Text/Ling Xin
Editor/Wang Xiao
Photo/pixabay
"Now that the situation of private hospitals is getting better, there is no rush to sell." Before many hospitals could not do it, invested 10 million in Chinese medicine outpatient clinics, 2.4 million did not sell. A person engaged in equity trading in the health industry found that after experiencing the "wave of closures" of the new crown pneumonia outbreak, some private medical institutions are now slowly breathing away.
In 2021, private hospitals that survived the most tense moments of the epidemic resumed normal outpatient clinics.
These hospitals, which are the first to recover, rely largely on "old patients". Under the epidemic, almost all small and medium-sized private hospitals have been closed for a time, and in the "post-epidemic" era, common diseases such as colds and diarrhea must also be referred, and business loss is inevitable. However, there are still some private hospitals that sink into the community, or specialty outpatient clinics that have been operating for many years, and maintain contact with patients during the epidemic through the influence of Internet hospitals and individual doctors.
These private medical institutions, which sink into the community, seem to have found their own way of survival: to serve a chronic disease patient for a long time, to become part of their rehabilitation life and even home care, and the income obtained by a single patient every year can reach seven or eight thousand yuan. Diseases such as high blood pressure and diabetes are to be treated for life.
There have been more than 1,000 hospitals looking for someone to take over, and the "Putian Department" has borne the brunt of it
"More than 1,000 hospitals want to sell." The above-mentioned health industry equity trader recalled that from the outbreak of the epidemic in 2020 to the middle of 2021, the operators of private hospitals urgently need buyers or investors, from outpatient clinics with construction costs of 10 million yuan to general hospitals of 50 million or 60 million yuan, many of which are insolvent.
The pandemic has reduced the number of patients visiting hospitals to a nearly five-year low in 2020. Among them, the number of visits to private hospitals decreased by 40 million, and the number of visits to grass-roots medical and health institutions decreased by 410 million, including private clinics and clinics.
Until 2021, according to the requirements of epidemic prevention, patients with fever, diarrhea, chest tightness, cough and other symptoms must be sent to the designated fever clinic. "In this way, we have lost a lot of patient sources, after all, many patients in the community are common diseases and multiple diseases." A relevant person in charge of a community outpatient chain agency said.
Income decreases, and daily expenditure will not be less.
Lin Xiangsong, chairman of Fuzhou Fuqixiang Traditional Chinese Medicine Hospital, calculated that the hospital with a construction area of 12,000 square meters spends at least 1 million yuan per month, of which labor costs account for 600,000 to 700,000 yuan, hydropower 60,000 or 70,000 yuan, plus drugs, consumables and depreciation of fixed assets, and many large medical equipment from financial leasing needs to be repaid regularly.
Just before the epidemic, Lin Xiangsong, who had been running hospitals in Minhou County and Shanggan Town in Fuzhou for seven years, had just built the new hospital, but the epidemic forced him to suspend outpatient clinics until October 2020. Of the planned 200 beds, 30 are currently open. Because once more beds are opened, labor costs may increase to more than one million.
Father and son are well-known local Chinese medicine, Lin Xiangsong's situation is far beyond his peers, at least, during the closure of the outpatient clinic, there will be old patients who take the initiative to find the door.
Many private hospitals have not been able to survive the "wave of closures" in the epidemic, and the "Putian system" that relies on advertising drainage has borne the brunt. They may not have been run by the first batch of businessmen from Putian, but the main profit model is similar, that is, through advertising and other publicity means to divert money, in the form of excessive medical treatment to obtain high profits.
This so-called marketing not only requires large amounts of money for advertising, but also cooperates with ground marketing. For example, some hospitals will recruit many agents to carry out health or health care lectures, so as to divert customers to the hospital. The above-mentioned health industry equity traders have contacted two similar hospitals and invested 50 or 60 million yuan before the epidemic, but after the epidemic, they are "completely insolvent, and only one license is worth a little money."
Because many private hospitals are built and maintained by loans, once there is no income, the capital chain will be broken. "The person in charge of a hospital asked me to find a way to borrow 1 million bridge funds to repay the bank, and used up to repay 1.8 million." With such a high financing cost, he thinks he is desperate. The above-mentioned health industry equity trader told Caijing Health.
For the closure of such hospitals, Cai Jiangnan, founder of Shanghai Chuangqi Health Development Research Institute, believes that it is a good thing. "Ordinary people do not trust private hospitals and are also afraid of the 'Putian Department'." Now that the 'Putian system' has withdrawn, it can be reshuffled. Let the pattern of private medical care go through a transition, make some brands, and slowly change their concepts. ”
In addition to the "Putian Department", the comprehensive private hospital opened in the county town is also the "hardest hit area" that has collapsed. For example, the Second People's Hospital of Shuyang County in Suqian City, Jiangsu Province, the Sanqiao Hospital in Kaizhou in Chongqing, and the "Fengqing Shunning Hospital" in Fengqing County, Lincang City, Yunnan Province are all listed here.
This kind of general hospital and the local public hospital business coincide, the number of beds is more than 100, there is no scale advantage; positioning at the county level, can not charge too high prices, but the cost must be borne by themselves, before the epidemic it is not easy to survive. "Such a hospital also wants to sell tens of millions, anyway, I can't say it," the aforementioned health industry equity trader admitted.
"Old Patients" in Private Hospitals
Lin Xiangsong's Fuqixiang Traditional Chinese Medicine Hospital is a general hospital opened in the county. They can ease up, completely relying on themselves and their father's identity as the inheritors of the Fuzhou Intangible Cultural Heritage Project.
Lin Xiangsong said that the hospital's single-day outpatient volume is now about 200 people, and he and his father's patients account for 150 of them, mainly using surgery and ancestral ointments to treat vasculitis, diabetic gangrene, etc., in addition to treating rheumatic pain and cervical spondylosis and other motor system diseases. Other departments such as the Department of Internal Medicine of Western Medicine are still "dragging down".
The hospital's recovery is mainly based on, "the elderly and sick population by word of mouth." Even when the door was not open during the epidemic, some people came to us. Lin Xiangsong said that at present, the monthly flow of the hospital has basically returned to the pre-epidemic level, which can reach 1.7 million yuan to 1.8 million yuan, with a slight surplus.
If ancestral Chinese medicine is a special kind of existence in private hospitals, at least, patients with chronic diseases such as diabetes and hypertension are also the main revenue of other private medical institutions in the epidemic.
Jiang Yiru, deputy general manager of Qingdao Bohou Huici Medical Technology Co., Ltd. (hereinafter referred to as "Bohou Medical"), said that in 2020, chronic disease management accounted for 60%, "mainly because they will come to our clinic on time for follow-up, most of them will come once a month or two."
Bohou Medical is a chain of medical institutions positioned in the community, and currently has more than 60 clinics and hospitals in Shandong. "I just need to serve the 30,000 residents around 2 km to 3 km, and the operation will not be too bad." Founder Yan Honghui said in an interview with Caijing Great Health.
Private hospitals should find a part of the market that suits their survival, such as chronic diseases, elderly care, postoperative rehabilitation, sports medicine and pain. "The diabetic foot project we are pushing now, some of the top three hospitals can not take care of the Qin department, or need to be transferred to the burn department, but it is a disease that requires long-term follow-up, so it is not realistic for patients to run around every week, we can serve nearby." Yan Honghui analysis.
Before the epidemic, the demand for follow-up prescriptions for chronic diseases accounted for about half of the outpatient volume of public tertiary hospitals. A dean told "Finance and Economics Health" that outpatient and bed resources are tight, medical staff is insufficient, and it is very hoped that the lower-level medical federation units can undertake the follow-up of patients with chronic diseases, "not to repeat a single dispensing, follow-up, dynamic and accurate follow-up is the most important."
Chronic disease does not mean that the disease does not change. Jiang Yiru admitted that the purpose of many patients with chronic diseases is to prescribe drugs, but "we have been trying to change this concept in recent years, and some patients think that the long-term medical treatment is not necessarily true, and some indicators monitoring and side effects they do not pay attention to."
Zhong Weizhen, chief physician of the Department of Endocrinology of the Affiliated Hospital of Qingdao Binhai University, introduced that according to the diagnosis and treatment standards, blood glucose should not only be effectively controlled, but also dynamically monitored. There are many patients who only measure blood glucose once or twice a day, slightly exceed the standard and do not pay attention to it, and the development of the disease is becoming more and more serious, which will lead to complications such as kidney disease and diabetic gangrene.
Private medical institutions hope to retain patients through indicator monitoring and daily life, including what to eat, how to eat, exercise mode, exercise intensity, how to achieve exercise effect, correct blood glucose monitoring, and even what kind of socks to wear.
Jiang Yiru analyzed that private hospitals also have an advantage and can serve patients more carefully. "From doctors to pharmacists, nurses and service directors, patients may stay in our clinic for 20 to 30 minutes. Because public hospital nurses may have 200 infusions a day, we may have 10 to 20 doses, and their time can be used to better communicate with patients. ”
According to data, after a chronic disease patient is received, his annual payment can reach 7,000 yuan - 8,000 yuan, and the service period is about 27 years. Yan Honghui believes that the time spent on these patients is worth it.
Integrate into the future of patients' lives?
Even if the revenue growth in the first half of 2020 has recovered to more than 30%, Jiang Yiru also admitted, "The two years as a whole are in a relatively difficult state, whether it is medical income or labor expenditure, has been looking for other ways to fill." ”
To put it bluntly, private medical care needs to discover new patients, or charging scenarios.
Internet marketing is a new approach. Bohou Medical tried this method, "This was developed after the epidemic. Many young people don't know us very well and want to open up this part of the business through online marketing. Of course, it has been found that there are also many middle-aged and elderly people who are willing to participate. Jiang Yiru told "Finance and Economics Great Health".
The way to play Internet marketing is to build an online platform to drain traffic, so that doctors and patients can connect here. On the basis of the original patient community, Bohou Medical has established an online platform to further promote the online order-based on-site service in 2021, from more than 300 yuan of newborn growth and development assessment, to dozens of yuan of door-to-door injection services, and even a diabetic foot care package that charges nearly 2,000 yuan.
Some patients who need to go home to order online are originally contracted customers of outpatient clinics. Jiang Yiru gave a case, there is a 70-year-old man, suffering from osteoporosis, one day accidentally fell at home calf crushing fracture, she and her family are outpatient contract patients, so the family from the line to order door to change the medicine.
What Jiang Yiru expects is not only the transformation of medical services from offline to offline + online, but also the expansion of service objects from a single patient to the entire family - most of the orderers are middle-aged and young people, and their dependence on community outpatient clinics is relatively low.
In early 2021, Internet giants Ali and JD.com launched an online appointment nucleic acid testing service. Alibaba provides door-to-door services in 120 cities across the country, including Beijing and Shanghai, of which the cost of door-to-door service in Shanghai is about 250 yuan, while the offline nucleic acid fee is 40 yuan.
Lin Xiangsong is also trying to find ways to undertake physical examination orders from nearby units, invite experts from top three hospitals to sit in clinics, actively participate in epidemic prevention and nucleic acid testing, launch "Double 11" marketing offers and seasonal creams, and open online micro-stores.
"It is not easy to make money by staring at Western medicine, but the current income of Traditional Chinese medicine ointments, decoctions and granules is still relatively good, and it can be sold through Internet channels, and the profit is relatively high." The view of the above-mentioned health industry equity traders is that at present, well-known Chinese medicine is relatively scarce, and chinese medicine preparations are less restricted, which may become a new "way of survival" for private hospitals, "not only to treat diseases, but to manage the course of illness, to get a patient to continue to serve, or to do it".
In this regard, Cai Jiangnan pointed out, "There are some market-oriented charging spaces in TCM clinics, and if you are a TCM practitioner with 'unique skills', it is still possible." In addition, in some new population inflow areas, some specialized public hospitals are relatively weak, such as pediatrics, emergency departments, rehabilitation, and private hospitals as a supplement to public hospitals, and they can also develop. ”
In Cai Jiangnan's view, the shortcoming of grass-roots private medical care is that general practitioners have no advantage over public hospitals. On the one hand, ordinary people trust public institutions more, on the other hand, there is also a problem of insufficient level of general practitioners, "some doctors are willing to do general practice, chronic diseases also need medical knowledge, diabetes also need to adjust the use of drugs." Grassroots general practitioners abroad need to be trained for eight years, and the doctors in our community clinics and village clinics cannot reach this level."
In some European and American countries, a family usually uses a family doctor for many years. In China, the concept of family doctors is still in its infancy.
Parts of the hospitals and outpatient clinics sinking into the community seem to want to do this, into the patients' homes. Including providing door-to-door services for disabled elderly or economically disadvantaged patients, paying attention to the mental and psychological state of them and their families, and carrying out stroke and secondary disease screening and vaccination according to the characteristics of residents. Can they succeed? It may take time to test.