Questioning the exposure of expert clinics: The "experts" in various hospitals make patients somewhat suspicious. From large tertiary hospitals to small urban and rural health clinics, are the experts really all technically superior? To address these doubts, a journalist began an investigation.
Don't overly idolize the expert clinics. Investigations revealed that some hospitals' expert clinics have many undisclosed inside stories. Some experts are simply "time-served" graduates.
For experts, there has never been a unified national standard. It does not equate to titles like professor or associate professor, nor does it equal degrees like master's or doctoral qualifications. Thus, an expert can only be an unofficial term of respect for someone with professional expertise. Generally, an expert should be someone who specializes in a particular field of work and research and has achieved significant success. A medical expert should naturally be a professional with treatment expertise in certain diseases. Experts should be scarce, but now in many hospitals, "experts" are everywhere. Some hospitals, in order to attract patients, label doctors without expert qualifications as "certain experts" for their clinics. The author saw at a municipal hospital in a city in Hebei that among the eight dentists, six were labeled as "expert physicians." In these smaller hospitals, there are even more impostor "experts."
Even in some larger hospitals, not all experts are "genuine." Nowadays, hospitals follow this unwritten rule: any doctor with the title of deputy chief physician or above can be considered an "expert" and can hold an expert clinic. However, the existing title evaluation method for determining chief physicians and deputy chief physicians does not represent their clinical ability to handle difficult cases. Many so-called experts are merely those who have waited long enough to gain their titles, and their clinical skills are often no different from ordinary outpatient attending physicians. There are also many department heads whose administrative positions have reached director but whose technical titles have not yet reached "deputy senior," and in order to stand in the "expert clinic," the hospital simply gives them a "low rank, high hire," turning attending physicians into deputy chief physicians and making them "experts." Some hospital experts are merely specialized doctors who have studied at major hospitals. And some unscrupulous hospitals even select older doctors with more wrinkles and longer beards to impersonate experts.
Monetary benefits lead to an overabundance of expert clinics. For patients eager to seek treatment, the first choice upon entering a hospital is naturally the expert clinic. However, because the registration fee for expert clinics is much higher than for regular clinics, sometimes more than ten times higher, costing 30 yuan, 50 yuan, 80 yuan, or even 300 yuan per visit, many economically strained patients are deterred.
Nowadays, the expert clinics in comprehensive hospitals are almost always overcrowded. Many patients go specifically for the experts, willing to spend more money for peace of mind. This mentality coincides with some hospitals' eagerness to set up more expert clinics. An expert's income is related to examination commissions and the number of patients seen, so the purpose of seeing patients has changed. Some lament that the "expert clinic" has become a "economic growth point" for some hospitals.
The "assembly line" operation of expert clinics poses risks of misdiagnosis.
Ms. Wang was a patient diagnosed by the expert clinic as having diabetes accompanied by hypertension and oral disease. For eight years, she followed the "expert's" diagnosis, taking countless antihypertensive and hypoglycemic drugs. Eight years later, however, a visiting intern discovered that she actually had a pheochromocytoma (a type of adrenal tumor). This case raises serious questions about the current state of expert clinics—can a few minutes of diagnosis truly determine a patient's exact cause of illness? According to the visiting intern, after reviewing the patient's condition before the expert's diagnosis, due to the long wait in the expert clinic, he did not immediately prescribe medication but instead carefully questioned the patient about other conditions. After further detailed examinations, it was found that the patient did not have simple diabetes but rather diabetes secondary to a pheochromocytoma. Now, after tumor removal surgery, the patient has regained her health. The intern doctor believed that when treating a patient, one must not only inquire about the main symptoms and visible symptoms but also look into past medical history and diagnostic history while performing necessary physical examinations, which generally take at least 15 minutes. However, under current circumstances, expert clinics see upwards of 70-100 patients a day, operating like an "assembly line." Experts cannot possibly thoroughly and comprehensively question each individual, leading to rushed diagnoses and prescriptions within a few minutes. Therefore, misdiagnosis is inevitable.
How should one choose the right expert clinic?
Choosing the right department and finding the right expert: A supposed expert isn't omnipotent. Even if they are genuine experts, it only means they specialize in a particular field or even a specific disease, while they may know little about diseases in other departments. In other words, a surgical expert diagnosing skin conditions might not be as good as a regular dermatologist, or even worse, could be completely out of their depth. Therefore, it is crucial to choose an expert whose specialty aligns with your condition. Even within the same department, experts have their own strengths. For example, among gastroenterology experts, some specialize in liver cirrhosis treatment, others in liver cancer treatment. Among general surgery experts, some excel at colorectal cancer surgery, others at stomach cancer surgery, and still others at vascular surgery. Among dental experts, some specialize in filling teeth, others in extracting teeth, others in crowns, and some in jaw and facial surgery. Hence, only by fully understanding each expert's specialty can one better choose the most suitable expert. One can inquire about the specialties of experts at the hospital’s consultation service desk, check the introduction panels in the hospital hall, visit the hospital's website, or learn through patient recommendations or acquaintances working in the hospital.
First-time visits should prioritize general clinics over expert clinics.
Ms. Li recently experienced frequent joint pain, and her daughter accompanied her to the affiliated hospital of a medical college for treatment. To quickly cure her mother's illness, they opted for the most expensive 50-yuan special need expert clinic. However, unexpectedly, there were over 40 people waiting for the expert appointment, and the consultation room was crowded with people. Helplessly, while queuing for the expert clinic, they also spent 5.5 yuan on a regular orthopedic clinic appointment. There were more patients in the general clinic, but the doctor carefully questioned them and issued several lab tests to further confirm the condition. By noon, the mother and daughter finally reached the renowned expert clinic, but after questioning them, the expert also issued several lab tests not much different from the general clinic.
It is unnecessary to always opt for the expert clinic, especially for first-time visitors. Regardless of whether it is an expert or a regular doctor, they first need to understand the patient's condition and medical history and conduct necessary examinations. Many diseases require lab tests, imaging tests, and other auxiliary tests to obtain a clear diagnosis and treatment plan, and regular doctors are perfectly capable of conducting these tasks. Therefore, after falling ill, patients should initially consult the general clinic. If further diagnosis or complex cases arise after examination, then seeking advice from experienced experts would be appropriate. This approach allows patients to save on the cost of expert appointments and the time wasted in queues, without delaying diagnosis or treatment.
Preparation is key for effective consultations.
Expert clinics typically see a large number of patients, and each patient will not have the opportunity for lengthy conversations with the expert. Therefore, patients should prepare to accurately convey their condition within limited time. You might consider listing important symptoms, onset time, possible triggers, bad habits, personal medical history, family medical history, infectious disease contact history, previous treatments received, and their effectiveness before seeing the expert. Preparing this information beforehand makes the expert consultation more efficient, saving time and reducing omissions, which aids accurate diagnosis. Nowadays, many second-level and above hospitals allow mutual recognition of examination reports. When visiting, ensure all medical records are prepared and organized chronologically, enabling the expert to refer to them for accurate diagnosis and continuous observation and analysis of the disease. This also reduces unnecessary repeated tests, saving both time and money.
During the limited consultation time, try to maximize communication with the expert.
Not only should you truthfully answer the expert's questions, but you should also actively inquire about your condition. For example, "What disease do I have? What might be the cause? Why am I prescribed this medicine? How should I take it? Are there side effects? What should I do after finishing the medication? How long will it take to improve? Are there other feasible treatment options? What precautions should I take? When should I return for follow-up?" Try to ask all your questions during the single consultation with the expert. Remember, do not interrupt when the expert is treating other patients; doing so can create strong negative feelings among both the expert and other patients.
Do not underestimate young doctors.