More than a township clinic: Grassroots facilities offer expert medical advice

"Your heartbeat is a bit too fast, but otherwise, you 'look' fine ― for now," a young doctor at a township medical clinic in suburban Shanghai told me on Monday after giving me an electrocardiogram test.

"You can trust the results of this electrocardiogram," she said assuredly. "They are endorsed by experts from Renji Hospital."

It sounded a miracle. As one of Shanghai's best hospitals, Renji is located far from our suburban town. How could Renji experts read my electrocardiogram and respond within a few minutes?

Sensing my puzzlement, she explained: "I sent your electrocardiogram report to Renji Hospital from my computer and asked for their expert opinion. They responded quickly!"

Now I understood I was having the best of both "worlds." At the township clinic near my suburban home, I enjoyed few waiting lines and high-quality medical service at the same time.

I had been suffering from heart arrhythmia and coughing over the past few weeks. I had to stop and squat for a break even if I had walked only 500 meters, as my irregular heartbeats would eventually cause tachycardia ― a heart rate over 100 beats a minute. My normal heart rate is around 70 beats a minute.

Usually I would shun township clinics for a lack of confidence in their medical treatment. But this time, I couldn't walk steadily, so I decided to "bet on" our neighborhood clinic. Normally, it's about 10 minutes' walk from my home, but it took me more than 20 minutes on Monday, as I dragged my feet along country roads.

I had hoped an average physician at the clinic would give me a basic check with a stethoscope. I had not expected this grassroots clinic to have a special electrocardiogram room, let alone its efficient cooperation with a top-class hospital that ensured timely long-distance diagnosis.

Based on the electrocardiogram test result read by Renji experts, the young doctor at our suburban neighborhood clinic advised I take a 24-hour Holter monitor as early as possible.

"An electrocardiogram records your heartbeats for only 20 seconds," she explained. "You need a Holter monitor to record the full pattern of your heartbeats ― how irregular they may be and whether a sudden heart arrest ― as you suspect ― may happen. Something like a sudden heart arrest is riskiest."

Xinhua

It sounded like another miracle. I had thought Holter monitors were reserved for major hospitals only. Indeed, there were only two Holter monitors in the neighborhood clinic. The young doctor quickly filled a form and booked one for me. She placed me in the earliest possible time slot. Two other patients were still wearing them on Monday.

"As with your electrocardiogram test, we will send your Holter report to special analysts (from Renji) and come back to you as soon as possible," she told me with a reassuring smile typical of a benevolent doctor.

At this time, a colleague of hers scrolled on her cellphone and found the name of an expert on cardiology from Zhongshan Hospital ― another top hospital. "Next time you may consult him about your future treatment plan. He comes to our clinic on the morning of the second and the fourth Mondays every month."

How warm-hearted and responsible these neighborhood doctors are! Their initial consensus was that my heart arrhythmia was a relatively serious post-COVID symptom, but instead of showering me with their own opinions, they nicely referred me to a senior cardiologist.

Such a spirit of sharing goes a long way toward helping every patient ― however remote he or she may be physically from a top hospital ― to access the best possible medical resources, especially at a time when many people need regular recuperation treatment after COVID-19.

Zhang Wenhong, a leading expert on infectious diseases who works at Huashan Hospital, visited many grassroots medical clinics, including the one near my home, earlier this year to help enhance their capacity of medical treatment.

Shanghai now has 249 neighborhood medical centers or clinics, with many more subsidiaries all the way down to rural villages. Municipal health officials said in April that grassroots medical centers now handle about 60 percent of the city's fever cases. In the future, some grassroots medical clinics may even begin to perform minor surgeries. Moreover, more types of medicines, including anti-COVID-19 drugs, are now available at grassroots clinics.

The promotion of grassroots medical clinics is no small matter. It will ensure local residents across Shanghai have access to high-quality medical services within a short walk. The township medical clinic near my home covers more than 90,000 permanent residents, one-third of whom are elderly people.

My "bet" on our township clinic was an unexpected success. Without this neighborhood clinic, whose medical capacity has greatly increased in less than half a year, I would have had a hard time going to a big hospital far away from my home. Even if a friend had accompanied me to that far away big hospital, my heart palpitations would make it hard for me to endure long waiting lines for electrocardiogram tests or expert consultation, which are a typical scene at most big hospitals.