For many older people, modern hospitals are confusing places, so a new breed of personal assistant is emerging. Yan Dongjie reports.

In the past calendar year, Wang Yuzhu has traveled to Beijing twice, but unlike most visitors who exit the Beijing Railway Station he came to consult a doctor.

After being diagnosed with cancer, the 63-year-old had a procedure to form a permanent opening into his rectum. He was so exhausted after riding the train for 14 hours that he found it hard to get into a taxi at the roadside.

However, Wang's trip was easier than his previous visit because his daughter, Wang Yaru, had arranged for him to be accompanied by a hospital companion she had found online. Even though it was 8 pm, Zhao Haiwei, the companion, arrived at the railway station to greet Wang Yuzhu and his wife.

In recent years, hospital companions have become popular on social media platforms. As the name suggests, they accompany patients on hospital visits. People age 60 and older account for the majority of their clientele, while patients who come from outside the country's big cities also account for a significant proportion.

The various challenges that have arisen in modern medical treatment have created and even boosted this new sector.

Provincial visitors

"Many people from my hometown come to Beijing to see doctors," said Wang Yuzhu, from Urad Front Banner, Bayannuur, Inner Mongolia autonomous region. It was his third medical trip this year having already visited Baotou, Inner Mongolia, and Hangzhou, Zhejiang province. This time, his destination was the Beijing Cancer Hospital.

In the waiting rooms of Beijing's major tertiary hospitals, it is common to see people from other provinces carrying their luggage as they visit for medical treatment. Some even spend the night at the hospital entrance, hoping to grab the first number to consult an expert when the options are released early in the morning.

As of 2021, there were more than 1,400 first-tier hospitals in China, while the total number was more than 30,000, according to statistics released by the National Health Commission.

After being diagnosed with rectal cancer, Wang Yuzhu had surgery at a hospital in Baotou in 2021.

Later, he had difficulty urinating, so he underwent procedures to make rectal and bladder stomas that would allow feces and urine to drain easily from his body.

In September, he came to the Peking University First Hospital in Beijing for checks on his bladder problem. Having had the bladder stoma for about 18 months, Wang Yuzhu found it inconvenient.

"The doctor looked at the data for a long time before saying 'Just remove it. If there's leakage, let it leak. It's fine.' The doctor said that wearing a fistula band for a long time can easily cause other problems," he said.

Wang Yuzhu returned to Baotou and had the bladder stoma closed. "After that, there was no more leakage," he said.

Before Chinese New Year's Eve in February, Wang Yuzhu went to Baotou for a checkup and learned that his tumor had recurred.

His daughter, who had been searching for information online, saw that there was a famous doctor of traditional Chinese medicine in Yiwu, Zhejiang, but a face-to-face consultation was necessary. So on March 12, she took her father to Yiwu, more than 2,000 kilometers away, to see the practitioner.

However, just after landing in Hangzhou, Zhejiang's capital, Wang Yuzhu was rushed to the hospital with unbearable abdominal pain and underwent emergency surgery. It was his third operation.

The doctor at the hospital said the cause of the pain was an intestinal obstruction, which was probably related to problems with the original operation.

"Our hospital is not as good as those in Beijing or Shanghai. If you're seeking treatment in the north, you can go to Beijing. In the south, you can go to Shanghai," he told Wang Yuzhu.

Complicated procedures

Wang Yaru was the 500th customer to connect with Zhao after the companion opened his Taobao platform in August.

Zhao often travels between a wide number of hospitals in the capital.

"Xuanwu Hospital is good for neurology, mainly for seniors' conditions such as Alzheimer's, strokes and Parkinson's disease. More patients go to the Tiantan Hospital for neurosurgery. Out-of-towners are mostly familiar with two other facilities as general hospitals," he said.

Zhao charges 240 to 260 yuan ($35 to $38) for each visit, with an average hourly rate of around 60 yuan, but the online contact, consultation and guidance in the early stages are provided free of charge. "This service requires individual payment as it's not covered by medical insurance, but the fee is not expensive," he said.

When communicating with clients online, Zhao usually asks about their general health and suggests the most suitable hospital and best expert. He checks if the patient has medical insurance and the type of coverage. Then, he provides suggestions about things such as how to make an appointment and claim reimbursement of fees to provide greater convenience for clients who are unfamiliar with the procedures.

"Take a very simple example, such as a thyroid nodule biopsy: before the procedure can be performed, an examination is required, including blood checks and an electrocardiogram, and a written report is required to make an appointment," he said.

"Many out-of-town patients do not understand this process and come to Beijing to do the examination, but they may not have time for the biopsy after that. However, I have been to many hospitals, so I can directly provide this knowledge to help them plan their journey better. Being able to give clients relevant information based on experience, saving time and alleviating anxiety, is one of a companion's most important values."

Wang Yuzhu made an appointment for a consultation at Peking University Cancer Hospital on April 25. Zhao arrived promptly at 1:30 pm and accompanied him to the hospital, helping with security check-in, card registration, number pickup, scanning codes and settling Wang Yuzhu in the waiting area.

"The procedures in Beijing's hospitals are very reasonable, and with online registration and other functions, seeking medical treatment is becoming easier. However, seniors may not be familiar with smartphones and using apps for registration, machine number retrieval, and payment," Zhao said.

Difficult circumstances

At the end of 2021, nearly 270 million people in China were age 60 and older, accounting for 18.9 percent of the population, according to data from the National Bureau of Statistics.

While seniors make up the main customer base of hospital companions, it is usually their children who place the orders. However, they are often their family's only child, and many are unable to take time off work or live too far away to help.

Wang Yaru is a senior high school teacher, and she is working hard to prepare her students for the fast-approaching national college entrance exam. "She really can't take any more leave. She has already taken leave for me many times," Wang Yuzhu said. As a high school teacher himself, he understands his daughter's situation.

After extensive prior communication, Zhao requested a preliminary consultation on behalf of Wang Yuzhu at the Beijing Cancer Hospital. He took the previous examination data to the doctor for a preliminary assessment. After, if it is deemed necessary, the patient can register and then see the doctor in person.

"This is much more convenient for patients from outside Beijing," Zhao said, adding that the price of a consultation on behalf of a patient is slightly higher than for regular hospital companion services.

He charges about 300 yuan for each consultation on behalf of a patient, which is still less than the special appointment fee for a well-known expert at a tertiary hospital in Beijing.

Deep knowledge

A post titled "How to Become a Hospital Companion: A 5,000-Word Must-Read Guide for Medical Companions," said that being a true "medical companion" is not simply about helping patients get in line, receiving results and getting medication. They should be familiar with the basic situations in local hospitals and their medical procedures, possess medical and nursing knowledge, know basic first aid, be familiar with payment and insurance reimbursement procedures, and even understand laboratory reports. They should also possess some psychological knowledge to provide patients with good advice and counseling, and be able to communicate effectively with the experts, it said.

For Zhao, his job is not just about providing "company". For Wang Yuzhu's appointment, his most important task was to be a proxy family member and help the senior communicate more professionally, efficiently and accurately with the doctor.

After waiting nearly two hours, Wang Yuzhu's name appeared on the screen. Zhao brought him to the consultation room and produced a file of medical records. After discussing the case for more than 10 minutes, the doctor said surgery was unnecessary and chemotherapy was unsuitable. Instead, he suggested immediate radiotherapy and a further examination.

Zhao quickly informed Wang Yaru. After consulting with her, he helped Wang Yuzhu obtain the last radiotherapy number of the day from the registration machine.

Wang Yuzhu and his wife have now been in Beijing for more than a month. With Zhao's full-time assistance and support, the senior has started radiotherapy treatment at the Beijing Cancer Hospital.

As spring turns into summer, the doctor said the senior's health is gradually improving.

Ren Xianying contributed to this story.