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At the final year medical students’ farewell party, JW told us a story.

A middle-age man attended the emergency department of a local hospital complaining of fever, jaundice and upper abdominal pain. Blood tests showed obstructive jaundice and high white cell count. The emergency doctor diagnosed common cold and sent the man away.

The man did not feel right and decided to seek second opinion at a hospital in Shenzhen. Magnetic resonance cholangiopancreatogram was performed on the same day and showed a small stone in the bile duct. The diagnosis of acute cholangitis was made. Eventually, the man was admitted under our team, and the cholangitis was successfully treated by endoscopy.

During morning round one day, the man talked about his experience. He did not really complain, but he could not help mentioning that he only spent RMB200 for the scan and was very satisfied with the service.

JW remarked that doctors in Hong Kong had been charging a premium of 5 to 20 times by claiming to deliver better service. He questioned if the performance of future doctors could still justify the premium. He anticipated keen competition from mainland 10 to 20 years later, but it appeared that the time had already come silently.

I rarely link money with medicine, but this is one of the few occasions in which I hope our students are worth the premium.