In recent years, specialized outpatient clinics have opened in
Beijing to treat symptoms normally overlooked in hospitals while
also offering coordinated services to patients. The outpatient
clinics are changing traditional ways and concepts of seeking
medical advice.
Clinics for Aches and Pains
This year, the outpatient pain clinic at the Sino-Japanese
Friendship Hospital, helped a 93-year-old woman, Xu, who had
suffered from neck and left arm pain for a year.
“She was unable to bear the pain, crying and shouting loudly,” said
Dr. Fan Bifa, associate director of the clinic.
The woman’s son said she used to be very happy and healthy, but
since becoming sick, she had lost her appetite and often threatened
to kill herself. Dr. Fan said Xu’s pain was caused by a loss of
cervical vertebra, which constricted nerves and caused severe pain
in her neck and left arm. Before coming to this clinic, she had
been treated at many hospitals, but to no avail.
Zhao, 40, is another patient successfully treated at the clinic.
His experience is worse than Xu’s. Several months ago, suffering
from a toothache, Xu went to a hospital where a doctor pulled out
one of his teeth. But soon, another tooth began to ache, so he
returned to the dental hospital. The treatment was much the same as
before. This treatment was repeated several times until he went to
the pain clinic. There he was diagnosed with neuralgia.
Many patients like Xu and Zhao are being treated as outpatients at
the two clinics that specialize in pain launched by the
Sino-Japanese Friendship Hospital and the Beijing Friendship
Hospital. All patients had had bad experiences seeking treatment
before they came to these specialized clinics. As their pain could
not be relieved, they went to different hospitals time and time
again, like a ball being kicked back and forth. These patients,
including those afflicted with pain caused by cancer, are now being
treated at the specialized clinics.
Other patients frequently treated here include those who underwent
surgery but still suffer from pain, and those who should have had
an operation, but did not. A doctor at one clinic said patients
with symptoms of pain should go to a special clinic first. The
establishment of specialized outpatient clinics is the outcome of
the development of the treatment of pain as a specialty in medical
science, and through the demands of patients who hope to escape
from pain.
A
clinical manifestation of many diseases, pain has a severe affect
on patients. They often go to doctors when they cannot bear the
pain any longer. Although the clinical manifestation of pain draws
the concern of traditional medicine, methods to deal with it have
been restricted to taking medication, surgery and injections.
Sometimes effects are not obvious. Therefore, a gap exists between
a patient’s desire to eliminate pain and the unsatisfactory result
of traditional methods. This created an opportunity for the
development of special outpatient clinics.
During the Ninth World Congress on Pain in Vienna in 1999, the
International Association for the Study of Pain declared to the
world that after 24 years of study of the clinical manifestations
of pain it had come to the conclusion that pain was not only a
symptom of disease but also a kind of disease itself.
Dr. Fan, also a member of the Pain Study Committee of the Chinese Medical Association,
said the main methods adopted by the specialized outpatient clinics
included injections to on free nerves, plus supplementary
treatments of medicine and manipulation. These methods help
stimulate blood circulation, block pain, and readjust nerves’
sensory functions, thus eliminating pain.
There is a great demand for pain treatment in modern society. It is
reported that, worldwide, 25 percent of patients were afflicted
with severe pain when they died. Easing patients’ pain also
alleviates their family’s mental and spiritual suffering.
Statistics show that China has 100 million patients suffering from
chronic arthritis. The pain that accompanies this disease is
difficult to cure through traditional methods. The cost of
replacing a bone joint is more than 100,000 yuan, which most
patients cannot afford. Looking at the situation from an economic
angle, treatment in specialized outpatient clinics has great
appeal.
Among patients afflicted with a protrusion of the lumbar
intervertebra, only a small number are suitable for operation. In
these cases, pain clinics also are the first choice. Treatment for
pain is developing slowly in China. At present, only large
hospitals in major cities have outpatient clinics specializing in
this treatment. But medical circles still have asserted their
concern.
In
the early 1990s, outpatient clinics specializing in the treatment
of pain existed in many hospitals, but closed because of a lack of
support. But in a few hospitals, the clinics remained and became
profit-making resources. The total income from a privately run
outpatient pain clinic in south China, which employs nine doctors,
is more than 5 million yuan, and it makes a profit of 3 million
yuan.
Clinics for Disease Prevention
“When you go to a doctor, you are afraid of being told that you
have a disease that is hard to cure -- and worse, that you will be
told it is too late,” said a doctor who works with a
disease-prevention outpatient clinic.
This clinic aims to prevent and diagnose disease as early as
possible through regular check-ups. If people often have check-ups,
it will be never be too late for diseases to be treated. This is
regarded as a leading idea toward a promoting a healthy
lifestyle.
Fuwai Hospital, known for its treatment of cardiovascular disease,
offers an outpatient clinic specializing in heart disease
prevention. Cardiovascular disease has become the main cause of the
death of Chinese people. Over the next 10 years, incidence of
cerebral hemorrhage is expected to increase by 42 percent among
middle-aged men, and by 13 percent in women. The incidence of
coronary disease among men will rise 26 percent and that among
women 16 percent.
The computer system used by the outpatient clinic here has two
functions: To keep health records and to provide prescriptions. The
computer system will follow a patient’s condition and constantly
readjust the prescription according to changes in health.
The clinic also gives guidance for people who are obese. The doctor
first measures the patient’s fat and then works out a diet and
exercise plan according their needs. The patient is kept fully
informed. The clinic has treated many people who are concerned
about, or have a family history of, obesity.
The special clinic launched by the Beijing Women’s Health-Care
Institute aims to prevent and treat diseases particular to women.
With advanced technologies and blood checks, the doctor can clearly
diagnose a patient’s physical condition.
With recent changes in dietary habits, women in China afflicted
with tumors are much younger than in previous years. The age of
women affected by breast cancer has dropped to 35 years, and that
of cervical cancer to 30 years of age. Ding Hui, director of the
institute, said all women of childbearing age should have an
overall health-check every three years. Those who have a family
history of certain diseases should pay extra attention to the
issue.
Clinics for Fatigue
Beijing Friendship Hospital opened a clinic for the treatment of
fatigue in April this year, to deal with the increasing number of
patients who need treatment. The purpose of opening such a
specialized clinic was, on the one hand, to divert patients from
crowded neuroscience wards in hospitals and, on the other, to help
concerned doctors to accumulate more experience in the treatment of
chronic fatigue syndrome, thus creating a special field of science.
However, the method of treatment here is no different from that of
other hospitals, so outpatient numbers are low.
（Beijing
Review No.38, 2001）