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Working languages: Chinese to English
| Anthony Sariti
Over 20 Years of Translation Experience
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| Freelancer and outsourcer | | Translation | | Specializes in: | | Advertising / Public Relations | Art, Arts & Crafts, Painting | | Finance (general) | History | | Medical: Health Care | Telecom(munications) |
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More Less | | PRO-level points: 32, Questions answered: 29, Questions asked: 11 | | U. S. dollars (usd) | Sample translations submitted: 1 Chinese to English: Shanghai Medical
General field: Social Sciences
Detailed field: Medical (general) | Source text - Chinese
上海居，醫療大不易
中國上海開放二十年來，台商台幹經歷「散兵遊勇探路」、「企業家創業天堂」、「白領階級攜家帶眷」等三波「台流」後，如今已有三十多萬名台灣民眾在此落戶生根。經過十多年腁手胝足的打拚，台商台幹也從青壯年步入哀樂中年。他們目睹上海的經濟起飛，有些人甚至興起日後可以在此安居退休的念頭。但移民上海，真是安全無虞？
Living in Shanghai – A Good Doctor Nowadays is Hard to Find
In the twenty years since the city of Shanghai opened its doors to the outside world, Taiwan businessmen and managers have arrived in three distinct waves—that of the ground-breaking pioneers, the entrepreneurs who lived in a businessman’s paradise and the white collar workers who came with wife and family. Today some 300,000 Taiwanese have settled here. After more than ten years of arduous work, the once youthful businessman and managers have now entered middle age. They have seen Shanghai’s spectacular economic rise, and some even imagine retiring here. But is emigrating to Shanghai really so worry free?
不少在上海長期居住的台灣民眾表示，他們可以和大陸人一樣，吃一餐6塊錢人民幣〈相當於台幣二十四元〉的便當、住一樣的員工宿舍、一起擠地鐵和公車，只有一項是不能忍受的，就是到大陸醫院看病；很多人會告訴你，「小病自己醫，大病回台灣，萬一不得已才去看大陸醫師」。
Many longtime Taiwan residents of Shanghai say they can live like the average mainlander—grab a box lunch for RMB$6, live in the same employee dormitories, squeeze into the subway coaches and public buses. But there is one thing they cannot take, and that’s going to a Chinese hospital. Many will tell you, “Small things, you take care of yourself. If you’re really sick, then you go back to Taiwan. Only if you have no other choice do you go to a Chinese doctor.”
硬體飛躍成長的上海背後，面對的是醫療環境軟體服務落後的嚴酷挑戰。大陸的看病文化和台灣究竟有何差別？真生了大病，又該怎麼辦？一直帶領大陸升級發展的台商，在這個領域又有何著力點？
Behind the spectacular material growth of Shanghai is the unrelenting challenge of the backward state of medical service. Just what are the differences between Mainland China and Taiwan in this area? If you really get sick, what do you do? What are Taiwan businessmen, who have been out in front leading development in China, doing about this?
主文：
如果沒有人告知，實在很難一眼看到隱身於江蘇路、延安西路口的上海電力醫院側門旁，有家台灣醫師看診的醫院。
If no one told you, it would be very hard to spot the hospital with Taiwan doctors tucked away next to the Shanghai Power Hospital at the intersection of Jiangsu Road and Yan’an West Road.
辰新醫院9樓病房裡住著劉太太國中二年級的兒子，兩天前兒子發燒住院觀察，她一直陪在身邊。談起在上海看病，她抱怨連連，直指這是台商家屬最大的煩腦。
In a room on the 9th floor of Chenxin Hospital lies the 8th grade son of Mrs. Liu. Two days before he was running a fever and entered the hospital for observation, and Mrs. Liu has been by his side ever since. A chat about health in Shanghai elicits a stream of complaints. Plainly, this is the biggest headache for family members of the Taiwan businessmen who work here.
第一年小女兒唸幼稚園要做體檢，帶到當地衛生局，結果護士抽血竟然拿出一根又大又粗的老式針管，嚇得小孩大哭，她也很害怕，但還是看著碩大的針頭插進女兒細嫩的皮膚。又有一次到兒科專屬醫院，醫師檢查口腔，拿出一隻黑漆漆、好像用了很久又沒消毒的木片伸進女兒喉頭，最離譜的是竟然用手電筒探照口腔。
When Mrs. Liu took her daughter to the local health station for her kindergarten physical, the nurse pulled out a big, outdated needle with a large diameter to take blood. Her daughter broke out in tears and Mrs. Liu herself was quite frightened but nonetheless watched as the huge needle pierced her daughter’s tender skin. Another time at a children’s hospital the doctor was giving an oral exam and pulled out a blackened wooden tongue depressor that looked like it had been used repeatedly and hadn’t been disinfected in a very long time and stuck it down her daughter’s throat. The most bizarre thing was when the doctor used a flashlight to examine her mouth.
◎住在上海的最大抱怨
劉太太多方探詢後，才知道辰新醫院有台灣醫師，讓她放心多了，「希望上海多一點像辰新一樣的台灣醫院。」她說，上海生活壓力大、樂趣少，「休閒生活不方便也就算了，但台商真的很需要專屬醫院。」
The No. 1 complaint
After much inquiry, Mrs. Liu learned that Chenxin Hospital had Taiwan doctors, and this made her feel a lot better—“I wish Shanghai had a few more Taiwan hospitals like Chenxin.” Mrs. Liu says life in Shanghai has many pressures but few pleasures. “Leisure activities are hard to come by—but it doesn’t matter. What does matter and what the Taiwan business community really needs is their own designated hospital.”
「就醫難」是台灣民眾的普遍心聲。上海科學院曾在去年7月小規模詢問過數十位台灣民眾在上海的生活起居，歸納出「台灣人最大的抱怨是：上海人文化素質低下、醫療品質品質太差，也很擔憂外地人太多造成治安問題。」
“Medical treatment is difficult,” this is the general complaint of the Taiwanese living in Shanghai. Last July the Shanghai Academy of Science conducted a small survey of daily life among a few dozen Taiwanese living in the city. The conclusion: “The biggest complaints of the Taiwanese living in Shanghai are (1) the low level of culture among Shanghaese, (2) the unacceptable quality of medical treatment and (3) security worries about problems caused by people coming into Shanghai from the countryside.
看到台灣民眾在大陸的醫療需求，4年前台灣桃園壢新醫院與上海電力醫院合作，借用電力醫院的空間，設立一個專為台灣民眾服務的辰新醫院，內部有家醫科、牙科、復健科、中醫科等，以及9間內科病房。
Seeing the medical needs of Taiwanese living in China, four years ago the Taoyuan Li Shin Hospital in Taiwan worked out a cooperative agreement with Shanghai Power Hospital under which they borrowed space and set up Chenxin Hospital, a dedicated facility to serve Taiwanese. The hospital had a department of family medicine, dental care, rehabilitation and Chinese medicine as well as nine sick rooms for internal medicine.
「不少台商寧願拖著、忍著、冒著延誤病情的風險等待休假時回台灣看病，而且台商就醫的心情都是，只要能回來，不管花多少錢都要回來，尤其病情越嚴重的越想回來，因為不敢信任大陸的醫療技術，」因醫療學術交流 常往返兩岸 的壢新醫院院長張煥禎說，台商對大陸醫院的看病流程、環境非常不習慣；大陸當然也有一流的特級醫院，但整體來說，就醫環境相當於15年前的台灣。
“Many Taiwanese would rather let things drag on, tough it out, run the risk of letting a disease develop and wait to see a doctor during their vacation leave back in Taiwan. Their attitude is just to get back to Taiwan, money is no object, and the more serious the illness, the more they are intent upon returning because they dare not trust mainland medical technology,” says Victor Chang, President of Li Shin Hospital and a person who has been back and forth to China often on medical exchanges. Taiwanese businessmen are not at all accustomed to the medical treatment available in Chinese hospitals. China of course does have some first class hospitals but generally speaking, medical treatment is fifteen years behind that of Taiwan.
4年來，在辰新看病的台灣民眾已超過兩萬人，一天平均20人，但「規模還是太小，譬如沒有加護病房，緊急重大病患還是得轉介其他醫院，」去年從桃園本院派駐辰新的周明仁副院長說，他曾碰到一名必須轉院的病患竟說出「寧願死在這裡也不要轉院」的話，可見這名病患對大陸醫療的印象有多壞。
More than 20,000 Taiwanese have been treated at Chenxin Hospital in the last four years, with an average of 20 people a day. But “the size is still too small. For example, we do not have an intensive care unit. Serious emergency patients still must be referred to other hospitals,” says Chou Ming-jen, Deputy Director of Chenxin, who last year was seconded here from Li Shin Hospital in Taoyuan. He even had a patient who had to be referred who told him, “I’d rather die here than be referred to another hospital,” a statement that shows how poor an image this patient had of Chinese medical treatment.
◎中文藥名霧煞煞
但辰新畢竟不是綜合醫院，萬一生大病怎麼辦？而上海人口接近１千7百萬，面積相當於五分之一個台灣、23個台北市，腹地廣大，台灣民眾還是得深入了解當地的就醫環境。
Curious labels
But Chenxin is not a general hospital. What if you come down with a serious illness? Shanghai has a population of close to 17 million with a land area 1/5 that of Taiwan and 23 times that of Taipei City. This is a huge expanse of territory, and the Taiwanese that live there must know the medical environment well.
一年半前張翠華辭去銀行的金飯碗，帶著兩位女兒遷居上海和先生團聚，事前她已有大陸看病不如台灣方便的心理準備，但還抱著「大陸同胞都可以看，我們為何不能看？」的想法，準備以不變應萬變。
A year and a half ago Chang Tsui-hua left the secure world of banking and brought along her two daughters to live in Shanghai with her husband. She was psychologically prepared for a medical environment that didn’t measure up to Taiwan standards but still prepares to meet changing circumstances with tried and true methods, wondering to herself, “our mainland brethren can see the situation, why can’t we?”
「有些台商太太會把所有可以帶的藥都帶過來，但這麼做是不是太神經質？不舒服就自己當醫生配藥吃，不是更危險！」這是她當時的想法。
“Some Taiwanese wives bring over all the medicine they can carry, but isn’t this a little too neurotic? Isn’t it more dangerous to play doctor?!” This was the way she thought when she first arrived.
沒想到14歲的女兒小狀況不斷，幾次往返醫院的看病經驗，讓她充滿疑問，也了解到兩岸的醫療文化確實大有差異。
Unexpectedly her 14-year-old daughter had a series of minor medical situations and had gone a number of times to the hospital for treatment, which raised a great many doubts in Chang’s mind and led her to understand that there really were vast differences between mainland and Taiwan medical treatment.
小女兒從台灣國中轉進當地學校，也許是轉校不適應，導致胃痛發作，到了相當於台灣教學醫院的三級甲等瑞金浦東醫院看診，醫師開了一堆藥，回來後她端詳「硫酸慶大霉素緩釋片」、「複方顛茄合利」這些藥名，想研究出個所以然來。「尤其『霉素』這兩個字看起來很可怕，好像是醫院自己開發的藥，但我們只能選擇吃或不吃，」她說。
Mrs. Chang's/Her daughter attended the local middle school and perhaps because she couldn’t adapt to this change she developed stomach problems. She then went to Ruijin Pudong Hospital, the equivalent of a Class A, Level III teaching hospital in Taiwan. The doctor gave her a bunch of medicine and when she got home, Chang took a good look at the labels, which were filled with odd-sounding names, and thought she would do some research and find out what they were. “It was especially the words ‘poisonous substance’ that gave me a fright. They all seemed to be medicine developed by the hospital itself but our only choice was to take it or not take it,” she says.
除了用藥習慣、藥名翻譯的差異外，醫生的服務態度也令人不敢恭維。今年暑假17歲的大女兒嘴唇邊長青春痘，結了個大痂被摳破後流血不止，然後變成水泡、越長越大，她們到以皮膚科聞名的教學級醫院華山去，看診醫師說，得用激光〈雷射〉切除，到了激光室後，執刀醫師卻說，「不能做，太大了，血流不止怎麼辦？先擦藥膏等痂小點後再回來。」於是她們拿回一罐聞起來像中藥、顏色像紅豆粉的三聖散，但抹了一星期完全無效，並沒有變小。
In addition to the differences in taking medicine and in the translation of medicinal names, the service mentality of the doctors left quite a bit to be desired. This summer Chang’s 17-year-old daughter developed some acne on the side of her lip that bled profusely when the scab broke. This was followed by a blister that continued to grow. Mother and daughter went to Huashan, a teaching hospital known for its dermatology department. The doctor they saw said he would have to excise the blister with a laser. When they got to the laser room the doctor who was to perform the procedure said, “I can’t do it. It’s too large. What happens if we can’t stop the bleeding? Put some salve on it and wait until it gets smaller, then come back.” So they took back with them a jar of something that smelled like Chinese medicine, the color of red bean powder, called san-sheng-san. But after using it week, it proved totally ineffective, the blister had not gotten any smaller.
一星期後她又回到激光室，這次輪值的醫師換人了，她小心翼翼地轉述上次那位醫師的說法，想不到這位女醫師很生氣地回說：「別人不能做，不代表我不能做！但可能會留下疤痕。」張翠華只好安慰自己，台灣的大牌醫師也都很「跩」，她的醫術應該很好。果不其然，現在連疤痕都逐漸變淡，總算沒有影響女兒準備大學會考的心情。
A week later she returned to the laser room, This time there was a different doctor on duty so she very carefully repeated what the previous doctor had said and, lo and behold!, this new doctor, a woman, angrily responded: “Just because someone else can’t do it doesn’t mean I can’t. But there may be some scarring.” Chang Tsui-hua could only console herself with the fact that all popular Taiwan doctors were a bit taken with themselves. This particular doctor, she figured, should be quite capable. And indeed, this was the case. Now the scar has gotten quite faint and the whole episode seems not to have affected in the least the daughter’s mood toward sitting for a university entrance exam.
幾次看小病的經驗，讓張翠華有個小心得，「大陸醫師講話比較粗率直接，他們不認為自己不禮貌，應該算是文化差異。下次生小病還會來，但大病就回台灣吧。」
These experiences with minor problems taught Chang Tsui-hua something: “Mainland doctors are rather brusk and direct. They don’t think they are being impolite. It’s rather a cultural difference. We’ll go again if it’s something small, but for something serious, we’ll return to Taiwan.”
◎一年一個樣
張翠華的資訊沒錯，華山醫院的皮膚科的確聞名中國。附屬於上海復旦大學的華山醫院，是上海數一數二的教學醫院，類似這種三級甲等的醫院，全中國有623家，上海有35家。
◎
What Chang Tsui-hua says is right. The dermatology department at Huashan, which is affiliated with Fudan University, is truly well known throughout China. It is one of Shanghai’s handful of teaching hospitals. Similar hospitals of this Class A, Level III variety number 623 in the country, and 35 of them are located in Shanghai.
華山醫院的重量級地位可由它的超高門診量看出。單以皮膚科來說，一天平均看3000名病人，最高紀錄可達4000人，皮膚科去年門診量為72萬人，今年可望突破80萬人，50%是慕名而來的外地病人；全院醫療業務年收入達10億人民幣，是台灣長庚醫院的幾倍、台大醫院的幾倍〈數字待查證〉。
Huanshan’s prominent position can be seen from the huge number of patients it handles. The dermatology department alone sees an average of 3,000 patients a day and has even hit 4,000 in one day. Last year the department handled some 720,000 patients and this year they are looking to break the 800,000 figure. Fifty percent of those who come from outside of Shanghai are attracted by the department’s reputation. The hospital’s yearly income runs around RMB$1 billion, a figure several times that for Taiwan’s Chang Gung Memorial Hospital or Taiwan University Hospital.
做為中國境內第一所與美國哈佛大學合作的醫院，華山醫院很早就體認到外籍人士在大陸的醫療需求，早在1989年就設立外賓門診，以歐美、日本病患居多，境外病患也從早期的個位數，增加到現在一天150人左右。近年更成為上海台商家庭最倚賴的醫院之一。
Huashan was the first hospital in China to have a cooperative relationship with Harvard University and very early on understood the medical needs of foreigners residing in the country. As early as 1989 it set up a foreigner’s clinic, the majority of patients being from the U.S., Europe and Japan. The number of patients from outside Shanghai has grown from just a few during the early period to about 150 a day at present. In recent years Huashan has become one of the hospitals most relied on by the Taiwan business community in Shanghai.
除了華山醫院這類特設外賓部門的醫院外，為了解決台商最大的擔憂，上海台辦又與衛生局協商，於2001年10月率先 指定 瑞金集團閩行區「中心醫院」開闢 台胞就診的「綠色通道」。
Aside from hospitals like Huashan that have set up special sections for foreigners, the Shanghai Taiwan Affairs Office has worked out an agreement with the Bureau of Public Health to take care of the biggest worry among the Taiwan business community in Shanghai. In October 2001 they took the lead in having the Ruijin “Central Hospital” in the Minhsing District open up a “green lane” for the medical treatment of Taiwanese.
閩行區台胞台屬聯誼會副秘書長朱余生表示，以前很多台商因為不熟悉上海的醫療資源，也不知道到哪找好醫生，一旦罹患生重病，馬上買機票回台灣。但他們也很擔心，萬一轉機時發生狀況怎麼辦？
Zhu Yu-sheng, Deputy Secretary of the Minhsing District Taiwanese Friendship Association, says in the past because many Taiwanese were unfamiliar with medical resources in Shanghai and didn’t know where to go to find a good doctor, they would immediately think about buying a ticket back to Taiwan the minute they became seriously ill. But they also worried about what they would do if something happened while they were changing planes.
目前台商定點醫院已逐步增加到浦東、長寧、徐匯等31家區域級醫院，來看病的台胞都會有專人陪同，從掛號、檢查到交款、取藥，所有程序「一路綠燈」。
The number of designated hospitals for the Taiwan business community has gradually expanded to some 31 district level institutions in Pudong, Changning, and Xuhui. Taiwanese who come in for treatment are accompanied by special personnel. From registration and examination to paying the bill and getting medicine, the way is cleared with “green lights” all the way.
◎軟硬何時並進？
「一路綠燈」固然方便，但還是不足以令台商安心。除了多數區域級醫院環境差，大陸病人衛生習慣更差，病人咳嗽不掩口、隨地吐痰擤鼻涕，走進大陸醫院隨時得擔心病菌上身，會不會 小病進人變成大病？
Keeping pace?
“Green lights all the way” certainly make things convenient but it’s still not enough. In addition to the substandard environment of most district level hospitals, public hygiene habits are even worse. Patients cough without covering their mouths and they spit and blow their noses out in the street. Whenever you enter a hospital you have to worry about being inundated with germs. In these circumstances, might not a minor disease turn into a major one?
目前，全上海雖有四百多家公立醫院，以及近八百家中外合資、合作的私立醫院和診所，但是台灣民眾不是憂心上海沒醫院，而是服務不到位。大陸醫療環境的問題在於，「硬體起拔」容易，短時間內立即可達國際水平，但服務品質是否同時跟進？
Shanghai currently has more than 400 public hospitals and close to 800 joint venture and cooperative private hospitals and clinics. Taiwanese do not worry that the city is without hospitals but are disheartened that service is not up to standard. The problem with mainland medical treatment is that it’s easy to “build hardware” and in a short time get up to international standards but can service quality keep pace?
兩年前接任華山醫院院長徐建光表示，華山醫院斥資6.5億人民幣在浦東新建的分院即將在年底前落成，他開玩笑說，現在不當醫師，改作工地監工，每天盯進度。
Xu Jianguang, who took over as Director of Huashan two years ago, says Huashan put out RMB$650 million for a new branch hospital in Pudong that is to be finished by the end of the year. He jokes that he is no longer a doctor but a construction foreman who checks on the daily progress of the work.
「我的新辦公室比 哈佛醫學院 麻省總院 院長 的辦公室還氣派，但我的管理水準比他差得多；這不是我的能力差，而是中國的制度、醫療系統、文化等諸多因素影響，我們不可能一步趕上，但會慢慢進步，還要靠整體民眾的文明提升。」
“My new office is more stylish than that of the director of Harvard University Hospital or Massachusetts General but my management standards lag far behind. It’s not that I don’t have the ability, it’s the influence of Chinese institutions, the medical system, the culture. We can’t catch up in one big jump, but we’ll make gradual progress, and we’ll have to do this in conjunction with a rise in the cultural level of the whole population.”
「華山醫院龐大的門診量 要提供好服務，可能有些困難，因為收費太低了。如果台商也擠在『基本醫療』的框架下，肯定不滿意，勢必要有個特殊的醫療服務機構或通道才行，」徐建光因此常敦促涉外醫療中心的醫師們，再強化服務意識。
“Providing good service to the huge number of patients who visit the Huashan clinic may entail some problems because the fees are too low. If Taiwanese were forced to accept ‘basic medical treatment’ they would definitely not be happy about it. There has got to be a specific medical service entity or channel for them.” Because of this, Xu Jianguang often urges doctors working in medical centers catering to foreigners to further improve their service mentality.
◎執法不嚴
大陸醫生素質參差不齊，有其深層的歷史因素。
Lax enforcement
The uneven quality of mainland doctors has deep historical roots.
文革10年「破四舊」，無產階級當家，知識份子被打成臭老九；幾十年前，農村出現一批聊具簡單醫學常識的「赤腳醫生」，目前仍在偏遠農村執業。90年代後雖然有大批出國留學的醫師回來，但當時中國醫療環境太差，很多人不願意留下來。
During the ten years of the cultural revolution aimed at “smashing the four olds,” the proletariat was on top and intellectuals became the “stinking old ninth” (i.e., the ninth category of class enemies). As early as 1958 what were called “barefoot doctors” appeared in the countryside. These were people with only basic, common sense medical knowledge. Even now these people are still carrying on their work in some remote areas. Although in the 1990s a great number of doctors returned to China who had been studying abroad, the medical environment in the country was very substandard and many were unwilling to stay.
曾走訪大陸城鄉各級醫療院所的 陽明大學 醫務管理研究所 副教授錢慶文，比較兩岸醫師養成教育說，台灣醫師從醫學院畢業，到醫院實習、訓練、再考執業執照，基礎知識與臨床經驗的過程清楚、完整，而大陸衛生單位執法不徹底，常有醫學系剛畢業、沒有臨床經驗者，卻也能 掛主治醫師 的情形。
Associate Professor Chien Ching-wen of National Yang Ming University’s Institute of Hospital and Health Care Administration has visited medical institutions of all levels on the mainland. Comparing medical education in China and Taiwan, he says that in Taiwan doctors graduate from medical school, do a practicum and training residency in a hospital, then take a license examination. The process of acquiring fundamental knowledge and clinical experience is clear and complete. In China Ministry of Health officials do not adhere strictly to the law. Often people who have just graduated from a medical department with no clinical experience are able to hang out their shingles as “doctor in charge.”
錢慶文指出，外科重視經驗，大陸醫院多、病患多，小醫師都可以操刀、累積經驗的速度也快，但對於高度依賴精密儀器 作病情判讀診斷 的內科，大陸醫師就差很多。
Chien points out that external medicine places a premium on experience. There are many medical schools in China and many patients. Young doctors can all wield the scalpel and quickly get experience. But when it comes to internal medicine where you rely heavily on sensitive instruments to make a diagnosis, mainland doctors are very far from the mark.
以移植醫學為例，台灣醫師技術高超，但缺少可供移植的器官。而大陸雖然也有像是天津醫科大學一流的肝移植技術等，但整體來說，技術水平不整齊，以致常發生台灣病患到大陸換肝、換腎後，因器官配對倉卒、處理術後併發症的經驗不足，病患又緊急轉回台灣的情形。不少台大、榮總外科醫師都有 為大陸醫師處理移植手術失敗 的棘手經驗。
Take medical transplants, for example. The skills of Taiwan doctors in this area are superior but there is a lack of organs. Although first class liver transplant technique also exists in China, like that at Tianjin Medical University, on the whole the level of technique is uneven. This frequently leads to a situation where a Taiwanese patient has had a liver or kidney transplant and, because there had been a hasty match up of the organ and Chinese doctors have insufficient experience in post-op complications, the patient makes an emergency evacuation back to Taiwan. Many surgeons at National Taiwan University Hospital and Taipei Veterans General Hospital have had some trying experiences because of transplant failures done by mainland doctors.
◎收費有蹊竅
由於台灣民眾不熟悉大陸醫療體系，能否碰到好醫師，得看運氣，其次，「大陸看病貴」也是台灣民眾普遍反映。在設備、服務較為台灣民眾接受的三級醫院內，設有專家名醫駐診的特需門診，但掛號費、診察費加藥費，平均要比基本門診貴上10倍。
Strange fees
Because Taiwanese are not familiar with the mainland medical system, stumbling upon a good doctor is a matter of luck. Next to this, Taiwanese also generally complain that “it’s expensive to see a doctor in China.” In a Level III hospital, where Taiwanese more or less accept the level of equipment and service, there is a clinic staffed by specialists and doctors of good reputation but the registration, examination and medicine fees average ten times that of the basic clinic.
自1980年代中國實施財政改革後，中共政府對公立醫院的補助大幅減少，在自負盈虧的壓力下，常出現自立名目、自定標準、建議重複或者不必要的檢查等亂收費的情況。
Since the financial reforms of the 1980s Chinese government assistance to public hospitals has dropped sharply. Under the pressure of economic self-sufficiency, a chaotic fee structure has emerged, with hospitals creating their own chargeable items, setting their own standards, and suggesting repeat or unnecessary examinations.
辰新醫院 劉宗瑜 中醫師的83歳外公，去年冬天來崑山探望在當地工作的舅舅，不慎感冒轉為肺炎，送進崑山第一人民醫院，他找了當地同學幫忙才有病房，第二天進了加護病房，第四天就過世了，醫師說法是「器官衰竭」。由於外公年事已高，劉家對醫師的解釋勉強接受，但住了4天卻得支付1萬人民幣醫療費，「感覺上實在很貴，因為醫師其實什麼都沒做」。
The 83-year-old grandfather of Liu Zongyu, a doctor of Chinese medicine at Chenxin Hospital, visited Liu’s uncle who was working in Kunshan last winter. He neglected his cold, which then turned into pneumonia, and was sent to the First People’s Hospital of Kunshan. He had to enlist the help of a classmate before he was able to get a room. The following day he went into an intensive care unit and on the fourth day he passed away, the doctor explaining this was due to “organ failure.” Because the grandfather was elderly, the Liu family was forced to accept the explanation but had to pay RMB$ 10,000 for the four-day stay in the hospital. “We felt this was actually quite expensive because the doctor really didn’t do anything.”
明基電通公司 蘇州新區 新事業及 市場高級經理 張世誠，1999年派駐蘇州，近水樓台娶了江蘇美女周鴻岸，3年前太太懷孕，他堅持產檢可以在大陸作，但一定要回台灣生產。
Chang Shih-cheng, the senior market manager in Suzhou for Acer Communications & Multimedia Inc., arrived in 1999. Living among the local inhabitants, Chang married a Jiangsu beauty named Zhou Hongan. Three years ago she became pregnant and Chang insisted that prenatal exams could be done in China but that his wife would definitely make the trip to Taiwan for the delivery.
已來返台北婆家十餘次的周鴻岸比較兩岸醫療環境說，「差太多了！」她的朋友在蘇州生產，羊水快破了趕往醫院，醫師卻要她下午再來住院，幾小時後這位年輕媽媽的羊水已經快流光了、胎兒心跳也有異狀，醫師才趕緊進行剖腹生產。這種不為患者著想的服務態度，不只先生不放心，她也嚇得不敢在大陸生。
Comparing the medical environment on either side of the strait, Zhou Hongan, who has now traveled more than ten times to Taipei to see her in-laws, says “It's so much worse in China!” A friend of hers who gave birth in Suzhou had had to be rushed to the hospital just before her water broke, but the doctors wanted her to wait and come again in the afternoon before going in. A few hours later, the young mother’s amniotic fluid was almost completely gone. The fetus also had heart palpitations. Only at this point did the doctor hurriedly perform a C-section. This service mentality, totally unconcerned with the patient, not only unsettled Chang, his wife was so frightened she dared not give birth in China.
每次兩歲的兒子偉偉感冒、發燒，周鴻岸帶到大陸醫院，醫師一定先打消炎針，若燒不退，就再吊點滴，有一次連吊3袋，她捨不得小孩痛、又得挨這麼多針，要求醫師用台灣通用的軟針，還得多付30元人民幣。小孩抵抗力差，她總擔心大陸醫師藥量下得太重，而台北醫師一定採取較緩和的治療方法，也會先告訴她，感冒至少要10天才會好，別急。為了讓偉偉準時接受日本腦炎、德國麻疹等疫苗注射，張世誠都得特別請假，帶母子兩人飛回台北。
Each time her two-year-old son Wei-wei caught a cold and ran a fever, Zhou Hongan would take him to a mainland hospital and the doctor was sure to first give him an anti-inflammatory shot and then follow that up with an intravenous drip, once giving him as many as three. She couldn’t stand the fact that her son was in pain and taking so many shots so she asked the doctor to use a relatively painless infusion needle common in Taiwan. This cost her an extra RMB$30. Her son’s resistance was poor and she worried that the doctors were giving him too much medicine. Taiwan doctors were always sure to take a more slow and easy approach to treatment and would first inform the mother about what they were doing. A cold would take at least ten days to get over, there was no rush for Taiwan doctors. So Wei-wei could get his vaccines for Japanese encephalitis and German measles on time, Chang Shih-cheng had to request vacation days to take mother and child back to Taiwan.
10年前，在上海的台商台幹年輕力壯、單身赴任，對醫療的需求還不強烈；10年後，台商台幹年紀漸長，才猛然警覺健康的身體是為事業打拚的最大資本，加上全家團聚，兒女父母也接過來，難免時有小病痛。當中國的城市建設向國際水平邁進，當孩子也在台商子弟學校成立後 獲得解決，他們更希望日後身體的健康也能安心托付，而這個基本的願望，還得靠兩岸醫界的攜手努力。
Ten years ago Taiwan businessmen and managers were young, strong and single, and there was no great demand for medical services. Ten years later these same men have aged and suddenly they realize that a healthy body is their most valuable asset in their job. Add to this the fact that now the family lives together, the children and parents are brought over, it’s hard to avoid small health problems. At a time when China’s urban development is approaching international standards and when the children’s education problem has been solved by the establishment of schools for them, Taiwanese businessmen are hoping that the health problem can be taken care of, but this basic wish still depends upon the close cooperation of the medical communities on either side of the strait.
今年9月中國衛生部下令，未取得醫師執業執照資格的 醫科大學畢業生 不得獨立從事臨床醫療工作。顯見長久以來非法行醫在大陸一直是嚴重問題。
In September of this year the Chinese Ministry of Health issued an order that graduates of medical universities who did not yet have a license to practice medicine may not independently engage in clinical medicine. Obviously, the practice of illegal medicine in China is a serious problem of long standing.
***************
| Translation - English
上海居，醫療大不易
中國上海開放二十年來，台商台幹經歷「散兵遊勇探路」、「企業家創業天堂」、「白領階級攜家帶眷」等三波「台流」後，如今已有三十多萬名台灣民眾在此落戶生根。經過十多年腁手胝足的打拚，台商台幹也從青壯年步入哀樂中年。他們目睹上海的經濟起飛，有些人甚至興起日後可以在此安居退休的念頭。但移民上海，真是安全無虞？
Living in Shanghai – A Good Doctor Nowadays is Hard to Find
In the twenty years since the city of Shanghai opened its doors to the outside world, Taiwan businessmen and managers have arrived in three distinct waves—that of the ground-breaking pioneers, the entrepreneurs who lived in a businessman’s paradise and the white collar workers who came with wife and family. Today some 300,000 Taiwanese have settled here. After more than ten years of arduous work, the once youthful businessman and managers have now entered middle age. They have seen Shanghai’s spectacular economic rise, and some even imagine retiring here. But is emigrating to Shanghai really so worry free?
不少在上海長期居住的台灣民眾表示，他們可以和大陸人一樣，吃一餐6塊錢人民幣〈相當於台幣二十四元〉的便當、住一樣的員工宿舍、一起擠地鐵和公車，只有一項是不能忍受的，就是到大陸醫院看病；很多人會告訴你，「小病自己醫，大病回台灣，萬一不得已才去看大陸醫師」。
Many longtime Taiwan residents of Shanghai say they can live like the average mainlander—grab a box lunch for RMB$6, live in the same employee dormitories, squeeze into the subway coaches and public buses. But there is one thing they cannot take, and that’s going to a Chinese hospital. Many will tell you, “Small things, you take care of yourself. If you’re really sick, then you go back to Taiwan. Only if you have no other choice do you go to a Chinese doctor.”
硬體飛躍成長的上海背後，面對的是醫療環境軟體服務落後的嚴酷挑戰。大陸的看病文化和台灣究竟有何差別？真生了大病，又該怎麼辦？一直帶領大陸升級發展的台商，在這個領域又有何著力點？
Behind the spectacular material growth of Shanghai is the unrelenting challenge of the backward state of medical service. Just what are the differences between Mainland China and Taiwan in this area? If you really get sick, what do you do? What are Taiwan businessmen, who have been out in front leading development in China, doing about this?
主文：
如果沒有人告知，實在很難一眼看到隱身於江蘇路、延安西路口的上海電力醫院側門旁，有家台灣醫師看診的醫院。
If no one told you, it would be very hard to spot the hospital with Taiwan doctors tucked away next to the Shanghai Power Hospital at the intersection of Jiangsu Road and Yan’an West Road.
辰新醫院9樓病房裡住著劉太太國中二年級的兒子，兩天前兒子發燒住院觀察，她一直陪在身邊。談起在上海看病，她抱怨連連，直指這是台商家屬最大的煩腦。
In a room on the 9th floor of Chenxin Hospital lies the 8th grade son of Mrs. Liu. Two days before he was running a fever and entered the hospital for observation, and Mrs. Liu has been by his side ever since. A chat about health in Shanghai elicits a stream of complaints. Plainly, this is the biggest headache for family members of the Taiwan businessmen who work here.
第一年小女兒唸幼稚園要做體檢，帶到當地衛生局，結果護士抽血竟然拿出一根又大又粗的老式針管，嚇得小孩大哭，她也很害怕，但還是看著碩大的針頭插進女兒細嫩的皮膚。又有一次到兒科專屬醫院，醫師檢查口腔，拿出一隻黑漆漆、好像用了很久又沒消毒的木片伸進女兒喉頭，最離譜的是竟然用手電筒探照口腔。
When Mrs. Liu took her daughter to the local health station for her kindergarten physical, the nurse pulled out a big, outdated needle with a large diameter to take blood. Her daughter broke out in tears and Mrs. Liu herself was quite frightened but nonetheless watched as the huge needle pierced her daughter’s tender skin. Another time at a children’s hospital the doctor was giving an oral exam and pulled out a blackened wooden tongue depressor that looked like it had been used repeatedly and hadn’t been disinfected in a very long time and stuck it down her daughter’s throat. The most bizarre thing was when the doctor used a flashlight to examine her mouth.
◎住在上海的最大抱怨
劉太太多方探詢後，才知道辰新醫院有台灣醫師，讓她放心多了，「希望上海多一點像辰新一樣的台灣醫院。」她說，上海生活壓力大、樂趣少，「休閒生活不方便也就算了，但台商真的很需要專屬醫院。」
The No. 1 complaint
After much inquiry, Mrs. Liu learned that Chenxin Hospital had Taiwan doctors, and this made her feel a lot better—“I wish Shanghai had a few more Taiwan hospitals like Chenxin.” Mrs. Liu says life in Shanghai has many pressures but few pleasures. “Leisure activities are hard to come by—but it doesn’t matter. What does matter and what the Taiwan business community really needs is their own designated hospital.”
「就醫難」是台灣民眾的普遍心聲。上海科學院曾在去年7月小規模詢問過數十位台灣民眾在上海的生活起居，歸納出「台灣人最大的抱怨是：上海人文化素質低下、醫療品質品質太差，也很擔憂外地人太多造成治安問題。」
“Medical treatment is difficult,” this is the general complaint of the Taiwanese living in Shanghai. Last July the Shanghai Academy of Science conducted a small survey of daily life among a few dozen Taiwanese living in the city. The conclusion: “The biggest complaints of the Taiwanese living in Shanghai are (1) the low level of culture among Shanghaese, (2) the unacceptable quality of medical treatment and (3) security worries about problems caused by people coming into Shanghai from the countryside.
看到台灣民眾在大陸的醫療需求，4年前台灣桃園壢新醫院與上海電力醫院合作，借用電力醫院的空間，設立一個專為台灣民眾服務的辰新醫院，內部有家醫科、牙科、復健科、中醫科等，以及9間內科病房。
Seeing the medical needs of Taiwanese living in China, four years ago the Taoyuan Li Shin Hospital in Taiwan worked out a cooperative agreement with Shanghai Power Hospital under which they borrowed space and set up Chenxin Hospital, a dedicated facility to serve Taiwanese. The hospital had a department of family medicine, dental care, rehabilitation and Chinese medicine as well as nine sick rooms for internal medicine.
「不少台商寧願拖著、忍著、冒著延誤病情的風險等待休假時回台灣看病，而且台商就醫的心情都是，只要能回來，不管花多少錢都要回來，尤其病情越嚴重的越想回來，因為不敢信任大陸的醫療技術，」因醫療學術交流 常往返兩岸 的壢新醫院院長張煥禎說，台商對大陸醫院的看病流程、環境非常不習慣；大陸當然也有一流的特級醫院，但整體來說，就醫環境相當於15年前的台灣。
“Many Taiwanese would rather let things drag on, tough it out, run the risk of letting a disease develop and wait to see a doctor during their vacation leave back in Taiwan. Their attitude is just to get back to Taiwan, money is no object, and the more serious the illness, the more they are intent upon returning because they dare not trust mainland medical technology,” says Victor Chang, President of Li Shin Hospital and a person who has been back and forth to China often on medical exchanges. Taiwanese businessmen are not at all accustomed to the medical treatment available in Chinese hospitals. China of course does have some first class hospitals but generally speaking, medical treatment is fifteen years behind that of Taiwan.
4年來，在辰新看病的台灣民眾已超過兩萬人，一天平均20人，但「規模還是太小，譬如沒有加護病房，緊急重大病患還是得轉介其他醫院，」去年從桃園本院派駐辰新的周明仁副院長說，他曾碰到一名必須轉院的病患竟說出「寧願死在這裡也不要轉院」的話，可見這名病患對大陸醫療的印象有多壞。
More than 20,000 Taiwanese have been treated at Chenxin Hospital in the last four years, with an average of 20 people a day. But “the size is still too small. For example, we do not have an intensive care unit. Serious emergency patients still must be referred to other hospitals,” says Chou Ming-jen, Deputy Director of Chenxin, who last year was seconded here from Li Shin Hospital in Taoyuan. He even had a patient who had to be referred who told him, “I’d rather die here than be referred to another hospital,” a statement that shows how poor an image this patient had of Chinese medical treatment.
◎中文藥名霧煞煞
但辰新畢竟不是綜合醫院，萬一生大病怎麼辦？而上海人口接近１千7百萬，面積相當於五分之一個台灣、23個台北市，腹地廣大，台灣民眾還是得深入了解當地的就醫環境。
Curious labels
But Chenxin is not a general hospital. What if you come down with a serious illness? Shanghai has a population of close to 17 million with a land area 1/5 that of Taiwan and 23 times that of Taipei City. This is a huge expanse of territory, and the Taiwanese that live there must know the medical environment well.
一年半前張翠華辭去銀行的金飯碗，帶著兩位女兒遷居上海和先生團聚，事前她已有大陸看病不如台灣方便的心理準備，但還抱著「大陸同胞都可以看，我們為何不能看？」的想法，準備以不變應萬變。
A year and a half ago Chang Tsui-hua left the secure world of banking and brought along her two daughters to live in Shanghai with her husband. She was psychologically prepared for a medical environment that didn’t measure up to Taiwan standards but still prepares to meet changing circumstances with tried and true methods, wondering to herself, “our mainland brethren can see the situation, why can’t we?”
「有些台商太太會把所有可以帶的藥都帶過來，但這麼做是不是太神經質？不舒服就自己當醫生配藥吃，不是更危險！」這是她當時的想法。
“Some Taiwanese wives bring over all the medicine they can carry, but isn’t this a little too neurotic? Isn’t it more dangerous to play doctor?!” This was the way she thought when she first arrived.
沒想到14歲的女兒小狀況不斷，幾次往返醫院的看病經驗，讓她充滿疑問，也了解到兩岸的醫療文化確實大有差異。
Unexpectedly her 14-year-old daughter had a series of minor medical situations and had gone a number of times to the hospital for treatment, which raised a great many doubts in Chang’s mind and led her to understand that there really were vast differences between mainland and Taiwan medical treatment.
小女兒從台灣國中轉進當地學校，也許是轉校不適應，導致胃痛發作，到了相當於台灣教學醫院的三級甲等瑞金浦東醫院看診，醫師開了一堆藥，回來後她端詳「硫酸慶大霉素緩釋片」、「複方顛茄合利」這些藥名，想研究出個所以然來。「尤其『霉素』這兩個字看起來很可怕，好像是醫院自己開發的藥，但我們只能選擇吃或不吃，」她說。
Mrs. Chang's/Her daughter attended the local middle school and perhaps because she couldn’t adapt to this change she developed stomach problems. She then went to Ruijin Pudong Hospital, the equivalent of a Class A, Level III teaching hospital in Taiwan. The doctor gave her a bunch of medicine and when she got home, Chang took a good look at the labels, which were filled with odd-sounding names, and thought she would do some research and find out what they were. “It was especially the words ‘poisonous substance’ that gave me a fright. They all seemed to be medicine developed by the hospital itself but our only choice was to take it or not take it,” she says.
除了用藥習慣、藥名翻譯的差異外，醫生的服務態度也令人不敢恭維。今年暑假17歲的大女兒嘴唇邊長青春痘，結了個大痂被摳破後流血不止，然後變成水泡、越長越大，她們到以皮膚科聞名的教學級醫院華山去，看診醫師說，得用激光〈雷射〉切除，到了激光室後，執刀醫師卻說，「不能做，太大了，血流不止怎麼辦？先擦藥膏等痂小點後再回來。」於是她們拿回一罐聞起來像中藥、顏色像紅豆粉的三聖散，但抹了一星期完全無效，並沒有變小。
In addition to the differences in taking medicine and in the translation of medicinal names, the service mentality of the doctors left quite a bit to be desired. This summer Chang’s 17-year-old daughter developed some acne on the side of her lip that bled profusely when the scab broke. This was followed by a blister that continued to grow. Mother and daughter went to Huashan, a teaching hospital known for its dermatology department. The doctor they saw said he would have to excise the blister with a laser. When they got to the laser room the doctor who was to perform the procedure said, “I can’t do it. It’s too large. What happens if we can’t stop the bleeding? Put some salve on it and wait until it gets smaller, then come back.” So they took back with them a jar of something that smelled like Chinese medicine, the color of red bean powder, called san-sheng-san. But after using it week, it proved totally ineffective, the blister had not gotten any smaller.
一星期後她又回到激光室，這次輪值的醫師換人了，她小心翼翼地轉述上次那位醫師的說法，想不到這位女醫師很生氣地回說：「別人不能做，不代表我不能做！但可能會留下疤痕。」張翠華只好安慰自己，台灣的大牌醫師也都很「跩」，她的醫術應該很好。果不其然，現在連疤痕都逐漸變淡，總算沒有影響女兒準備大學會考的心情。
A week later she returned to the laser room, This time there was a different doctor on duty so she very carefully repeated what the previous doctor had said and, lo and behold!, this new doctor, a woman, angrily responded: “Just because someone else can’t do it doesn’t mean I can’t. But there may be some scarring.” Chang Tsui-hua could only console herself with the fact that all popular Taiwan doctors were a bit taken with themselves. This particular doctor, she figured, should be quite capable. And indeed, this was the case. Now the scar has gotten quite faint and the whole episode seems not to have affected in the least the daughter’s mood toward sitting for a university entrance exam.
幾次看小病的經驗，讓張翠華有個小心得，「大陸醫師講話比較粗率直接，他們不認為自己不禮貌，應該算是文化差異。下次生小病還會來，但大病就回台灣吧。」
These experiences with minor problems taught Chang Tsui-hua something: “Mainland doctors are rather brusk and direct. They don’t think they are being impolite. It’s rather a cultural difference. We’ll go again if it’s something small, but for something serious, we’ll return to Taiwan.”
◎一年一個樣
張翠華的資訊沒錯，華山醫院的皮膚科的確聞名中國。附屬於上海復旦大學的華山醫院，是上海數一數二的教學醫院，類似這種三級甲等的醫院，全中國有623家，上海有35家。
◎
What Chang Tsui-hua says is right. The dermatology department at Huashan, which is affiliated with Fudan University, is truly well known throughout China. It is one of Shanghai’s handful of teaching hospitals. Similar hospitals of this Class A, Level III variety number 623 in the country, and 35 of them are located in Shanghai.
華山醫院的重量級地位可由它的超高門診量看出。單以皮膚科來說，一天平均看3000名病人，最高紀錄可達4000人，皮膚科去年門診量為72萬人，今年可望突破80萬人，50%是慕名而來的外地病人；全院醫療業務年收入達10億人民幣，是台灣長庚醫院的幾倍、台大醫院的幾倍〈數字待查證〉。
Huanshan’s prominent position can be seen from the huge number of patients it handles. The dermatology department alone sees an average of 3,000 patients a day and has even hit 4,000 in one day. Last year the department handled some 720,000 patients and this year they are looking to break the 800,000 figure. Fifty percent of those who come from outside of Shanghai are attracted by the department’s reputation. The hospital’s yearly income runs around RMB$1 billion, a figure several times that for Taiwan’s Chang Gung Memorial Hospital or Taiwan University Hospital.
做為中國境內第一所與美國哈佛大學合作的醫院，華山醫院很早就體認到外籍人士在大陸的醫療需求，早在1989年就設立外賓門診，以歐美、日本病患居多，境外病患也從早期的個位數，增加到現在一天150人左右。近年更成為上海台商家庭最倚賴的醫院之一。
Huashan was the first hospital in China to have a cooperative relationship with Harvard University and very early on understood the medical needs of foreigners residing in the country. As early as 1989 it set up a foreigner’s clinic, the majority of patients being from the U.S., Europe and Japan. The number of patients from outside Shanghai has grown from just a few during the early period to about 150 a day at present. In recent years Huashan has become one of the hospitals most relied on by the Taiwan business community in Shanghai.
除了華山醫院這類特設外賓部門的醫院外，為了解決台商最大的擔憂，上海台辦又與衛生局協商，於2001年10月率先 指定 瑞金集團閩行區「中心醫院」開闢 台胞就診的「綠色通道」。
Aside from hospitals like Huashan that have set up special sections for foreigners, the Shanghai Taiwan Affairs Office has worked out an agreement with the Bureau of Public Health to take care of the biggest worry among the Taiwan business community in Shanghai. In October 2001 they took the lead in having the Ruijin “Central Hospital” in the Minhsing District open up a “green lane” for the medical treatment of Taiwanese.
閩行區台胞台屬聯誼會副秘書長朱余生表示，以前很多台商因為不熟悉上海的醫療資源，也不知道到哪找好醫生，一旦罹患生重病，馬上買機票回台灣。但他們也很擔心，萬一轉機時發生狀況怎麼辦？
Zhu Yu-sheng, Deputy Secretary of the Minhsing District Taiwanese Friendship Association, says in the past because many Taiwanese were unfamiliar with medical resources in Shanghai and didn’t know where to go to find a good doctor, they would immediately think about buying a ticket back to Taiwan the minute they became seriously ill. But they also worried about what they would do if something happened while they were changing planes.
目前台商定點醫院已逐步增加到浦東、長寧、徐匯等31家區域級醫院，來看病的台胞都會有專人陪同，從掛號、檢查到交款、取藥，所有程序「一路綠燈」。
The number of designated hospitals for the Taiwan business community has gradually expanded to some 31 district level institutions in Pudong, Changning, and Xuhui. Taiwanese who come in for treatment are accompanied by special personnel. From registration and examination to paying the bill and getting medicine, the way is cleared with “green lights” all the way.
◎軟硬何時並進？
「一路綠燈」固然方便，但還是不足以令台商安心。除了多數區域級醫院環境差，大陸病人衛生習慣更差，病人咳嗽不掩口、隨地吐痰擤鼻涕，走進大陸醫院隨時得擔心病菌上身，會不會 小病進人變成大病？
Keeping pace?
“Green lights all the way” certainly make things convenient but it’s still not enough. In addition to the substandard environment of most district level hospitals, public hygiene habits are even worse. Patients cough without covering their mouths and they spit and blow their noses out in the street. Whenever you enter a hospital you have to worry about being inundated with germs. In these circumstances, might not a minor disease turn into a major one?
目前，全上海雖有四百多家公立醫院，以及近八百家中外合資、合作的私立醫院和診所，但是台灣民眾不是憂心上海沒醫院，而是服務不到位。大陸醫療環境的問題在於，「硬體起拔」容易，短時間內立即可達國際水平，但服務品質是否同時跟進？
Shanghai currently has more than 400 public hospitals and close to 800 joint venture and cooperative private hospitals and clinics. Taiwanese do not worry that the city is without hospitals but are disheartened that service is not up to standard. The problem with mainland medical treatment is that it’s easy to “build hardware” and in a short time get up to international standards but can service quality keep pace?
兩年前接任華山醫院院長徐建光表示，華山醫院斥資6.5億人民幣在浦東新建的分院即將在年底前落成，他開玩笑說，現在不當醫師，改作工地監工，每天盯進度。
Xu Jianguang, who took over as Director of Huashan two years ago, says Huashan put out RMB$650 million for a new branch hospital in Pudong that is to be finished by the end of the year. He jokes that he is no longer a doctor but a construction foreman who checks on the daily progress of the work.
「我的新辦公室比 哈佛醫學院 麻省總院 院長 的辦公室還氣派，但我的管理水準比他差得多；這不是我的能力差，而是中國的制度、醫療系統、文化等諸多因素影響，我們不可能一步趕上，但會慢慢進步，還要靠整體民眾的文明提升。」
“My new office is more stylish than that of the director of Harvard University Hospital or Massachusetts General but my management standards lag far behind. It’s not that I don’t have the ability, it’s the influence of Chinese institutions, the medical system, the culture. We can’t catch up in one big jump, but we’ll make gradual progress, and we’ll have to do this in conjunction with a rise in the cultural level of the whole population.”
「華山醫院龐大的門診量 要提供好服務，可能有些困難，因為收費太低了。如果台商也擠在『基本醫療』的框架下，肯定不滿意，勢必要有個特殊的醫療服務機構或通道才行，」徐建光因此常敦促涉外醫療中心的醫師們，再強化服務意識。
“Providing good service to the huge number of patients who visit the Huashan clinic may entail some problems because the fees are too low. If Taiwanese were forced to accept ‘basic medical treatment’ they would definitely not be happy about it. There has got to be a specific medical service entity or channel for them.” Because of this, Xu Jianguang often urges doctors working in medical centers catering to foreigners to further improve their service mentality.
◎執法不嚴
大陸醫生素質參差不齊，有其深層的歷史因素。
Lax enforcement
The uneven quality of mainland doctors has deep historical roots.
文革10年「破四舊」，無產階級當家，知識份子被打成臭老九；幾十年前，農村出現一批聊具簡單醫學常識的「赤腳醫生」，目前仍在偏遠農村執業。90年代後雖然有大批出國留學的醫師回來，但當時中國醫療環境太差，很多人不願意留下來。
During the ten years of the cultural revolution aimed at “smashing the four olds,” the proletariat was on top and intellectuals became the “stinking old ninth” (i.e., the ninth category of class enemies). As early as 1958 what were called “barefoot doctors” appeared in the countryside. These were people with only basic, common sense medical knowledge. Even now these people are still carrying on their work in some remote areas. Although in the 1990s a great number of doctors returned to China who had been studying abroad, the medical environment in the country was very substandard and many were unwilling to stay.
曾走訪大陸城鄉各級醫療院所的 陽明大學 醫務管理研究所 副教授錢慶文，比較兩岸醫師養成教育說，台灣醫師從醫學院畢業，到醫院實習、訓練、再考執業執照，基礎知識與臨床經驗的過程清楚、完整，而大陸衛生單位執法不徹底，常有醫學系剛畢業、沒有臨床經驗者，卻也能 掛主治醫師 的情形。
Associate Professor Chien Ching-wen of National Yang Ming University’s Institute of Hospital and Health Care Administration has visited medical institutions of all levels on the mainland. Comparing medical education in China and Taiwan, he says that in Taiwan doctors graduate from medical school, do a practicum and training residency in a hospital, then take a license examination. The process of acquiring fundamental knowledge and clinical experience is clear and complete. In China Ministry of Health officials do not adhere strictly to the law. Often people who have just graduated from a medical department with no clinical experience are able to hang out their shingles as “doctor in charge.”
錢慶文指出，外科重視經驗，大陸醫院多、病患多，小醫師都可以操刀、累積經驗的速度也快，但對於高度依賴精密儀器 作病情判讀診斷 的內科，大陸醫師就差很多。
Chien points out that external medicine places a premium on experience. There are many medical schools in China and many patients. Young doctors can all wield the scalpel and quickly get experience. But when it comes to internal medicine where you rely heavily on sensitive instruments to make a diagnosis, mainland doctors are very far from the mark.
以移植醫學為例，台灣醫師技術高超，但缺少可供移植的器官。而大陸雖然也有像是天津醫科大學一流的肝移植技術等，但整體來說，技術水平不整齊，以致常發生台灣病患到大陸換肝、換腎後，因器官配對倉卒、處理術後併發症的經驗不足，病患又緊急轉回台灣的情形。不少台大、榮總外科醫師都有 為大陸醫師處理移植手術失敗 的棘手經驗。
Take medical transplants, for example. The skills of Taiwan doctors in this area are superior but there is a lack of organs. Although first class liver transplant technique also exists in China, like that at Tianjin Medical University, on the whole the level of technique is uneven. This frequently leads to a situation where a Taiwanese patient has had a liver or kidney transplant and, because there had been a hasty match up of the organ and Chinese doctors have insufficient experience in post-op complications, the patient makes an emergency evacuation back to Taiwan. Many surgeons at National Taiwan University Hospital and Taipei Veterans General Hospital have had some trying experiences because of transplant failures done by mainland doctors.
◎收費有蹊竅
由於台灣民眾不熟悉大陸醫療體系，能否碰到好醫師，得看運氣，其次，「大陸看病貴」也是台灣民眾普遍反映。在設備、服務較為台灣民眾接受的三級醫院內，設有專家名醫駐診的特需門診，但掛號費、診察費加藥費，平均要比基本門診貴上10倍。
Strange fees
Because Taiwanese are not familiar with the mainland medical system, stumbling upon a good doctor is a matter of luck. Next to this, Taiwanese also generally complain that “it’s expensive to see a doctor in China.” In a Level III hospital, where Taiwanese more or less accept the level of equipment and service, there is a clinic staffed by specialists and doctors of good reputation but the registration, examination and medicine fees average ten times that of the basic clinic.
自1980年代中國實施財政改革後，中共政府對公立醫院的補助大幅減少，在自負盈虧的壓力下，常出現自立名目、自定標準、建議重複或者不必要的檢查等亂收費的情況。
Since the financial reforms of the 1980s Chinese government assistance to public hospitals has dropped sharply. Under the pressure of economic self-sufficiency, a chaotic fee structure has emerged, with hospitals creating their own chargeable items, setting their own standards, and suggesting repeat or unnecessary examinations.
辰新醫院 劉宗瑜 中醫師的83歳外公，去年冬天來崑山探望在當地工作的舅舅，不慎感冒轉為肺炎，送進崑山第一人民醫院，他找了當地同學幫忙才有病房，第二天進了加護病房，第四天就過世了，醫師說法是「器官衰竭」。由於外公年事已高，劉家對醫師的解釋勉強接受，但住了4天卻得支付1萬人民幣醫療費，「感覺上實在很貴，因為醫師其實什麼都沒做」。
The 83-year-old grandfather of Liu Zongyu, a doctor of Chinese medicine at Chenxin Hospital, visited Liu’s uncle who was working in Kunshan last winter. He neglected his cold, which then turned into pneumonia, and was sent to the First People’s Hospital of Kunshan. He had to enlist the help of a classmate before he was able to get a room. The following day he went into an intensive care unit and on the fourth day he passed away, the doctor explaining this was due to “organ failure.” Because the grandfather was elderly, the Liu family was forced to accept the explanation but had to pay RMB$ 10,000 for the four-day stay in the hospital. “We felt this was actually quite expensive because the doctor really didn’t do anything.”
明基電通公司 蘇州新區 新事業及 市場高級經理 張世誠，1999年派駐蘇州，近水樓台娶了江蘇美女周鴻岸，3年前太太懷孕，他堅持產檢可以在大陸作，但一定要回台灣生產。
Chang Shih-cheng, the senior market manager in Suzhou for Acer Communications & Multimedia Inc., arrived in 1999. Living among the local inhabitants, Chang married a Jiangsu beauty named Zhou Hongan. Three years ago she became pregnant and Chang insisted that prenatal exams could be done in China but that his wife would definitely make the trip to Taiwan for the delivery.
已來返台北婆家十餘次的周鴻岸比較兩岸醫療環境說，「差太多了！」她的朋友在蘇州生產，羊水快破了趕往醫院，醫師卻要她下午再來住院，幾小時後這位年輕媽媽的羊水已經快流光了、胎兒心跳也有異狀，醫師才趕緊進行剖腹生產。這種不為患者著想的服務態度，不只先生不放心，她也嚇得不敢在大陸生。
Comparing the medical environment on either side of the strait, Zhou Hongan, who has now traveled more than ten times to Taipei to see her in-laws, says “It's so much worse in China!” A friend of hers who gave birth in Suzhou had had to be rushed to the hospital just before her water broke, but the doctors wanted her to wait and come again in the afternoon before going in. A few hours later, the young mother’s amniotic fluid was almost completely gone. The fetus also had heart palpitations. Only at this point did the doctor hurriedly perform a C-section. This service mentality, totally unconcerned with the patient, not only unsettled Chang, his wife was so frightened she dared not give birth in China.
每次兩歲的兒子偉偉感冒、發燒，周鴻岸帶到大陸醫院，醫師一定先打消炎針，若燒不退，就再吊點滴，有一次連吊3袋，她捨不得小孩痛、又得挨這麼多針，要求醫師用台灣通用的軟針，還得多付30元人民幣。小孩抵抗力差，她總擔心大陸醫師藥量下得太重，而台北醫師一定採取較緩和的治療方法，也會先告訴她，感冒至少要10天才會好，別急。為了讓偉偉準時接受日本腦炎、德國麻疹等疫苗注射，張世誠都得特別請假，帶母子兩人飛回台北。
Each time her two-year-old son Wei-wei caught a cold and ran a fever, Zhou Hongan would take him to a mainland hospital and the doctor was sure to first give him an anti-inflammatory shot and then follow that up with an intravenous drip, once giving him as many as three. She couldn’t stand the fact that her son was in pain and taking so many shots so she asked the doctor to use a relatively painless infusion needle common in Taiwan. This cost her an extra RMB$30. Her son’s resistance was poor and she worried that the doctors were giving him too much medicine. Taiwan doctors were always sure to take a more slow and easy approach to treatment and would first inform the mother about what they were doing. A cold would take at least ten days to get over, there was no rush for Taiwan doctors. So Wei-wei could get his vaccines for Japanese encephalitis and German measles on time, Chang Shih-cheng had to request vacation days to take mother and child back to Taiwan.
10年前，在上海的台商台幹年輕力壯、單身赴任，對醫療的需求還不強烈；10年後，台商台幹年紀漸長，才猛然警覺健康的身體是為事業打拚的最大資本，加上全家團聚，兒女父母也接過來，難免時有小病痛。當中國的城市建設向國際水平邁進，當孩子也在台商子弟學校成立後 獲得解決，他們更希望日後身體的健康也能安心托付，而這個基本的願望，還得靠兩岸醫界的攜手努力。
Ten years ago Taiwan businessmen and managers were young, strong and single, and there was no great demand for medical services. Ten years later these same men have aged and suddenly they realize that a healthy body is their most valuable asset in their job. Add to this the fact that now the family lives together, the children and parents are brought over, it’s hard to avoid small health problems. At a time when China’s urban development is approaching international standards and when the children’s education problem has been solved by the establishment of schools for them, Taiwanese businessmen are hoping that the health problem can be taken care of, but this basic wish still depends upon the close cooperation of the medical communities on either side of the strait.
今年9月中國衛生部下令，未取得醫師執業執照資格的 醫科大學畢業生 不得獨立從事臨床醫療工作。顯見長久以來非法行醫在大陸一直是嚴重問題。
In September of this year the Chinese Ministry of Health issued an order that graduates of medical universities who did not yet have a license to practice medicine may not independently engage in clinical medicine. Obviously, the practice of illegal medicine in China is a serious problem of long standing.
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More Less | | Years of translation experience: 20. Registered at ProZ.com: Jan 2002. | | N/A | | N/A | | N/A | | Adobe Acrobat, Microsoft Word, Powerpoint | | http://www.inter-change.org | | English (DOC) | | About me Retired diplomat and university professor with linguistics degree and Ph.D. in Chinese studies.
I have done Chinese translations in virtually every field, from nuclear medicine to Beijing opera, from Classical Chinese to modern slang conversation.
For the most part, I work with a small number of translation agencies but am always looking to expand my circle of contacts.
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Keywords: trade, finance, economics, wto, art, literature, history
Profile last updated
Dec 28, 2010 |
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