A Shanghai hospital stay is nothing to fear. Read our tips before you're admitted
The quality and choice of healthcare for Shanghai expats has been improving rapidly over the last few years.
It wasn't long ago that expats from all over China, including Shanghai, would travel to Hong Kong or further afield to get good care, but now many expats from other parts of China will travel to Shanghai instead.
The main choices for Shanghai expats' medical care include the standard care provided by state-run public Shanghai hospitals, the VIP care available at some public or private Shanghai hospitals, the high-end care provided by Shanghai international hospitals and clinics, or a hybrid of the above.
In this article we shall take a look at healthcare provided in state-run public Shanghai hospitals. We have another article especially about foreign invested international hospitals and clinics in Shanghai.
For other Shanghai Healthcare issues you can check out these articles:
We have a list of Shanghai public hospitals at the end of this article.
Public state-owned hospitals are the heart of the Chinese healthcare system.
Unlike in the West, where we commonly use primary care services such as family GPAs or neighborhood clinics, most Shanghai hospitals are set up to offer basic healthcare consultations, as well as emergency and surgery services.
Some general hospitals offer all types of medical care, whereas others are more specialized, focusing on one or a few types of health issues, such as the Shanghai Chest hospital for heart issues, or the Shanghai Skin Disease and STD Hospital.
There are some small neighborhood clinics and more and more local private healthcare providers around China, but most Chinese people believe the public hospitals’ doctors are more qualified, and their equipment superior.
Both of these perceptions are basically true, based on how the Chinese healthcare system developed in the last 30 years. It has led, however, to over-crowded hospitals and poor preventative care, which the Chinese government is starting to tackle through a wide variety of reforms.
Although some Shanghai hospitals offer appointment booking services, they are not easy to use, and most often people will just show up at a hospital, find the required department, register on the spot, receive a number on a small piece of paper and then sit in the waiting area for their number to be called.
Recent developments, however, have made it easier to book a Shanghai doctor appointment through several new healthcare apps in Shanghai. Unfortunately most of these require a Chinese ID number so not very useful for expats.
Hospital departments have both general outpatient service (PuTong MenZhen 普通门诊) as well as highly experienced Specialist Doctors (Zhuānjiā yīshēng 专家医生). The specialists are usually on duty only one or two days a week, so people will arrive very early in the morning on those days to wait in long lines for an appointment. For local Chinese it has recently become easier to book a specialist doctor appointment using the healthcare apps, which as mentioned above are not available for expats.
If you have a health problem that you have not been able to cure even after several visits, trying to see a specialist could be a good idea, but otherwise the general physicians are very qualified.
The consultation fee to see a general practitioner is usually RMB 22 (US$3-4), and to see a specialist doctor anywhere from RMB 50-300 (US$10-45).
When your number is called, you will enter a small consultation room to meet the doctor. After a quick chat to find out what is ailing you, the doctor will do a few checks with their instruments.
If they don't find anything serious, they will give you a prescription. If the doctor thinks you might have an infection, or more serious problem, then they could order some bloodwork and other tests.
If tests are required you will first need to find the fee counter to make the payment. Then with your receipt head to another section where tests are carried out. There you will hand in your hospital card and receipts, and wait for your name to be called.
Basic blood and other tests could cost from RMB 50-400 (US$7-60), quite cheap relative to Western standards.
You can get the results for many of the tests within one hour, but some will require you to come back another day. As hospitals take lunch breaks, you might also end up having to wait until after lunch to have the test, or get your results.
If you get the results quickly, you can return to the consultation area, find your original doctor and without waiting in line ask them to check the results and give you a prescription. If you need to come in another day for the results, then you will have to register again to see another doctor.
Once you have your prescription you will find another counter to pay the fee, and then wait in the pharmacy area for your number to be called.
China also has specialized Traditional Chinese medicine hospitals (中医医院, Zhōngyī yīyuàn), but even in the more common Western medicine hospitals (西医医院, Xīyī yīyuàn) they will often prescribe Chinese medicines to go along with your Western medicine prescription.
If the doctor decides you require hospitalization and/or surgery, then they will check when a bed and surgery slot is available. You will then need to pay a deposit that will more than cover all the potential costs in order to confirm this appointment.
Before you become an inpatient, you should pick up some extra clothes, toiletries, reading materials and other supplies that public Shanghai hospitals do not provide. Most Chinese patients will have relatives or friends visit them daily in the hospital to bring supplies.
There is normally a food service, and someone will come by to take your order each day, although there is usually little choice.
When taking advantage of the cheap rates for standard care, you will probably end up sharing a room with several other patients. You could choose, however, the Shanghai hospital VIP service (discussed below) which will be much more expensive, but allow you to have a private or semi-private room.
Most expats who have had surgery in the large public Shanghai hospitals are quite impressed with the very clean and modern surgery rooms, and high quality of imported and local medical equipment used.
Shanghai Doctors come from the top medical universities in China. They go through long University and residency training before getting their license to practice.
Previously each hospital had their own residency training program, and only the doctors at the top Shanghai hospitals received the best on-the-job training. Since 2010, however, all new Shanghai doctors, regardless of where they end up, will go through the same standardized three-year residency program at one of the cities top hospitals before getting their license.
After becoming a Shanghai doctor, they will deliver hundreds of general consultations and many surgeries every year. Due to this intensive experience, their skills become quite good very quickly.
Although they might not always use the newest and most expensive foreign drugs and equipment, they receive plenty of on-the-job training on the newest drugs and medical equipment approved in China so their knowledge is quite up to date.
Although a public Chinese hospital will not usually accept the private medical insurance used by most Shanghai expats for direct billing in their standard care facilities, you can usually get reimbursed with your receipts and doctor's diagnosis forms afterwards.
Be sure to check what your medical insurance policy covers, and what documents are required to get reimbursed, before you use any services.
If you do have an emergency, the first thing to know is the emergency hotline number; 120. They can send an ambulance to pick you up at your home. Otherwise you can also go to the emergency ward at a Shanghai hospital, day or night.
One local hospital, Xinhua, has also launched a emergency hotline with English service; 2507 8999
Although Shanghai expats can enjoy the relatively cheap and subsidized service available from a public Shanghai hospital, they will need to accept its drawbacks which we list here.
Long waiting times:
Shanghai is a city of more than 23 million people, all sharing a limited number of hospitals. Most Chinese are attracted to use the same well-known large public Shanghai hospitals that expats would like to use.
So, be prepared to wait in several lines during the different stages of your hospital visit. Many of these waits could last more than one hour. You might have to miss a whole day or more of work just to complete your consultation and tests.
Since the good reputation of Shanghai hospitals extends to smaller cities and towns nearby, some people from neighboring areas will also come to Shanghai for their healthcare, thereby increasing wait times.
Most of the local Shanghai doctors can speak some basic English and read and write quite well, but only a few will be fluent. In the hospital you will also need to deal with many other staff while you register, pay for medicine, take your tests etc, who will speak very little English.
The nurses are usually very kind and do their best to help foreigners, but they are also very busy, so you need to be very patient and not have high expectations. Having a Chinese-speaking friend to go with you, therefore, is at the least very helpful if not critical.
With the huge number of patients and visitors, a Shanghai public hospital is not only crowded, but also less clean than Westerners are accustomed to.
Occasionally you will also see people smoking on hospital premises. A law banning smoking inside hospitals and schools in Shanghai was enacted in 2010, but sometimes it is difficult to enforce.
Lack of privacy:
During the consultation, tests and other interactions at the hospital, don’t expect much privacy. Sometimes the doors will stay open and other patients and staff will enter frequently.
Lack of personal care:
In the West, it is common to use the same family doctor and clinic over many years. They will learn about your family medical history and your overall health issues, in addition to your current ailment. They will keep your records for many years and consult them each time.
At a Shanghai hospital, however, you will rarely see the same doctor twice, and even if you do they probably won't remember you, due to the huge number of patients they see each day.
You will receive a small booklet when you register, in which the doctor will fill in their diagnosis. You can bring this booklet with you for future visits, but the new doctor usually only consults this if you are returning to discuss the results of recent tests and treatment. (Often they can't even read what a previous doctor wrote in the booklet.)
Each patient will only get a short amount of time with the doctor, as there are so many people waiting. Two to five minutes for the consultation for basic healthcare issues is the norm.
Lack of preventative care:
Shanghai doctors might give you some general preventative healthcare advice, but this is usually no more than "Stop drinking and smoking and go to bed early." So although the physicians’ medical skills cannot be questioned, you might come out wondering if they should be checking more thoroughly, and making sure they are giving you the most appropriate treatment for your long-term health.
Unlike Western doctors, Chinese doctors don't have the time to give you the peace of mind which can be important for your overall health and well-being.
If you require better care, the international hospitals and clinics in Shanghai are definitely worth the extra money.
Over-prescription of drugs, tests and treatments:
This is a big item in the Western news about the Chinese healthcare system, but actually it has been a common complaint of Chinese people for many years.
There are a number of factors involved. One is the huge pressure on Shanghai doctors to see many patients in a short period of time, while still being responsible to make sure they cure each patient's ailment.
Some doctors think it is safer to over-prescribe antibiotics and other medicines in order to ensure any infection is quickly cured, to avoid being accused by a patient of not taking their ailment seriously enough.
It is also acknowledged that many hospitals get over half their income from prescribing drugs, which contributes to salaries and bonuses earned by staff.
Chinese healthcare is going through huge reforms recently to tackle these issues.
It is common for Chinese doctors to prescribe intravenous (IV) for minor ailments. If you are prescribed the IV, then you will have to sit for a few hours in a special room with many other patients, and possibly need to come back for several days to complete your treatment.
IV is usually only used in the West to deliver antibiotics and other medications quickly into the bloodstream for seriously ill patients, or when patients are dehydrated from serious diarrhea or vomiting. Normally oral antibiotics are just as good and save time.
Although this custom does seem to be changing in Shanghai, it is still common around many parts of China. Many people claim it is to increase revenues for doctors, but sometimes the IV can actually be a cheaper solution.
You can always tell the doctor your time is limited, so you prefer oral medicine. If they insist you take the IV, however, there could be legitimate reasons.
Huashan Hospital in Jingan district is one of the largest in Shanghai
Some public Shanghai hospitals have established VIP wards, especially for expats and wealthy locals. Some of these are joint-ventures or in cooperation with overseas medical companies or investors. The first to do so was Huashan hospital in Jingan district, when it set up the Huashan Worldwide Medical Center in 1989.
These facilities often make use of the same Chinese doctors and equipment from the public hospital they are connected to. They will choose, however, doctors whose English language and other skills and experience are superior. The nurses and other staff in these VIP sections also speak better English than those in the main wards.
You can sometimes book appointments in English over the phone for VIP wards, although it can be difficult to dial in, so you might have to just show up get an appointment in person.
When you go to the VIP section of the hospital, you will not have to wait in long lines, as they will arrange a doctor to see you quite quickly.
The consultation rooms are much bigger and you will have more privacy. Some simple tests might be delivered in the VIP section directly, but for more complex tests you will be escorted by a nurse back into the main section of the hospital, where you will usually be taken to the front of the line and have the tests done immediately.
If you require hospitalization, then you can get a comfortable private or semi-private room, and you will have doctors and nurses visiting you more frequently than in the standard section.
For such VIP care, however, you will pay a lot more. The consultation fees for such VIP wards are quite similar to those at the international hospitals in Shanghai, and all the tests and treatments you receive will cost several times the price charged in the standard hospital section.
Some of these clinics cooperate with private medical insurance companies allowing direct billing, but you should always make sure first. If direct billing is not available, then make sure what you are covered for and what documents you require for reimbursement before your start the treatment.
The Shanghai government is now developing High-end private medical services for both high-wealth locals and expats at two new international medical centers; the Pudong International Medical Center and the Hongqiao International Medical Center.
It is unclear if this will lead to the closure of all or just some of the VIP wards in Shanghai public hospitals.