, I spent about a year in the United States. My first visit to the Cleveland Clinic left a profound impression on me. What struck me most was its registration hall, where none of the overcrowding commonly seen in Chinese hospitals was evident. As the second-ranked hospital in the U.S., its differences from PUMCH are worth contemplating.

During my tenure at Peking Union Medical College Hospital, I often reflected that the challenges we faced mirrored those prevalent in China’s healthcare system. First, physicians at tertiary hospitals bear an excessive workload yet remain dissatisfied with their compensation. Second, doctor-patient conflicts occur frequently, compromising physician safety. Meanwhile, the general public struggles with difficult and costly access to medical care. In response to these issues, some attribute them to China’s large population, the perceived unreasonableness of patients, the overwhelming busyness of doctors, or inadequate government support. But are these truly the root causes?

Upon reflection, I believe the primary cause of these issues is the excessive regulation of the healthcare sector. A key manifestation of this is that prices for medical services in public hospitals are set by the government, and such pricing is often inaccurate. In my view, medical pricing should be left to the market. Much like dining at a restaurant, where market forces determine prices, consumers are unlikely to patronize an establishment whose prices are significantly higher than the market rate. The market is far more adept at setting appropriate prices than we are. To quote Professor Zhu Hengpeng, “Government-set prices are inevitably inaccurate; it is far better to let the market determine them.”

A major reason for the frequent occurrence of doctor-patient disputes is inaccurate pricing. Inadequate medical services are inevitably associated with underpriced medical labor. When prices are forced down, akin to expecting a five-star hotel stay for only 100 yuan, service providers unable to cover costs must resort to other means to reduce expenses. The healthcare sector faces similar challenges; the fundamental cause of conflicts arising from over-treatment is the lack of marketization in healthcare.

Public Hospitals: Education, Research, and Basic Healthcare Coverage
Social Hospitals: Market-Oriented Mechanisms
When I was in Cleveland, I was quite surprised the first time I walked into their operating room. The lead surgeon was actually a fellow in training, with his attending physician serving as an assistant by his side, along with a resident who also acted as an assistant. This differs significantly from the situation in China, where nearly all patient care revolves around senior specialists. In our so-called training system, young doctors merely observe as assistants alongside the lead surgeons. These experts handle an overwhelming workload day after day, leaving them exhausted, while young physicians eager to gain hands-on experience often find themselves without such opportunities. So where do foreign doctors or specialists provide their services? One can visit outpatient clinics—privately operated practices run by individual physicians—where many surgical procedures are performed. Thus, within overseas healthcare systems, many physicians essentially operate as their own masters.

Upon returning from abroad, my personal view is that the future direction of healthcare reform should be as follows: leave market-driven services to the market, while the state provides a safety net for public welfare services. Physicians may open private clinics or engage in other market-oriented services. There is no need to worry about all doctors leaving public hospitals to establish private practices. We can draw lessons from international examples. For instance, in the United States, even if a physician could earn $1 million by running a private clinic, many would still choose to work at Harvard University with an annual salary of $700,000. This is because, in addition to compensation, they gain access to resources for teaching students, conducting research, and other professional activities. Therefore, market pricing is reasonable, and there is no need for concern regarding physician retention in public hospitals.

So, what should our public hospitals do? I believe they should focus on teaching, scientific research, and providing basic medical security. In most foreign countries, the prices at public hospitals are often very low, primarily covered by the government. The amount the government spends is determined based on the market pricing for physicians’ services. Therefore, while patients benefit from low costs when receiving treatment at public hospitals, the subsidies provided by the government to cover the price difference are not insignificant. Through this approach, healthcare should return to its proper market track.

The Path of Internet Healthcare: Practicing at Peking Union Medical College Hospital → Multi-site Practice → Freelancing + Entrepreneurship

After leaving Peking Union Medical College Hospital in 2013, I moved to Shanghai to embark on an experiment aimed at transforming the current state of medical practice. Prior to my relocation, I discussed this initiative with President Duan Tao, whose views aligned perfectly with mine. Consequently, I established a teaching clinic there. During my tenure at the public hospital, I had founded a specialized gynecology outpatient group (Group 5), primarily supervising five medical students during consultations. The workflow typically involved the students performing initial physical examinations, followed by discussions with me to formulate treatment plans. If a plan was deemed feasible, we proceeded with treatment; if not, I would re-examine the patient and devise a revised plan. Through this process, I found that patients were satisfied, students improved their clinical skills, and my own workload became more manageable. Previously, seeing 30–40 patients in a single morning, with only five minutes allocated per consultation, left me exhausted. Now, the model is different: we can see up to 50 patients, with each of the five students responsible for 10 cases under my supervision, resulting in a more relaxed and efficient workflow.

If patients wish to consult me, they can also register at a private hospital. The consultation fees for my specialist appointments at private hospitals are set at my discretion. Initially, the private hospital suggested a price of 2,000 yuan, but I considered it excessively high and inconsistent with market rates, so I adjusted it to 500–600 yuan. This pricing has helped maintain a manageable workload while ensuring patient satisfaction with my services. Whether at Shanghai First Maternity and Infant Hospital or at private hospitals, I adhere to a fundamental principle: perform surgeries only when medically indicated, and firmly refrain from unnecessary procedures; prescribe medications only when necessary, and firmly avoid inappropriate drug use. This patient-centered approach must be upheld in all settings, ultimately earning positive patient testimonials and reputation.

Due to my entrepreneurial ventures, I moved to Beijing in February this year to practice medicine as an independent practitioner. As a result of this independent practice, I have completely severed employment ties with any single hospital; I am no longer affiliated with any specific institution. More accurately, I now maintain collaborative partnerships with multiple hospitals, a model that is both logical and aligned with my professional needs. When I see patients at private hospitals, they seek me out personally rather than being referred by the hospital. When surgical interventions are required, these institutions must provide the necessary facilities and support. This represents a significant departure from my previous experience in public hospitals, as the current focus is firmly patient-centered, with all efforts dedicated to serving patients.

From the perspective of my personal career journey, many milestones were unexpected. In 2000, I founded the China Obstetrics and Gynecology Network, initially driven purely by personal interest; I never anticipated it would evolve into a leading portal for the obstetrics and gynecology industry. In 2008, I began using the Haodf platform, where I unexpectedly rose to become the top-ranked obstetrician-gynecologist. In 2010, I joined Weibo and amassed a substantial following. In 2013, I became the first obstetrician-gynecologist to launch an official WeChat public account. Last year, my team and I developed the Hyacinth App. Thus, my personal journey has been closely intertwined with the internet.

Return to the Market, Build a Personal Brand for Doctors

Nowadays, everyone uses Dianping to find restaurants, and many friends leave reviews for restaurants on the platform. In fact, doctors are similar to restaurants in that they both have their own brands. Patients also provide feedback on the services received. Positive reviews attract more patients, so doctors should also pay attention to managing their personal brand.

The core of a physician’s brand lies in being a good doctor. How should we define a good doctor?

First and foremost, we must prioritize the patient’s interests. Treatment plans should not be altered for personal gain or convenience; instead, we must practice empathy and consider matters from the patient’s perspective.

Secondly, as physicians, we must possess strong clinical skills, which should always be patient-centered. For a given condition, there may be multiple treatment options; we must strive to learn and master the approach that offers the greatest benefit to the patient. Only after establishing ourselves as competent clinicians can we consider engaging in market-oriented activities.

Unfortunately, during their education, doctors learn about patient care, technical skills, and theoretical concepts, but few are taught to master practical tools that could benefit their practice. This represents a notable gap in medical training.

In 2013, approximately 70% of my patients were referred through the Haodf website. By this year, the proportion from Haodf has been declining, while the share from self-media platforms such as WeChat and Weibo has been increasing. Meanwhile, patients coming through outpatient registration have become virtually negligible.

What exactly defines a good doctor? I once discussed this issue with Haodf.com. Professor Lang is a leading authority in our obstetrics and gynecology department. Why wasn’t Professor Lang ranked higher? Haodf’s response was that if the general public considers you a good doctor because, to some extent, you can help them resolve their health issues, then you are a physician demanded by the market. Therefore, the use of such platforms is highly beneficial for many physicians, enabling patients to find relatively trustworthy doctors online. This represents a future transformation in our healthcare system.

Mobile healthcare has been a hot topic in recent years. In my view, mobile healthcare is essentially a knowledge-based tool; the key area that truly needs transformation is the marketization of medical services. Only by returning to a market-driven model will many aspects fall into place. Whether it involves online or offline healthcare, as long as physicians are reintegrated into the market framework and the appropriate compensation for their services is clearly defined, the market will undoubtedly operate more smoothly.

Let’s discuss what we are currently doing.

China OB/GYN Network has been in operation for approximately 17 years since its inception. We have now built a foundation of over 100,000 obstetricians and gynecologists. Leveraging this base, we have decided to launch market-oriented services. Our initial entry point is from the perspective of pregnant women. Currently, it is common for patients to wait two hours in hospital queues only to have a two-minute consultation with their doctor. This patient population has significant service needs, which can be effectively addressed through internet-based healthcare solutions.

What services do we offer? Our primary focus is on post-consultation advisory services. Why are physicians willing to provide these services after their regular working hours? During standard clinical hours, consultation fees are set by the government at a nominal rate (e.g., just a few yuan per registration). Physicians would certainly not be inclined to offer additional consultations for such minimal compensation outside of hospital settings. Consider the analogy of ride-hailing services like Didi Chuxing: when it rains and cabs are scarce, passengers can add a surcharge of 10 yuan to secure a ride. Similarly, when physicians operate within a market-driven framework, they will have clear incentives to participate.

Unlike Didi ride-hailing drivers, whose services differ minimally, physicians exhibit substantial variability in the quality of care they provide. Consequently, if medical services were left to market forces, they would become prohibitively expensive, although market-driven pricing would ultimately rationalize price structures.

The core philosophy of our Hyacinth app is to return doctors’ services to the market by enabling patients to purchase these services directly. Only by reintegrating into the market can physicians establish their personal brands while engaging in multi-site and independent practice. This approach aligns with the reach of mobile healthcare, ultimately rebuilding medical services through market mechanisms.

 

Q&A Highlights

1. From working within the public healthcare system to multi-site practice and then to independent practice, how has your mindset evolved?

Gong Xiaoming:Transitioning from the public system to multi-site practice, I believe the most significant change has been the streamlining of operational relationships. Let me share an example I often cite. In my previous role at a public hospital, if a patient’s surgery was scheduled until 7:00 PM but couldn’t be accommodated, the operating room team would cancel the procedure, citing medical safety concerns. Did this decision truly prioritize the patient’s interests? No, it did not. Now, as I engage in multi-site practice at a private hospital, our workflows are well-aligned. For instance, on a weekend evening, a patient required surgery and wished to take only two days off before returning to work on Monday. I agreed, recognizing both the patient’s need and my willingness to proceed; consequently, the hospital fully supported this arrangement. Currently, all processes run smoothly, whereas previously, many aspects were fraught with friction. Although we claimed to serve patients’ best interests in the past, in reality, we often fell short.

2. Can the Internet Transform Traditional Healthcare?

Gong Xiaoming:I believe the internet is merely a tool. It is not the internet that transforms healthcare, but rather the market. As long as market forces are allowed to play their proper role, healthcare will inevitably change. Of course, there are still key issues and supporting factors to address, including public acceptance and whether physicians’ mindsets have evolved.

3. Will excessive marketization of healthcare drive up medical prices?

Gong Xiaoming:I believe the goal is not to drive up the prices of medical services, but rather to allow them to return to a market-based perspective. Consider our current pricing model: as I just mentioned, is a fixed price of 5 RMB for childbirth accurate? Would 500 RMB be more accurate? Ultimately, the aim is to restore pricing to a reasonable level. But what constitutes “reasonable”? If a restaurant in Qingdao charges 38 RMB for a single shrimp and no one buys it, that is unreasonable. However, if a restaurant clearly lists a plate of shrimp at 38 RMB and customers accept it, that is reasonable. The market is far smarter than we imagine. Therefore, we should not reject market mechanisms; their impact on transforming our entire industry will be substantial.

4. How can primary care physicians better develop and expand their practices through self-media?

Gong Xiaoming:In fact, I believe that every physician, much like a restaurant owner, serves a specific customer base regardless of whether they practice in primary care settings or in major cities. Restaurants in grassroots communities also have their own clientele; by providing excellent service to these customers, one can similarly build a strong brand. This brand presence need not be limited to the internet; it can be cultivated through both offline and online channels. Whether in large metropolitan areas or smaller towns, every professional has their own customer foundation. Therefore, I maintain that everyone is capable of delivering high-quality customer service.

5. What are the intrinsic motivations for physicians to engage in freelance multi-site practice? What benefits can physicians derive from it?

Gong Xiaoming:This issue was addressed in an article on my WeChat official account. I believe that multi-site practice serves as a pivotal lever under the current circumstances. While many hospital physicians remain within the public system and are not yet able to practice independently, multi-site practice can serve as a foundation for driving change. With a market in place, public hospitals should refocus their mission on training medical students. For further insights, please refer to my article titled “My Perspective on Multi-Site Practice” on my WeChat official account.

6. How to balance the realization of physicians' value with the government's inclusive healthcare initiatives?

Gong Xiaoming:In fact, if all prices were properly aligned, the share of healthcare in our current GDP would certainly increase. To be honest, the essence of our current healthcare system is that the government procures our services at low prices through bulk purchasing, leaving providers with no bargaining power. Under the present circumstances, this approach pressures physicians into committing errors, which is clearly incorrect. Market-driven valuation enables the public to enjoy diverse healthcare services. The government should use tax revenues to purchase medical services. But how should the purchase price be determined? If market prices serve as the benchmark, the government will naturally know how much it should pay for medical services. Arbitrary decision-making, as seen today, is undoubtedly inappropriate.

7. How long do you think it will take for China to truly achieve a system of freelance physicians?

Gong Xiaoming:Freedom for Chinese Physicians Requires Changes in Three Areas: (1) Smoothly Resolve Issues Encountered by Physicians Practicing at Multiple Sites; (2) Untie Policy Knots from the Past; (3) Reform and Align Corresponding Insurance Policies.

8. How should the relationship between clinical practice and scientific research be viewed?

Gong Xiaoming:I personally believe that scientific research is essential, but it should be driven by genuine interest rather than the pursuit of professional promotion. Research motivated by true curiosity is more likely to yield high-quality outcomes. Currently, every physician is expected to engage in scientific research. However, the fundamental purpose of healthcare is to serve patients; there is greater societal demand for physicians who can effectively address the health concerns of the general public. The current situation is fraught with tension and misalignment. Therefore, I believe that once healthcare returns to a market-oriented model, scientific research will no longer be a mandatory requirement for physicians, and the system may operate more smoothly at that time.

9. How do you assess whether a physician meets the standards of freelance practice?

Gong Xiaoming:We can look at how things are done abroad. There are two mechanisms: one is peer review, and the other is the market. Peer review means that if you engage in misconduct, you are held accountable by laws and lawyers. The market mechanism implies that the better a doctor’s service and technical expertise, the more they are favored by the public. Conversely, doctors who are popular in the market must be those who provide high-quality services, which is logically sound.

10. What do you consider to be the biggest bottleneck for doctors practicing independently?

Gong Xiaoming:The biggest bottleneck for freelance physicians, in my view, lies in certain policy issues stemming from the era of administrative management. Not long ago, a friend of mine gave birth at a private hospital. Her baby, at 30 weeks’ gestation, required transfer to another facility due to preterm labor. The attending physician at the private hospital was formerly affiliated with Peking Union Medical College Hospital, and the hospital itself was well-equipped. So why was a transfer necessary? Because under previous regulations, premature infants born before 30 weeks of gestation had to be transferred to Grade A tertiary hospitals. Such regulatory requirements are unreasonable legacies of the past administrative management system. These issues become particularly prominent in the context of freelance medical practice. Only by addressing and resolving these problems can freelance physicians practice with greater peace of mind.

11. How do you understand the differences and connections between a physician’s personal brand and a hospital’s brand? What are the future trends, and where does their brand influence primarily lie? How can young physicians seize opportunities and build their personal brands?

Gong Xiaoming:I believe that personal branding and hospital branding are mutually reinforcing. When physicians work in public hospitals, they should leverage the hospital’s brand to build their own personal brand—in other words, capitalize on the hospital’s reputation to establish their individual presence. From the hospital’s perspective, if an institution is composed of many physicians with strong personal brands, its overall institutional brand will also be robust. On this point, I have exchanged views with Dr. Duan Tao, President of Shanghai Yiyun Maternal and Infant Health Hospital. He believes that every physician in a hospital should proactively cultivate their personal brand, as this does not conflict with the hospital’s brand; rather, when individual physicians’ brands become stronger, the hospital’s brand is strengthened as well. Therefore, I consider the two to be complementary and mutually beneficial.

12. I am a primary care community pediatrician. Through several years of leveraging self-media platforms, I have amassed thousands of followers in our small county town and built a solid reputation. However, I see approximately 100 pediatric patients daily and feel constantly overwhelmed by my workload. How can I better advance my career while balancing this conflict?

Gong Xiaoming:A doctor can find a market wherever they have a good reputation. Just like small restaurants in small cities that attract many repeat customers, they are bound to have their own market. Another advantage of the market mechanism is that while many public hospitals have rigidly fixed pricing, once services are subjected to market forces, pediatrics will emerge as a highly promising specialty. The scarcer your expertise, the higher your fees and income will be. A strong reputation is the foundation for your future practice across multiple institutions or in independent private practice.

13. What do you consider to be the competitive advantages of your current Hyacinth products in the maternal and infant industry?

Gong Xiaoming:Our team is developing the Hyacinth product, leveraging our influence within professional B2B circles over the past 16+ years. Our service model operates on two ends: one catering to the B-side and D-side (doctors), and the other to patients and pregnant women. Similar to Taobao’s marketplace model with merchants on one side and consumers on the other, strength in one segment allows you to focus exclusively on cultivating the other. Our key advantages lie in our physician network and professional background, which enable us to deeply understand doctors’ needs.

14: Without systemic reforms and deregulation, marketization is difficult to achieve, making it easy to operate on the regulatory fringe. Even Didi has faced investigations; for medical practices, which carry higher risks, how can we compel policy reform?

Gong Xiaoming:From a macro perspective, the central government is willing to relax policies; however, some local leaders within the system still struggle to shift their mindset. For instance, under the old way of thinking, Didi Chuxing would have been stifled in its infancy, but at the leadership level, there is now an acceptance of such market-driven service platforms. Therefore, I believe the healthcare sector follows a similar trajectory. Although current healthcare reforms involve certain regulatory measures, there will likely be greater opportunities for change in the future, which ultimately depends on policy evolution.