Only When a Doctor Is Unhurried Can the Best Treatment Outcomes Be Achieved

Medical workers in China are all far too busy, and I am no exception.

I am ashamed to say that the outcomes I achieved for cancer patients in my early years were better than now. My results have not improved as my clinical experience grew, and the reason is none other than that in my early years I could treat patients with great composure.

Back then there were fewer patients, and I could give each one meticulous care; I could keep abreast of changes in their condition and even their emotional fluctuations in time. Once the number of patients grew large, this became impossible.

My ability to diagnose disease and to prescribe prescriptions has grown stronger than in the past. But these two abilities may not be the most important factors in treating illness. Sometimes, because experiential errors are unavoidable, rich experience can even work against you.

Chronic disease must be treated with the mindset of chronic-disease management. The doctor must be the patient's health guardian, closely observing every change in the patient, promptly handling every new symptom, understanding the reasons behind the patient's condition and emotional fluctuations, and sometimes even intervening to a degree in the patient's psychology, untangling the knots in the patient's heart at any time—only then can the most ideal treatment effect be achieved.

Many years ago, this is exactly how I treated patients. Back then my reading volume was not as large as now, my clinical experience not as rich, and I did not have as many patients. But back then I had full enthusiasm and patience to provide very meticulous diagnostic and treatment service to each patient, looking up the literature whenever something was unclear. So though I was young and shallow then, my treatment results were outstanding.

Some cancer patients I treated in my early years, though already in the middle-to-late stages, still have a high quality of life today. This has much to do with the focused treatment and care I provided them at the time.

At the end of last year, I stopped for two months, reading and settling myself, and gained a lot. My work pace in recent years has been too fast; with word of mouth spreading among patients, my reputation has grown and the number of patients seeking me has risen, leaving me exhausted—yet my treatment results have declined. This is a deeply problematic state.

Only when a doctor is unhurried can the best outcomes be achieved. If too many followers swarm around you, your mind never stops, and your body is in a subhealthy state from overwork, then it will definitely affect your ability to think through problems and analyze conditions, and it will drastically cut the time you spend looking up the literature for each patient. Ultimately, ideal outcomes are simply impossible.

We overemphasize that doctors should be compassionate and respond to every request, while neglecting medical quality. The profession of doctor is no different from any other trade; it must follow the objective law that "slow work yields fine work." Overloaded work crushes the doctor and is also highly detrimental to patients.

Many patients like to seek out doctors whose waiting rooms are full, believing such doctors are experienced and highly skilled. When my own waiting room was truly full, I learned that under such a workload, outcomes are hard to guarantee.

So starting in 2019, I will gradually return to my former state: strictly control the number of patients, serve a moderate rather than excessive number, increase the time I spend reviewing the literature, increase my reading time, increase my rest time, and adjust myself into an unhurried state—calmly providing every patient with conscientious diagnosis and treatment based on the chronic-disease-management model.

Life is priceless. Treating a hundred patients and losing ninety-nine is not as good as treating ten and saving three or four. I believe that present-day Chinese medicine, while overdrawing doctors, is also failing in its duty to patients. Under this rushed diagnostic-and-treatment model, the result, though related to the doctor's professional level, is more a matter of luck.

I often see medical records that even get the patient's actual age and basic situation wrong. During my father's most recent hospitalization, the resident physician even got his gender wrong. Yet these historical records are important materials by which other doctors understand a patient's past history and treatment course. Such sloppy treatment can hardly guarantee results.

In the United States, each family doctor commonly serves about six hundred patients. Many of our doctors see over a hundred patients in a single morning; the patients they see in one week already reach that number. This is one of the most important reasons that, as a developing country, our medical-service quality cannot keep up with that of developed countries.

From my own practical experience, I feel that the number of long-term follow-up patients an oncologist can sustain is only one-third to one-half of what an American family doctor serves—that is, two or three hundred. Beyond that, you cannot treat them well.

Because cancer patients are more complex than ordinary patients, the oncologist's work pressure is greater than the family doctor's, and far more energy goes to each patient. I have seen some doctors boast in their books of having served hundreds of thousands of patients in a lifetime; this is highly debatable. Serving hundreds of thousands over a lifetime makes the quality of care very questionable.

In ancient times, because transportation was undeveloped and the total population was smaller, each physician treated only a limited number of patients. Even the great, famous doctors of the day did not see as many patients in a single day as doctors do now.

Some medical students, after treating patients for a few years, give up the profession. The reason is none other than that, when studying medicine, their ideal was to solve patients' problems and realize their own life value in saving lives. But after starting work, they find that because the workload is too heavy and the patient load too large, outcomes are poor; they are physically and mentally exhausted, and patients complain. At that point, they can no longer derive much joy from the profession.

Under the current medical system, doctors working in hospitals have no authority to adjust their own work pace, which is a major problem. This state of affairs is unfavorable to both doctors and patients. If the workload of clinical doctors could be drastically reduced, I believe both doctor and patient satisfaction would rise considerably.

I am someone who works outside the system, so I can actually adjust my own work pace. Over these past years, I was more often unconsciously led by too many seekers—some of them patients with all kinds of difficult illnesses unrelated to the tumors I study long-term—into an overbusy state.

This may be an unavoidable stage in professional maturation; one always discovers one's own problems only after encountering confusion. Human reason must not be ruled by emotion. Reducing my workload and raising my diagnostic and treatment quality is my pressing priority.