There are two occupations in the American medical system that we don't have in China: medical social worker and family doctor. These two kinds of people are the cornerstone of the efficient functioning of the American health care system.
Medical social workers are mainly responsible for helping people find all kinds of health care services, providing support to those who have serious or chronic diseases, helping the homeless, drug addicts and abused children to tide over difficulties, and seeking legal health resources and financial assistance for patients. Their work is not easy at all. Most of their work objects come from the bottom of the society. They need patience, compassion, certain physical strength and problem-solving ability and skills to be competent. When I was working in the AIDS department, a social worker named Roswell took me to follow up a transsexual AIDS patient. We came to one of San Francisco's most chaotic neighborhoods, where we were asked for money from time to time. It is said that there are always traces of drug trade on the streets. I followed Roswell closely to the transgender's home. Roswell treated him as kindly as a friend, asked him why he didn't continue to insist on HARRT treatment, and encouraged him to cheer up. When he learned that the patient was in a very low mood these days, he left a phone number to contact a depression treatment organization. Although this is only a short visit to patients, it is enough to make me respect the work of medical social workers in the United States. Afterwards, Roswell told me that if I want to be a successful social worker, the key is one word: respect, respect all people.
In China, we are not in urgent need of medical social workers, because most patients have the full support of their families, and filial piety is also a traditional virtue in China for many years. In addition, even with the help of social workers, it is difficult to find many charitable organizations or business groups in China to support these people at the bottom of society. However, China needs to introduce the American family doctor system. They are the gatekeepers of the whole American health care system and play an important role.
In China, tertiary hospitals such as Union Medical College Hospital are always overcrowded, while primary hospitals have very few patients. The main reason for this situation is that we do not have a referral system, and the price of medical treatment in hospitals at all levels is the same. Therefore, anyone with a minor illness such as a cold can come to see the professor of Union Medical College Hospital. In contrast, the referral system in the United States has greatly relieved the pressure of tertiary hospitals and saved patients time and money. In the United States, a family doctor is the first to see a doctor, who decides whether to refer to a specialist hospital for further treatment. In the endocrine clinic of UCSF, a doctor can spend nearly an hour answering various questions of a patient and conducting disease education. I went to the clinic with many doctors and found that they had to ask the same question before the patients left, that is, "do you have any other questions?". And Chinese doctors are most afraid that patients will have endless problems. Who let so many anxious patients wait at the door? The number of patients that American doctors see in a morning can not be compared with that of Chinese doctors, but it is obvious that the service quality of other people is beyond our expectation. Fortunately, China's medical system reform has also noticed this prominent problem of uneven distribution of medical resources, and is actively raising funds to establish a family doctor system and referral system with Chinese characteristics.
