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What was originally supposed to be a temporary job after her time in the military became the definitive career move of Sylvia Pan, now the General Manager of Beijing United Family Hospital and Clinics, part of the United Family Healthcare (UFH) network, which has hospitals and clinics in Shanghai, Guangzhou, Tianjin, Qingdao and Mongolia.

The first foreign-invested hospital established in Beijing, Beijing United opened in 1997. But Pan joined before that – in 1996 – to work at its parent company, the publicly-traded Chindex. A pragmatic leader, Pan has a strong commitment to implementing the most efficient and effective practices for every type of patient. Pan leads with an approachable style, using WeChat to share best practices with staff across her domain, which includes Beijing United in Lido, a rehabilitation hospital close to Joy City, a hospital in Tianjin and a network of eight satellite clinics all under her watch.

Pan has been instrumental in many of Chindex’s critical decisions. She recently sat down with Business Now to share her thoughts on managing the expectations of Chinese patients and dealing with fake UFH hospitals sprouting up around China.

Why did you first join Chindex?

I say it was fate or destiny. When I was in the army I was allowed to transfer to the civilian job after six years. My plan at that time was to go to the US or another foreign country to study. I applied to school but couldn't ask my mom for the air ticket or tuition so I decided to get a job to earn money for airfare. Chindex was looking for a project assistant for the hospital, which hadn’t even opened. They needed an interpreter, so they gave me the job. It was supposed to be temporary; I didn’t expect it to last 19 years.

What are some challenges you’re facing at Beijing United right now?

A challenge as well as an opportunity is the shift in our customer base. When we started, 80 to 90 percent of our clients were foreigners. Now, the majority of our patients are Chinese. We have to meet their expectations and provide services while educating them on basic international healthcare practices. 

With foreign patients, they are familiar with international healthcare standards and are happy to see that we are very similar to the hospital in their hometown. But Chinese patients have no benchmark. They only know that their fee is several times that of a public hospital. We have to manage these expectations.

For example, we saw a grandma complain about how much they paid the doctors and they didn’t even get an IV. We told her that it means that the child or patient didn’t need the IV, and if we gave it just to satisfy you, it would harm the patient. A lot of people who come in with the flu or a cold are asking why they didn’t get antibiotics. That’s because it’s a virus (not a bacterial infection).

Our Chinese colleagues spend a lot of time working on patient education. One of our doctors, Dr. Cui, has over 4 million Weibo fans. One of our pharmacists, Sabrina Ji, has almost 1 million Weibo followers simply by introducing proper use of medication and how to take care of a baby without antibiotics.

What are some of the challenges of being an international hospital operating in China?

As a pioneer in international healthcare, we spend a lot of time educating people on what “international healthcare” is. Here's one example. Our New Hope Oncology Center offers outpatient chemo and radiation therapy. It’s a very unique model in China because oncology treatment, according to the Chinese government license requirement, must be delivered on an inpatient basis. In China, even if the patient is just getting radiation treatment or chemotherapy, they have to stay in hospital for the whole period. In the Western model, when people have cancer, they go to the community treatment center and in many cases are able to still carry on their normal lives. When we first introduced this new model of care, we had a lot of resistance and were denied a license. They said, “Oh, you must have inpatient beds, you must be a tertiary hospital to give radiation therapy.” We continued to educate the necessary people on the value of our model of care, utilizing case studies from the United States and Europe and eventually were granted a license. Now we're celebrating the 5th anniversary for the New Hope Center.

With more than 1,000 employees under your responsibility, how do you exert influence across your staff?

I have been with Beijing United even before the opening. In the early days, we all supported each other. Even after we expanded and developed, the key team members are still here and quite familiar with each other.

One way (I exert influence) is through social media. We have lots of WeChat groups in which we share with each other how to improve our services. I’m always sending messages about the articles and books I’ve been reading, or the patient case I’m focused on, and they know I care.

You mentioned that the key team members are very close-knit. I got a sense for that when I saw that during your 19 years here, you’ve taken two breaks to pursue masters degrees.

Actually, I did my first masters (an MBA from Peking University's Guanghua School of Management) by myself. But later on, the company gave me the opportunity to get my master’s in healthcare business administration at the University of Colorado.

The government has opened up to more foreign investment in healthcare. How does that affect what UFH does in Beijing?

I think this change is very encouraging. In the early days, when we started Beijing United, the healthcare sector was officially categorized as “with limitation.” The government wanted to limit the growth of the sector. It was tough going, but there were also some benefits. Those of us developing hospitals in the early days were able to import medical equipment without having to pay any duty. That meant a huge amount of money was saved as this tax normally amounts to around 20 percent of the market price of each piece of sophisticated medical equipment. Now, as there are more entrants to the market, there is no longer a tax exemption, making things fairer but more difficult in many ways. In general, though, the total environment is improving as competition pushes everyone to perform better.

What’s your take on the future of senior care in Beijing and in China?

Beijing United invested in a rehabilitation hospital two years ago. The main reason that drove us to make the investment is the aging population in China. The second is the shortage of rehabilitation medicine in China. With a population of 1.3 billion, we have less than 20,000 rehab doctors. Also, in China, if we do the analysis, I think the majority of healthcare now focuses on end-of-life care. That’s something we need to change as it is much less expensive to focus on prevention and rehab care.

There are unaffiliated hospitals falsely claiming to be UFH clinics. How do you deal with these fakes?

It bothers me. Those people use a fake name and even use our logo. But thanks to social media, people know where to find me. My public Weibo has close to 100,000 fans. I once received a complaint from a patient who had care at one of these fake hospitals; they thought I was the General Manager. I had to explain that I was not responsible for the care they received as they were not at the “real” Beijing United. In some cases, these copycat hospitals can even be found on the government website. But you know, in China, when people begin knocking-off your brand, one positive way to look at it is that you've attained a high level of brand-awareness.

How do you retain staff?

To keep retention high, especially for key positions, we choose people that share our same values and have a high level of integrity.  At Beijing United, we have such a wonderful learning environment. We developed a young leaders training program for people who have been identified as high potentials, and we support them with additional training / learning opportunities, giving them the chance to grow. Personnel development is an essential component of any retention plan.  Of course, I am a good example of this.  Moving from Project Assistant to General Manager shows that with hard work and some planning, anything is possible in a good organization.

Who do you think has influenced your leadership style?

I would say the PLA (People's Liberation Army), since I have six years of experience in the army. After graduating from university, I became an English interpreter with the Chinese army. Regardless the aims of the army, I think it gives people lots of basic training or standards.

The first (lesson I got was) that you have to listen to the person who leads the team, even if that person makes the wrong decision. You can speak out, but once the decision is made, forget about your plan. When I started to work, I took it that way and thought that I should speak out about what’s on my mind. I was a follower in the beginning of my career; I learned to lead later. Slowly I learned to speak out and sometimes I got disciplined and sometimes I didn’t.  But I agree with what’s finally decided on, and go ahead in that direction.

The other lesson I learned in the army is belief in yourself and perseverance. Sometimes you may think you cannot do it, but if you hang on for a little bit, you will make it.  I was very thin and once we were forced to do a 10 kilometer, full-armored run in the mountains of Shaanxi province. I thought I’d never be able to make it. They had a jeep, and if you sat on the roadside and shook your hand, they’d pick you up. And I thought, OK, I can’t make it, but these guys will pick me up. I ran in the beginning and then I walked. By the end I was dragging my feet with all of the other thin, short little girls. But guess what? I made it. I didn’t faint or take the jeep. So all my life, if my career is hard or difficult, I think about that and say, “Hang on for a little while.”

What books have influenced you?

There are many books! The book I’m reading now is about business, A Way of Life by William Osler. He's a Canadian and considered one of the founding doctors of Johns Hopkins in the early 20th century. It's full of philosophy. He talks a lot about healthcare and his words are really touching. It makes you believe that you’re doing something right, something worth doing.

I tell my colleagues I sometimes feel a little lost because change is happening so fast in China. The private sector used to be strictly controlled by the government, but now there are huge government efforts to incentivize private investment in this sector. A lot of people have rushed into this industry and sometimes you don’t know if you’ve made the right decision. Like a captain driving a boat, you must know what’s turbulence and what are rocks under the water. It’s so overwhelming when you check online and you see so-and-so has opened five or six hospitals all over the country, or they were trying to steal your staff and pay them three or four times the salary. When you’re dealing with a situation like that, you need to ask yourself what is going on here and is it temporary or long-term?

What would be the best advice you would give someone who is looking to move into the senior management level?

At the middle management level, people become more conservative because comparatively you have a larger group or team reporting to you.  Sometimes they can easily become complacent and cautious of risk taking. This is why some say that middle management can become troublemakers in an organization. They become less innovative and don’t deal with challenges well. To move into senior management, you need to be creative, think outside the box and always keep learning. 

I think it is very different for women looking to get into senior management.

“For women, especially in China, I think Chairman Mao understated it when he said “Women can hold up half the sky.” We actually often need to hold up the whole sky. We’re trying to take care of the family and work and can sometimes forget ourselves. I encourage everyone to keep looking for that “right balance.” But balance doesn’t mean that you have to make everything perfect. I think women need to accept that sometimes things in life or work will be imperfect. You have to find a balance.