In recent years, specialized outpatient clinics have opened in Beijing to treat symptoms normally overlooked in hospitals while also offering coordinated services to patients. The outpatient clinics are changing traditional ways and concepts of seeking medical advice.

Clinics for Aches and Pains

This year, the outpatient pain clinic at the Sino-Japanese Friendship Hospital, helped a 93-year-old woman, Xu, who had suffered from neck and left arm pain for a year.

“She was unable to bear the pain, crying and shouting loudly,” said Dr. Fan Bifa, associate director of the clinic.

The woman’s son said she used to be very happy and healthy, but since becoming sick, she had lost her appetite and often threatened to kill herself. Dr. Fan said Xu’s pain was caused by a loss of cervical vertebra, which constricted nerves and caused severe pain in her neck and left arm. Before coming to this clinic, she had been treated at many hospitals, but to no avail.

Zhao, 40, is another patient successfully treated at the clinic. His experience is worse than Xu’s. Several months ago, suffering from a toothache, Xu went to a hospital where a doctor pulled out one of his teeth. But soon, another tooth began to ache, so he returned to the dental hospital. The treatment was much the same as before. This treatment was repeated several times until he went to the pain clinic. There he was diagnosed with neuralgia.

Many patients like Xu and Zhao are being treated as outpatients at the two clinics that specialize in pain launched by the Sino-Japanese Friendship Hospital and the Beijing Friendship Hospital. All patients had had bad experiences seeking treatment before they came to these specialized clinics. As their pain could not be relieved, they went to different hospitals time and time again, like a ball being kicked back and forth. These patients, including those afflicted with pain caused by cancer, are now being treated at the specialized clinics.

Other patients frequently treated here include those who underwent surgery but still suffer from pain, and those who should have had an operation, but did not. A doctor at one clinic said patients with symptoms of pain should go to a special clinic first. The establishment of specialized outpatient clinics is the outcome of the development of the treatment of pain as a specialty in medical science, and through the demands of patients who hope to escape from pain.

A clinical manifestation of many diseases, pain has a severe affect on patients. They often go to doctors when they cannot bear the pain any longer. Although the clinical manifestation of pain draws the concern of traditional medicine, methods to deal with it have been restricted to taking medication, surgery and injections. Sometimes effects are not obvious. Therefore, a gap exists between a patient’s desire to eliminate pain and the unsatisfactory result of traditional methods. This created an opportunity for the development of special outpatient clinics.

During the Ninth World Congress on Pain in Vienna in 1999, the International Association for the Study of Pain declared to the world that after 24 years of study of the clinical manifestations of pain it had come to the conclusion that pain was not only a symptom of disease but also a kind of disease itself.

Dr. Fan, also a member of the Pain Study Committee of the Chinese Medical Association, said the main methods adopted by the specialized outpatient clinics included injections to on free nerves, plus supplementary treatments of medicine and manipulation. These methods help stimulate blood circulation, block pain, and readjust nerves’ sensory functions, thus eliminating pain.

There is a great demand for pain treatment in modern society. It is reported that, worldwide, 25 percent of patients were afflicted with severe pain when they died. Easing patients’ pain also alleviates their family’s mental and spiritual suffering.

Statistics show that China has 100 million patients suffering from chronic arthritis. The pain that accompanies this disease is difficult to cure through traditional methods. The cost of replacing a bone joint is more than 100,000 yuan, which most patients cannot afford. Looking at the situation from an economic angle, treatment in specialized outpatient clinics has great appeal.

Among patients afflicted with a protrusion of the lumbar intervertebra, only a small number are suitable for operation. In these cases, pain clinics also are the first choice. Treatment for pain is developing slowly in China. At present, only large hospitals in major cities have outpatient clinics specializing in this treatment. But medical circles still have asserted their concern.

In the early 1990s, outpatient clinics specializing in the treatment of pain existed in many hospitals, but closed because of a lack of support. But in a few hospitals, the clinics remained and became profit-making resources. The total income from a privately run outpatient pain clinic in south China, which employs nine doctors, is more than 5 million yuan, and it makes a profit of 3 million yuan.

Clinics for Disease Prevention

“When you go to a doctor, you are afraid of being told that you have a disease that is hard to cure -- and worse, that you will be told it is too late,” said a doctor who works with a disease-prevention outpatient clinic.

This clinic aims to prevent and diagnose disease as early as possible through regular check-ups. If people often have check-ups, it will be never be too late for diseases to be treated. This is regarded as a leading idea toward a promoting a healthy lifestyle.

Fuwai Hospital, known for its treatment of cardiovascular disease, offers an outpatient clinic specializing in heart disease prevention. Cardiovascular disease has become the main cause of the death of Chinese people. Over the next 10 years, incidence of cerebral hemorrhage is expected to increase by 42 percent among middle-aged men, and by 13 percent in women. The incidence of coronary disease among men will rise 26 percent and that among women 16 percent.

The computer system used by the outpatient clinic here has two functions: To keep health records and to provide prescriptions. The computer system will follow a patient’s condition and constantly readjust the prescription according to changes in health.

The clinic also gives guidance for people who are obese. The doctor first measures the patient’s fat and then works out a diet and exercise plan according their needs. The patient is kept fully informed. The clinic has treated many people who are concerned about, or have a family history of, obesity.

The special clinic launched by the Beijing Women’s Health-Care Institute aims to prevent and treat diseases particular to women. With advanced technologies and blood checks, the doctor can clearly diagnose a patient’s physical condition.

With recent changes in dietary habits, women in China afflicted with tumors are much younger than in previous years. The age of women affected by breast cancer has dropped to 35 years, and that of cervical cancer to 30 years of age. Ding Hui, director of the institute, said all women of childbearing age should have an overall health-check every three years. Those who have a family history of certain diseases should pay extra attention to the issue.

Clinics for Fatigue

Beijing Friendship Hospital opened a clinic for the treatment of fatigue in April this year, to deal with the increasing number of patients who need treatment. The purpose of opening such a specialized clinic was, on the one hand, to divert patients from crowded neuroscience wards in hospitals and, on the other, to help concerned doctors to accumulate more experience in the treatment of chronic fatigue syndrome, thus creating a special field of science. However, the method of treatment here is no different from that of other hospitals, so outpatient numbers are low.

（Beijing Review No.38, 2001）