Prof. Zhen Xiao: it is our responsibility to preserve and bring Chinese Medicine to the world

Expert introduction

Prof. Zhen Xiao (Figure 1), MD, MPA, is the President of Longhua Hospital Shanghai University of Traditional Chinese Medicine, chief physician and professor of Pediatrics in Chinese Medicine. After graduated from Shanghai University of Traditional Chinese Medicine (SHUTCM) in 1986, he joined the Longhua Hospital and focused on clinical, scientific research and teaching of Pediatrics in Chinese Medicine, following Prof. Da-Nian Zhu, a well-known professor in the field of Pediatrics in Chinese Medicine. In 2007, he worked as the Chief of the International Exchange Department of SHUTCM and the Dean of the International Education Division, dedicating to the academic exchange and cooperation worldwide. Five years after that, he was then appointed the President of Longhua Hospital in May 2012.

Figure 1 Prof. Zhen Xiao.

To know more, please refer to the following in-depth interview with Prof. Xiao by Longhua Chinese Medicine (LCM).

LCM: Could you share with us the reason why you decided to learn Chinese Medicine?

Prof. Xiao: I have been seeing doctor as a sacred job since I was a child. My parents were all medical workers, so I had a certain level of understanding about the hospital when I was little.

When I was ten years old, shocking news arrived in our family. My grandmother, who I was very closed with, died of lung cancer. I had a hard time at that point. And I made my mind to be a doctor, hopefully saving as many lives as possible ever since. Later, my interest in ancient prose, which is one of the many reasons I choose to study Chinese Medicine, has pushed me to start my journey with Chinese Medicine.

LCM: Through the adherence and studying of Chinese Medicine all these years, what have you learnt the most?

Prof. Xiao: I have learnt that Chinese Medicine is profound and wide. Thousands of years, it has made indelible contributions. Its continuous development and achievement for clinical treatment are unquestionable.

I would like to share two stories with you. The first one is the story when my residency just started. I only worked in the clinic when they were in short-handed. One day, I received a letter from a mother whose child had been suffered from respiratory tract infections for six months. The infections didn’t change much after seeing several doctors from different hospitals. However, after my prescription, the symptoms had a distinct improvement. The mother then wrote a letter to express her sincere gratitude for me as my schedule in the clinic was not regular at that time and she couldn’t find me. As a young doctor, receiving a warm letter from the patient’s family, was a moment of recognition for me. The trust from patients always makes you love your job even more. The child has turned to a twenty-year old girl and our families has become friends ever since.

The second story is about my mentor, Prof. Da-Nian Zhu, who has been an influential person for me. He is also the Editor of a science textbook, the Fifth Edition of Pediatrics in Chinese Medicine. If he were still with us, he might become a national master in the medical world. I watched and learnt beside him. One time, I noticed his distinctive way of giving the prescription and asked if there were any principles during the process of observing patients’ physical condition. He told me there were two key elements, a good mentor and myself. Inspired by him, I learnt that to better serve our patients, we need to work even harder and have as much experiences as possible, rebuilding our own classic.

LCM: It must have been a lot of pressures and transformation of thinking from a doctor to the role of hospital manager. How do you manage the two roles at the same time? What do you think they have in common?

Prof. Xiao: If you are a good doctor, you can also be a good manager. I put the key to be a good manager into four points. “Overall Strategy-Planning”—a doctor needs to think comprehensively while examining patients’ symptoms and making the diagnosis, so as a manager; “Thinking Carefully”—doctor’s thinking is relatively logical. He/She needs to make diagnosis while several symptoms show up at the same time. You need to excavate a clean path to overcome the initial contradiction, so as a manager; “Decision-Making”—it is always an urgency when it comes to life-saving. A doctor needs to be decisive under certain condition. It is also one of the basic requirements to be a good manager. In the end, “The integration of Theory and Realization”—learning medical theories on the textbook and applying effective treatment to the patients are similar to the condition when I pushed myself to the training of management. I use those knowledge and apply them to my work. As time goes by, with the four core value, the methods of managing our hospital and the experiences will appear to be what we are looking for.

LCM: How do you think your experience as a pediatric doctor have influenced you?

Prof. Xiao: First of all, Pediatric Department is also called a ‘Mute’ Department because children normally wouldn’t explain their condition into words. You can only tell from the level of their cries, results of physical examination and reaction to make the synthetic judgment. This job helped build my sensitivity of observation and judgment.

Second, the prescription for children is calculated per kilogram of their weights. Therefore, the accuracy for the prescription has led to the precision and the sensitivity to the numbers for my job.

Last but not the least, I think all the pediatric doctors have a big warm heart, which is what managers need as well. And the employees and patients will receive positive energy in the meantime.

LCM: Longhua Hospital is one of the four earliest Clinical Chinese Medicine Hospitals. It has become a Class A tertiary comprehensive hospital that committed to delivering state-of-the-art clinical care, innovative scientific research and rigorous medical education since its establishment in 1960. And you have been in Longhua Hospital for more than 30 years. What do you think is the hospital’s biggest change?

Prof. Xiao: Many are still the same. One is that we never give up our principle and heart on the road of development. Chinese Medicine is still the core of the hospital, even though our location is in the southwest of Shanghai, where the medical resources are the most concentrated and it is also the most competitive battlefield. Secondly, we are still a big loving family. We respect knowledge. We respect our teachers. Thirdly, our hospital has always operated on the direction of Public Welfare.

Now, let’s talk about what has changed. Firstly, the hospital had a make-over on the inside and outside. Especially in 2008, it has become a national clinical research center and all the technical devices were upgraded. Secondly, we became more focus on enriching the inside. Using the featured advantages of a Class A tertiary Chinese Medicine Hospital will lead to the integration of clinical and science research. Therefore, while treating various kinds of diseases through Chinese Medicine, we can come up with new research directions from clinical works and keep moving forward to up-to-date findings and treatment.

We have changed our pursuit of the service quantity to the enhancement for both quality and quantity. The outcome can be seen from the leading number of publication and achievement of our hospital. And the progress in brand-building is another thing that’s worth celebrating. Thanks to the fast and effective of information transmitting, the social influence and recognition of our hospital are greatly improved. This is also the joint efforts from generations and being the pioneer in emphasizing on the clinical research and the quality of work.

LCM: Could you briefly introduce the development and featured advantages of Longhua Hospital? What efforts have you made to persist on those features, to enrich the construction inside and outside, and to concentrate on clinical research?

Prof. Xiao: We have never changed our basis, Chinese Medicine in Longhua Hospital since the very beginning. From the beginning, we have recruited eight renowned Chinese Medicine doctors from Shanghai to South of China. They were called “The Eight Masters”, Dr. Dong-Wen Huang, Dr. Xiao-Shang Shi, Dr. Shou-Yan Lu, Dr. Xin-Fu Fan, Dr. Bo-Hua Gu, Dr. Ji-Min Ding, Dr. Zhong-Cai Xu and Dr. Da-Nian Chen. They all were the first directors of the different Department in Shanghai University of Traditional Chinese Medicine and in Longhua Hospital.

In 1956, there are only four Chinese Medicine schools in China. Different from the old times, students started to study Chinese Medicine through medical courses, instead of following and inheriting from their mentors. In 2001, we established “Chinese Medicine Workshop”. In the workshop, we matched each student with a mentor. In this way, students could learn closely from their mentors. They might do some academic researches together and developed new drugs. In 2014, most of the Chinese Medicine schools in China have applied to this successful operating mode.

In 2013, we were still in a small scale with only 1,250 beds in the hospital. However, it is easy to tell that we are a Chinese Medicine Hospital because of the 370 thousands appointments in the clinic and the enormous consumption for Chinese Medicine, which is 20 tons of it. The volume is the biggest in the country. And since 1984, we have started to hold the Herbal Paste festival every year. The paste for winter is one of the most popular herbal pastes. Every year, we have prescript over 30 thousands of Herbal pastes. All those achievement have helped promoting the features of Chinese Medicine.

Longhua Hospital has been the leading hospital on transforming science research into practice through the efforts from our workshop. We are certainly the best in the field of Chinese Medicine. In the 2016 National Science and Technology Impact Rankings, which included Chinese Medicine and Western Medicine Hospitals as well, we were in the 54th place. It is the highest ranking among Chinese Medicine Institutions and even higher than some of the Western Medicine Hospitals. In the Hong Kong Ailibi Hospital Ranking, we have been in the second place before and the fourth place this year, maintaining in the first five every year. In 2010, we have received three different national awards for progress in science and technology, including two second prizes as the first-finished unit and a first prize as the fourth-finished unit. From 2013 to 2017, we have been awarded the first prize for Shanghai Science and Technology Progress Award for five consecutive years, which is the one-and-only in the whole country. What’s more is that all the prizes are awarded to different departments of our hospital every year. That shows the solid and strength of the science research in Longhua Hospital.

LCM: It is getting more and more competitive between high-ranking hospitals? How to consolidate and enhance the academic superiority of Longhua Hospital in terms of quantity and quality? What is your vision for the Longhua Hospital?

Prof. Xiao: First of all, we should copy successful models and apply them to other departments in our hospital.

Longhua Hospital is one of the sixteen National Chinese Medicine Clinical Research Bases and the only base that covers two important diseases, “Malignant Tumor & Degenerative Bone Disease”. From 2008 to 2016, the integration of clinical research and science research had a series of successful outcome, including receiving the first prize of Chinese Medicine for Spinal Disease Department, which is the very first Chinese Medicine Department to receive this award and other departments have also been awarded Shanghai Science and Technology Progress Award. These exciting news have encouraged us and enhance our confidence.

LCM: How do you think to successfully maintain and promote the feature of Chinese Medicine internationally under current status?

Prof. Xiao: We have exchanged our perspectives with doctors from all over the world. Through the sharing, we found that what interest them the most are always things that are well-preserved with their tradition and originality. Some of them notice the fading of the features of Chinese Medicine. And as the origin of Chinese Medicine, it is our responsibility to act on this circumstance.

First of all, it is important for us to persist on the features of Chinese Medicine. Second, we should set up “Classic Prescription” and “Only Chinese Medicine” treatment for Emergency and Critical Care. Then, under modern monitor devices, we may be able to treat the diseases, such as Drug-resistance Infection, Chronic Heart Failure, and Tumor in advanced phases, which are all hard to cure even with Western Medicine as well. This is a turning point for Chinese Medicine because people normally think that Chinese Medicine can only treat chronic diseases. But now, with the modern monitor system and ICU, we will be able to treat the emergency and critical diseases.

At last, Standardization is a crucial key for Chinese Medicine to step in the world. We should collect the successful cases and categorize them into a big giant database. In the meantime, using common language is equally important as well. And the day when our precious researches are being published on international journals, won’t be long.

LCM: What do you think is the core value of building a modern management regulation for hospitals? How do you realize?

Prof. Xiao: The modern management for the hospital is still in the stage of exploring. Every manager in the hospital is asked to learn the related knowledge and they are supervised by the council board, including the Dean, who is responsible for managing the whole hospital.

Here is the three keywords from my understanding of the modern regulation for hospital management, “Regulation, Elaboration, Scientific”. ‘Regulation’ refers to the maintaining of Public Welfare and the duty of serving people in the public hospital under the existing law and regulations to ensure the effective operation of the hospital. ‘Elaboration’ refers to the decision-making that is under assessment and controlled. In order to reach the requirements, the use of information technology and management software is also important. ‘Scientific’ refers to the grasp on the trend and forefront for the medical development, the understanding of the nature of your own hospital and lesson learning from the hospitals. The whole process is transparent, hoping to give those who are a part of the hospital a chance to understand the process of decision-making.

Longhua Hospital has been pursuing modern hospital management, trying to meet the international standard. Longhua took the lead in carrying out the JCI accreditation for hospital administration in the National Hospital of Chinese Medicine. At present, the JCI accreditation has passed and the formal accreditation will be conducted in April or May next year. If passed, it is the first comprehensive Chinese medicine hospital to pass JCI.

LCM: What is your secret in attracting and keeping talented people in Longhua Hospital?

Prof. Xiao: To attract talented and outstanding people in this competitive world, you have to build up a shining platform. People will be attracted by the compensation providing from the hospital. Then the platform will determined their willingness of staying. The design of the whole system should be the recruitment, working environment, and a platform. And it is the combination of the hospital development and development of employees’ personal career that will keep those talented people to stay. In the old times, we thought that people might stay because of emotional issue and compensation, but after all, I think it is the platform that gives the final word. Compensation is important at the moment, but having a platform for them to shine is the key.

LCM: Could you share with us the initial intention and vision to cooperate with us on launching the Longhua Chinese Medicine?

Prof. Xiao: I want to build an international influential academic journal of Chinese Medicine. Through the first step in academic world, I aim to promote and bring Chinese Medicine to the world.

LCM: Do you have any suggestions or expectation to younger generation? How to better inherit and promote the characteristic of Chinese Medicine?

Prof. Xiao: I think the younger generation has lived in a better era, which Chinese Medicine has received unprecedented attention from the government. They should seize the rare opportunity for the development and innovation.

The integration of theory and realization of Chinese Medicine can only be done in Mainland China. For instance, doctors in Hong Kong couldn’t use stethophone in the Chinese Medicine Clinics. The Eastern and Western Medicine are completely separated in Hong Kong, but not in China. In China, the eastern and western can be used together and that gives extra possibilities to realization. It is an unquestionable and good opportunity for younger generation. On the other hand, science technologies nowadays provide a more effective way of learning, including teleconsultation, academic exchange and electronic reading. These are what we didn’t have. I would like to tell young people to keep their faith and passion for Chinese Medicine. Let us keep Chinese Medicine standing in the medical world for the benefit of all mankind.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the Editorial Office, Longhua Chinese Medicine for the series “Meet the Professor”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/lcm.2017.12.02). The series "Meet the Professor" was commissioned by the editorial office without any funding or sponsorship. WEF reports that she is a full-time employer of AME Publishing Company (publisher of the journal). The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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(Science Editor: Wei-En Fan, LCM, lcm@amegroups.com)