Roberta Lipson, CEO and Chairman of the Board of United Family Healthcare, came to China in 1979. So when she speaks about "China back then," the kind of then-versus-now comparisons that she's making are on a whole other level than what most foreigners in this country can claim.
Some people frame their China Experience by what they've witnessed pre- and post-Beijing Olympics, and some others, before and after the 2010 Expo in Shanghai. For Lipson, however, "China back then" meant a China where ultrasound technology had yet to arrive. When it was the norm for women to give birth without any treatment for pain. When the healthcare system was entirely state-run.
Roberta Lipson helped change all that. She was behind the first ultrasound machines that came into Chinese hospitals, and when she and her partners founded United Family Hospital (UFH), they transformed how healthcare in this country looks and operates.
Here, in her own words, Roberta Lipson walks us through some of the profound changes that have taken place throughout her 40+ years at the frontier of China's healthcare industry – and how United Family Healthcare has stayed agile and responsive to their clients' needs throughout these changing times.
Medical Equipment & Technology in China
"I discovered that Chinese hospitals hadn't upgraded their hardware in many, many years. There were so many important tools that weren't available in China then"
I came to China to work for a trading company that was among the first US companies invited to open an office in Beijing. They were mostly involved in raw materials, but they said "Go and explore what it is that you can help us do," and during this time I discovered that Chinese hospitals hadn't upgraded their hardware in many, many years. There were so many important tools that weren't available in China then.
So, we were able to bring in the first ultrasound machines in China. Real-time ultrasound was a brand-new concept, and from us bringing in the machines and the right people to share their knowledge on the subject, to it becoming one of the most important tools in healthcare, that was really something. We were also able to bring in things like central patient monitoring, electric surgical knives, ultrasound knives, and the first MRI machines.
After about 10 years, we saw that the hospitals were becoming really well-equipped, at least, for the 3A Chinese hospitals in big cities. However, we saw a lot of opportunity in serving patients directly, so in 1997 my partners and I opened our first hospital – United Family Hospital in Beijing, which became the first hospital in China to receive accreditation from Joint Commission International.
We've built our capabilities over the years, investing in new equipment, new technology, and most importantly, in talent. Our general hospitals are now in six cities across China and offer over 20 specialties. In Shanghai, our hospital in Hongqiao was recently upgraded into a new 20,000 square meter facility with a 24/7 emergency room, pharmacy and lab.
Service and Patient Care Standards
"There was no patient privacy, not for childbirth either. In many cases, it was common to see overuse of antibiotics. It was apparent that the whole concept of healthcare delivery could be improved."
When Chinese hospitals needed hardware, that was an easy thing to resolve – they became well-equipped rather quickly, but Chinese patients were extremely dissatisfied with the service that they were getting.
Healthcare at that time was extremely inconvenient. If you wanted to go to the doctor, you had to get in line very early in the morning – especially if you wanted to go to a good hospital, you waited in line for hours, and maybe got five minutes with the doctor. There was no patient privacy, not for childbirth either. In many cases, it was common to see overuse of antibiotics. It was apparent that the whole concept of healthcare delivery could be improved, and that there could be a different kind of option. A more convenient option, a more humanistic option.
In terms of hospital visits, it's gotten a lot better with public facilities where patients can now make appointments online, but still, the time that you get to spend with the doctor is short and the level of privacy still leaves something to be desired.
One development that we saw was that Chinese patients started to see us as healthcare providers throughout the entire lifecycle, not just for themselves but for everyone in the family. So, women who gave birth at United Family, after they became moms, they brought their children back – for their vaccinations as well as baby care. In our system, we look over the babies' development, make sure that everything's going right and be able to spot early on if there's anything that's not going right. We also help moms in parenting, in psychological issues as well as nutritional issues. People value comprehensive care like this.
And, we became one of the first platforms to open community clinics that have Continuity of Care with UFH hospitals. So in Shanghai and Beijing, for example, our community clinics cover most ordinary issues such as prevention, screening and early intervention so that people don't have to go all the way to the hospital. Should there be a more serious issue, if further diagnosis is needed or a patient needs to be admitted to the hospital, then the clinic doctor will follow the patient to our hospital and partner with the specialists there to make sure their patients get the best care and return to good health.
Working With the Government
"We started the concept [to build a private hospital] in the early ‘90s. It took over 180 government approvals from the health, economic and trade departments, and our first hospital opened in 1997."
When we started to talk to the government in the early ‘90s about our idea – to let us build a model hospital, or a small private model hospital, the first reactions we got were like "That's crazy. We don't have private, for-profit healthcare in China. What kind of model are you going to operate with?"
We kept looking for people who were on board with our concept. It took us many years. It required us to do an IPO in the United States to raise funds, and we had to keep going back to the government to talk to them about the actual reality of building a hospital and licensing it. We started the concept in the early ‘90s. It took over 180 government approvals from the health, economic and trade departments, and our first hospital opened in 1997.
They still require a large number of government chops, but the government is increasingly recognizing that the public healthcare system can be well complemented by privatized premium healthcare, and it is also showing commitments to healthcare stimulus spending.
When COVID hit, every one of our hospitals – in Beijing, Shanghai, Guangzhou, Qingdao, Tianjin – was getting visits from government health bureaus every day. We were grateful, though, because the government was not only inspecting us, but giving us lots of direction and information about how to keep our patients safe and how to stay safe ourselves. They were sharing information with us about what they'd learned about the disease and how we need to adjust our processes to deal with what might be a long-term battle. Many of our doctors and nurses have since joined public health initiatives to help the government deal with testing, and now with vaccinating, in public venues.
Childbirth & Women's Health
"I realized there was just so much we could do to improve the experience [of childbirth] for Chinese patients and Chinese delivering moms."
In the past, I had never really seen Chinese hospitals from a patient perspective. Then I accompanied a friend to deliver her baby in a public hospital in Nanjing. I was so disappointed. Having a baby should be an opportunity for celebration and a really happy experience, and I ended up watching my friend being treated with little concern for her physical comfort, or recognition for the fact that this was a very important event in these people's lives.
And in those days in China, pain control for childbirth was usually not available. It was very rare, unless you were having a C-section, to have any. I realized there was just so much we could do to improve the experience for Chinese patients and Chinese delivering moms.
We were the first hospital in China to have the family-centered childbirth concept where we invited in husbands as part of the experience, and we had it all in one very comfortable home-like room rather than in a sterile tiled delivery room. And the whole process circled around the mom and the new baby, rather than having the mom go through an assembly line of being in a labor room, then a delivery room, then a recovery room. We made pain control available to every single woman. You can imagine how attractive that alternative was to women at the time.
So, very quickly, women became interested in the new approach to childbirth that we brought. That's why we became famous then, as a maternity hospital, even though from the beginning we've always been a general hospital. We're actually about to open our very first women's and children's specialty hospital in Beijing to give new mothers a more specialized experience.
Changing Perspectives on Healthcare & Mental Health
"After COVID... we saw a lot of people who had never had psychological or mood problems before, experience them for the first time and see impacts to their physical health. It's a reminder of how important it is to care for people holistically."
People's interest in staying healthy has really changed. Generally, before, besides getting vaccinations in the public system, you went to the hospital for sick care, not for preventive care such as check-ups and health maintenance.
At the same time, more and more Chinese families have the economic wherewithal to pay for their own healthcare and are choosing the option for high-end healthcare. It also used to be a big stigma to talk about mental health issues. Chinese people, just as much as Western people, if not more, are often not willing to admit to being depressed, needing help or needing counseling. We are seeing huge and great developments there, though.
We partner with our patients in prevention and in helping them to design a healthy lifestyle and caring about them not only their bodily issues, but also their psychological issues, and even social good health.
We were bringing on mental health specialists and psychiatrists right from the beginning, because we knew that people's healthcare needs to be extended beyond just their physical bodies. Very often, psychological and health problems are intertwined. After COVID, for instance, we saw a lot of people who had never had psychological or mood problems before, experience them for the first time and see impacts to their physical health. It's a reminder of how important it is to care for people holistically.
From United Family Hospital, to United Family Healthcare
"In the beginning, roughly 99% of our patients were from the international community...now, we're very proud that in some cases we're trusted by up to four generations of Chinese families."
When I had worked with hospitals importing medical equipment, I met some doctors who I really admired and felt inspired by. They came to work with us early on in the development of United Family, and that was something really amazing. We were very fortunate that some of these people who were so dedicated, really believed in the mission that we were pursuing for a more humanistic approach to healthcare in China.
Our first hospital was quite small. We started off with four departments: obstetrics, pediatrics, family medicine and surgery. In the beginning, roughly 99% of our patients were from the international community. Chinese women started to come to us for our mission-based childbirth approach, and would return for other healthcare needs. Then their husbands started to come, and soon enough we were having grandma and grandpa as our patients. So now, we're very proud that in some cases we're trusted by up to four generations of Chinese families.
[United Healthcare, Now] — and Into the Future:
From our first model hospital, United Family Healthcare has grown into a nationwide network of six general hospitals – about to be seven – plus a rehabilitation hospital and many community clinics. We're constantly offering new treatments and new technologies to help our patients, including our clinic in Hainan (and soon, our Shenzhen hospital) that offers some drugs that are not yet available in China. This year we'll also become officially licensed as an internet hospital. While we're already able to do a lot with our patients on our online platform, soon we will also be able to formally prescribe online, and give patients all over China access to specialists no matter which city they're in.
We're always adapting along with advancements in modern medicine and what our patients need from us. During the worst of the pandemic, we had to keep changing processes on a frequent basis. We did not have a single positive case in any of our hospitals, and we were able to treat many patients who couldn't get access to public hospitals at the time – for stroke, heart attack, or ongoing cancer treatment therapy.
Watching China and the way it's developed is an ongoing story that just keeps getting better and better and more interesting. All these years, what has drawn me in is the opportunity to really make a difference in a very important area in a very important country. I haven't been able to pull myself away and, perhaps, the best is yet to come.
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