BEIJING – Professor Wong Tien Yin sits in a room on the 13th floor of a big, bustling Beijing hospital affiliated with Tsinghua Medicine, a new academic health system he helped set up when he was named its founding head and chair professor in 2021.
But today, he is not here as its chief or a doctor; he is a patient who has just had surgery for an anterior cruciate ligament injury.
He is sitting up in his bed, his left knee in a cast after a fall. Despite the balmy, 25 deg C autumn day, the hospital does not run its air-conditioning – not even for a VIP.
This personal medical episode has given the 56-year-old Singaporean healthcare practitioner and administrator first-hand experience of being on the receiving end of the Chinese public healthcare system.
“I’ve practised as a doctor, and I’ve done the teacher route. Now I have the patient perspective,” the renowned ophthalmologist and physician-scientist, who is one of the most cited eye care specialists in the world, said from his hospital bed.
That perspective has allowed him to witness the problems faced by under-resourced Chinese public hospitals – where surgeons operate from the early hours of the morning till past midnight – and the inefficiencies and wastage brought on by a lack of integration.
Routine tests are often repeated because data systems between hospitals are not linked, unlike in Singapore, where significant resources have been invested to set up a national health record repository.
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China’s healthcare policies also have not kept up with its rapidly ageing population, since its hospital-centric approach to care makes it difficult to manage an increasingly large number of patients.
Moreover, a shortage of doctors – exacerbated by low pay making the profession unattractive – has led to endemic corruption. The authorities launched a sweeping campaign in 2023 to root out corruption, arresting hundreds of health officials and hospital directors.
“These are China’s healthcare challenges, and coping with them is not easy,” said Prof Wong.
He was recruited after a global search to build an integrated academic and healthcare ecosystem at Tsinghua University, arguably China’s best varsity, whose alumni include many of the country’s former and current top leaders, notably President Xi Jinping.
Nearly three years since he left Singapore – and his job as deputy group chief executive for research and education at SingHealth – Prof Wong has transformed what was once a network of independent or loosely affiliated schools and hospitals into a cohesive structure. His goal is to improve medical education, research and innovation, and produce a new generation of physician-scientists at Tsinghua University.
In November, Tsinghua Medicine will announce the plans that Prof Wong – the highest-ranking foreigner in a university in China – has systematically laid the groundwork for.
These include a new campus with an artificial intelligence (AI) hospital, a first in China.
The “three ‘S’es” – structure, strategy and space – is how Professor Wong describes his task.
The first S, structure, is already 80 per cent done.
“But the foundation is not yet consolidated enough for it to continue. If it is left by itself, the glue will not stick, and maybe the centrifugal forces will pull it apart,” he said of the ongoing integration of Tsinghua’s five medical institutes and four hospitals.
Getting to this stage took three years of breaking down barriers and undoing concepts and decisions that might have been right initially, but ultimately became wrong as there was no long-term vision to guide the administrators.
For instance, the same clinical departments of the affiliated hospitals were working in silos, with no exchange between them. Neither was there any synergy between Tsinghua’s medical school and the hospital where students were sent for their clinical training.
“I took three years to get us from minus one, minus five or minus 10 to zero, but now I’m ready to go from zero to one,” said Prof Wong, who, colleagues say, often works six or seven days a week.
The key is to keep emphasising a single vision, mission and culture. “You’re building an institution that lasts,” said the former President’s Scholar.
The second S – strategy – is one that will take Tsinghua University and the medical ecosystem it is building up to 2050. This involves leveraging what Tsinghua is known for: its excellence in engineering and computer science.
As medicine becomes increasingly reliant on technology, such as imaging, robotics and nanotechnology, Tsinghua’s traditional strengths will come into play.
Part of the strategy is to bring a school of healthcare management into the fold to foster thinking on future healthcare policies.
One order of business when Prof Wong came on board was to build bridges with medical schools and academic healthcare systems in other parts of the world such as the US, Europe and Singapore.
He is in talks with UK and Singapore universities to partner Tsinghua’s medical school.
Since Prof Wong’s appointment, there has been an uptick in academic exchanges and international collaborations. Nurses have gone to Singapore for training, while NUS medical students have also gone to Tsinghua Medicine for an elective programme.
His vision for Tsinghua Medicine could potentially be a model for the rest of the country.
The upcoming campus in Beijing’s western district of Haidian – the third S, or space – will experiment with a healthcare model that will significantly move away from China’s current tertiary hospital-centric framework, and towards a set-up aimed to cope with the challenges of the demographic crisis.
China has one of the fastest-growing ageing populations in the world: By 2040, a projected 402 million people will be over the age of 60, making up 28 per cent of the population.
“You need to strengthen family medicine, primary care and community care. That part of the culture has not been developed, so we will train people in that area simultaneously,” he said.
The AI hospital, which will be built on the campus, will pilot a new system where patients could be managed by telemedicine and diagnosed with analytics, and have medicine delivered to their homes.
It has taken patience to come this far.
“The first three years was essentially building trust,” Prof Wong said of China’s intrinsic culture of relationship-nurturing.
It has also taken time to figure out whether some of the international best practices are relevant to and suitable for China.
Prof Wong studied medicine at NUS and received his PhD from Johns Hopkins University in the US. From 2003 to 2008, he was chair of ophthalmology at the University of Melbourne in Australia, and was also formerly medical director of the Singapore National Eye Centre and vice-dean of Duke-NUS Medical School.
Since moving to Beijing to work within a public institution, he has also learnt – the hard way – that the Chinese do not say “no” or express their real opinions. Things are often simply left unsaid.
“What is unspoken could be ‘we will not support it, it is not relevant’. Or it could be ‘maybe it’s not the right time’,” said Prof Wong, whose father is the late Professor John C H Wong, an eminent economist who was a leading expert in China’s economic transformation. His mother is sociologist and former People’s Action Party politician Aline Wong.
“There are a lot of dead ends here and there. You have to figure them out yourself, and no one will tell you very much until you discover them yourself.”
He says he will go back to Singapore “at the right time”. His wife, Dr Ng Hsueh Mei, a family physician, splits her time between Singapore and Beijing. Their elder son is also a doctor in Singapore, while their younger son is studying medicine in the UK.
“Hopefully I will bring back some of these things that will be useful for Singapore.”