Scanning 20,000 People per Day
The First Affiliated Hospital to Zhengzhou University is the largest hospital in China, which means it might well be the largest hospital in the world. Its radiologists see 20,000 patients each day.
radiology.bayer.com (rbc): How large is your hospital?
Jianbo Gao (JG): Our hospital with its three branches has 11,085 beds, about 8,000 are on the main campus.
rbc: How many patients do you and your colleagues in radiology see each day?
JG: For radiology altogether – meaning ultrasound, MRI, CT, and everything else – we see about 10,000 patients every day. Including outpatients, it’s 20,000 patients each day.
rbc: 10,000 inpatients per day?
JG: About 1500 in general Radiology, another 1500 for CT; 800 to 1000 for MRI; 4,500 patients for ultrasound; 1000 for nuclear medicine. Then, of course, we also see pre-OP patients from our international department. So it is around 10,000 altogether.
rbc: What made you decide to work for such a super-large hospital?
JG: In 1985, I graduated from Henan University, one of the most famous medical schools in China. I stayed to work for the First Hospital affiliated to this university. After a merger in 2000, the name changed to the First Hospital Affiliated to Zhengzhou University. I have been working at this hospital for over thirty years now and I have witnessed an incredible development process; I saw this hospital getting bigger and bigger.
rbc: Why did you decide to start this kind of growth?
JG: It fits in with our strategy to make the whole hospital stronger and bigger; and the department is in line with this strategy.
We figured we need world-class level, so we bought equipment from GE, Siemens, Phillips and Toshiba.
rbc: How did your equipment change over the years?
JG: Back in 2008, we just had one single-slice CT scanner and one 1T MRI scanner, one DSA and four ultra sound machines.
Now we have 300 ultrasound machines, 34 X-ray-based scanners, 23 DSA machines, 20 CT scanners, 17 MRI scanners, and 6 PET-CTs and the according nuclear medicine equipment.
rbc: Do you sometimes think the growth might be too fast?
JG: Just like our chairman Xi Jinping said, it is most important not to forget about our original dream to make China stronger and bigger. We need to work as hard as we can to make this dream of China come true.
Attracting the Best
rbc: How do you handle this superfast growth in radiology?
JG: I try to attract the most efficient talent. I also built up a platform to optimise our diagnostic process and to combine our resources perfectly. With the information advantage we have here, we guarantee quality despite the quantity of scans we cover.
rbc: What does ‘information advantage’ mean?
JG: Digital platforms, the digital systems in our hospitals, patient care registries, outpatient WeChat platforms, just to name a few examples.
rbc: When you say ‘I’m trying to attract the best people to my hospital’, what do you do to get them?
JG: We do put out job openings online, but we also get a lot of applications. We make sure to reimburse all travel and accommodation expenses for applicants, we pay for their meals and hotels. We will also schedule the interviews on the weekends only, so potential employees have enough time to come here and do the interviews.
rbc: How do you keep your staff despite the huge workload?
JG: We attract and train talents, we increase our academic abilities, focus on scientific exchange, nationally and on an international level. And keep an innovative mind.
We also have flexible work time regulations; it doesn’t matter what it says on your contact, you have to work through all your patients, and then you can go home, but you can also take an hour off, if you have to.
rbc: You are also recruiting renowned research experts. How do you attract them?
JG: We supply research funds in a range of three to five million Renminbi*, which is a very high amount.
We also encourage special accomplishments, like publications in international journals. A researcher will get 10,000 Renminbi for every Impact Factor; if the paper is above 5, the amount will be doubled.
Our goal is to deepen our research and expand our international influence.
rbc: The hospital is planning to build a huge research complex. Will radiology be a part of this?
JG: The total building will be about 140,000 square meters and yes, radiology will be a part of it.
rbc: How do you and your colleagues find time for research?
JG: Firstly, flexible schedules help; secondly, we have special research teams. Half of their time is for research, the other half for clinical work.
We have a special encouragement policy for new, innovative research and one especially for younger radiologists’ education. The latter is truly one of the most important reasons we are getting stronger.
Staying On Top
rbc: What are challenges do you still need to tackle?
JG: I think, we are facing three main challenges now. Keeping the status as the biggest hospital, keeping up innovation, and continuing to get stronger. The biggest challenge is to keep being number one.
rbc: What do you enjoy about your work most?
JG: The part I enjoy most is the daily clinical work. To deal with that, get everything done and provide service to patients with high quality satisfies me.
Number two is being a very good teacher and researcher. Our hospital is an affiliated hospital to a medical university, so it is also my job to train talents. If they become better than me, then I am a good teacher.
rbc: How much time do you spend on your clinical work, on research, and on teaching?
JG: Clinical work is everywhere, all the time, so I cannot come up with any percentage guesses. Education takes about one third of my time, because I have to teach at the university, and train the fellows and residents here at the hospital. I do research work in the evenings, when the patients are gone and I do not get disturbed. It is not unusual to do meetings and discussions about our clinical research until midnight.
rbc: How do you want to develop your department in the next five years?
JG: The development our department should be aligned with the direction of the whole hospital. In the next five to ten years, we want to keep improving, establish radiology as one of the most advanced disciplines at our hospital and try to build up our international work, network and platform.
We want our diagnostic techniques and research level to be aligned with international levels. I think this will lead to very good economic and social effects.
rbc: Which strengths will put you on the international level?
JG: Gastrointestinal is our speciality; we will keep on focussing on this.
The Business Part
rbc: How much of a businessman do you have to be to successfully lead such a huge department?
JG: I must point out that we are a public, non-profit. So unfortunately, I cannot answer your question with a very explicit answer.
To manage such a big department in hospital we have to use various management techniques. I can tell you that in Chinese hospitals, the income from radiology departments covers around 10-15% of the whole hospital’s income.
rbc: Does this mean that if you say, ‘I need a new machine, I have patients’, you discuss it with the board, and if it is necessary, there will be funds, no matter how much it costs?
JG: We have two kinds of equipment, one for clinical work, the other for research. If I want to purchase new equipment, I have to do a lot of pre-work. There is an expert team counselling the board that explains which effects we get from purchasing a particular machine.
We follow the principle to only purchase world-class equipment. Firstly, this will serve our patients better, and secondly, we can do a lot of research on new techniques, which in turn helps many new radiologists to get their papers published at RSNA or ECR. In the last couple of years, an average of around ten of our staff attended RSNA with a lecture or a poster. That is a definite advantage our new and high-tech equipment has brought us.
rbc: What else would you would like your global colleagues to know about your work?
JG: Radiologists in China already work together to increase the visibility of radiology within hospitals. We are aiming for this visibility on an international level as well. We want an international platform to expand the influence of radiology and we also want to expand the influence of China.
Communism With a Chinese Character
rbc: What do foreigners usually not understand about China?
JG: Just like Chairman Xi Jinping said that during the recent Congress of the Chinese Communist Party, communism has entered a new era. It is communism with its own Chinese character. Our country has to acknowledge the need of our people to live better and better, and it has to deal with the uneven development between the different regions in China.
The knowledge radiologists around the globe is fairly similar, but the culture of every country is very different.
rbc: Where would you put your radiology department within China as far as ranking goes?
JG: Well, the Chinese people tend to be modest. I would estimate radiology here in the upper middle section. There are many other hospitals and departments we need to learn from. There are plenty of other Level 3 hospitals, which may not be at the same level as we are in general, but they might have a specialty, or a mind-set we can learn from.
About Jianbo Gao
Jianbo Gao is the department chair-CT and the vice president of the First Hospital Affiliated to Zhengzhou University in the central Chinese province of Henan.
He starts his day at the hospital at 7 o’clock in the morning and usually works until midnight every day. “If I have social events outside, I will come back to the office, no matter how late it is”, he says.
* 1 million RMB is approximately 150,000 US dollars.