Best, Wang Shi Kai Email 4 Part 1

This post is part of a series we are calling "Best, Wang Shi Kai." Dr. Rich is an Emergency Medicine Physician from Los Angeles who picked up and moved to China where he is currently practicing. He was given the name Wang Shi Kai by the Chinese Medical Board. In this series of posts we feature his emails sharing his unique experiences practicing medicine in China. Here are the links to his first email which gives some background Email 1 Part 1,  Email 1 Part 2Email 2 Part 1Email 2 Part 2, Email 3 Part 1, Email 3 Part 2

Hi Ben,

My first full year in China is almost finished. Hard to believe. It's been an incredible experience. Most of my family and friends still think I'm crazy, which may be true, but I have no regrets for coming here.

The healthcare system in China is damaged but I do have some hope. It's exciting being in the middle of so much change. I do think that the West's skewed view of China means that some fundamental positives are being overlooked. 

National standards in Emergency Medicine training and certification have not yet been developed but there has been some progress. The Fellows that I supervise remind me of the residents I worked with in California in some ways. They are quite eager to learn and they always love hearing a good story. Most of them have a pretty good sense of humor too. I would compare their knowledge of Medicine to below-Intern level. They definitely need close supervision. Sometimes I have to remind them to actually perform a physical exam on patients that they see. And when I commented out loud that one of them failed to write a complete H&P, our Charge Nurse overheard and told me that I should "humiliate and punish" him. Interesting approach.

They tell me that their medical school teaching was inconsistent and definitely not evidence-based. One Fellow said that she was sometimes forced to document false findings to justify giving certain medications to patients so that her Attending could get monetary kickbacks from the pharmaceutical companies. Many Doctors and nurses that I have spoken with admit that they would not go into this profession if they had it to do all over, which makes me sad to hear. And i have certainly witnessed Nurses being verbally and physically abused by patients. The recruitment of ER physicians is still a big challenge due to heavy workloads, difficult working conditions, poor pay and lack of respect from colleagues and the general public who don't view Emergency Medicine as a "specialty". Sound familiar? But despite that, the Fellows here, who earn $2000 RMB/month ($333 US Dollars), seem to be optimistic. That's good, because this year Emergency Departments in China will manage around 100 million visits. 

Last month, one of our Dentists was murdered by a patient who was unhappy with his dentures. Really, really unhappy I guess. The patient posted a picture of the Dentist's bloodied, smashed skull on social media, then committed suicide. He would have been put to death anyway. I hope I don't have any toothaches over the next few years. 

The conclusion to this email in the next post

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