Medical escort, temporary family member or medical scalper?
【Reporter's investigation escort service】
□ Our reporter Wen Lijuan
□ Intern Zhou Yubu Zhang Gongye
On the most tiring day, Guo Liang ran up and down the 1st to 6th floors of the outpatient building of a tertiary hospital in Beijing, holding a large pile of documents.
He lined up at the entrance of various clinics to help patients make appointments for examinations, queue up for registration, pay for medicines...
Guo Liang is a professional medical escort. He usually shuttles between various hospitals in Beijing. His work mainly includes running errands, escorting doctors and consulting on behalf of others.
The reason why he chose this industry is because he has deeply experienced the difficulty of seeking medical treatment. In 2020, his mother came to Beijing to see a doctor. Even if he did some homework in advance, he could face more and more detailed departments and more and more intelligent people. equipment, still a little overwhelmed, let alone a mother in her 60s.
Now, Guo Liang has his own experience on how to be a professional escort: when the patient is nervous, he will act as a microphone and relay the condition to the doctor in an orderly manner; if the family member is flustered, he should be reassured, from psychological comfort to auxiliary examination , to solve urgent needs.
"Now I have maps of more than 20 major hospitals in Beijing in my head," he said with a smile.
Some patients thank him because he helped solve the pain points of medical treatment; some doctors praised him because he helped improve the efficiency of medical treatment.
But not everyone can understand this profession. He has been questioned many times whether he is a scalper, where the pricing standards come from, and whether he has relevant qualifications.
Since last year, the popularity of escort services has gradually increased, and Guo Liang has more and more colleagues.
A reporter from the "Rules of Law Daily" recently investigated and found that there are more than 500 stores providing escort services on various e-commerce platforms, and they are located in cities with abundant medical resources such as Beijing, Shenzhen, Wuhan, Chongqing, Xi'an, and Hangzhou. The monthly sales volume is thousands of orders; the escorts include not only employees of medical institutions, freelancers, but also some part-time college students.
So, who are the main groups who spend money on escort services?
What qualities and skills do you need to have to become a medical escort?
What problems are hidden in the rapid development of this emerging industry, and how should it be standardized and professionalized?
Pain points in medical treatment give rise to the need for accompanying consultation
The scale of industry development is expanding rapidly
"I don't know how to use a smartphone. I wandered around in the hospital, but still couldn't find the registration window. My children are not around, so I can't help it." Ms. Wang, a 58-year-old Beijing resident, felt discomfort in her knee a while ago and thought about it. Going to the hospital for a check-up was apprehensive.
Later, her daughter made an appointment for her to escort her, and she agreed to go to the hospital.
At 10:00 a.m. on July 13, the reporter saw Ms. Wang at the gate of a hospital in Beijing, accompanied by a patient.
As soon as she entered the hospital, the escort waited in line to register, and then took Ms. Wang to take CT films and MRIs.
During the waiting process, the escort chatted with her to relieve anxiety, and told her the test results in time; after getting the results, they explained to her patiently, and told her to take medicine on time as prescribed by the doctor.
During the entire medical treatment process, Ms. Wang mostly sat in a nearby chair and waited.
"For the elderly, the hospital is like a 'maze', and we are often at a loss in front of the intelligent call machine. We don't know how to make an appointment to save time and energy. You need to go up and downstairs and go back and forth." Ms. Wang said about her experience in this visit, she couldn't help but sigh, "With the help of the escorts throughout the whole process, the efficiency of medical treatment has been greatly improved. In the past, it took a whole day to come to the hospital to see a doctor, but this time it took less than two It will be completed in an hour. In case you have to see a doctor next time, I will call another doctor to avoid trouble for the child. "
Guo Liang observed that the groups who need to accompany the doctor mainly include the following categories: empty-nest elderly people who are not around their children, single young people who work alone in the city, treasure mothers who are incapable of taking their children to the doctor, and acute and critically ill patients who seek medical treatment in other places.
"Post-00" Zhou Zhou is a customer of Guo Liang. Not long ago, he needed to go to the hospital for a gastroscopy because of stomach pain.
Since she has experienced the difficulty of seeing a doctor alone, this time she spent 200 yuan to book Guo Liang's escort service on social platforms.
Before going to the hospital, Zhou Zhou called Guo Liang, and the two agreed on a meeting place.
After the meeting, Guo Liang briefly introduced the specific process of accompanying the doctor, and then took Zhou Zhou straight to the registration office of the hospital, and quickly completed the process of registration, medical treatment card and other procedures.
Before the gastroscopy, he noticed that Zhou Zhou was very nervous, and Guo Liang carefully enlightened her and let her relax gradually.
"After living alone for a long time, it is not the loneliest to find that there is no one to accompany you when you are sick. The process of going to the hospital to see a doctor and waiting for the result is even more frightening and lonely." Zhou Zhou said with a wry smile, the escort can give himself to a certain extent Psychological companionship.
A while ago, Guo Liang also received an eldest sister who came to Beijing alone from Zhejiang to see a doctor. She lived in Beijing for more than 20 days. Since the puncture requires local anesthesia, she needed someone to accompany her, so she found Guo Liang.
After the escort was over, she suddenly called Guo Liang one day, saying that her follow-up treatment plan urgently needed a new pathology report, but due to the limitation of the number of registrations, I could not register in a short time, nor could I find a doctor.
After listening to Guo Liang, he took her to the relevant departments to consult one by one on how to deal with it, and finally resolved the matter.
"If I didn't have you, I was ready to give up treatment and go home." The eldest sister told Guo Liang that he was more like his "temporary family member" and helped her when she needed it most.
Guo Liang was very sad after hearing this, and deeply felt the meaning of this job.
Demand creates markets.
On social software and second-hand market trading platforms, there are many advertisements providing escort services.
An An, whose coordinates are in Shenyang, Liaoning Province, often updates the information of accompanying clinicians on social software, and people have successively asked him about "how to do business" and "whether he can work part-time".
"The people who consult are mostly housewives and college students." An An said that the entry threshold for this industry is not high.
During the interview, the reporter also found that some college students in the school worked as escorts for part-time jobs, mostly running errands. Some nursing students also used their professional knowledge to accompany others to see a doctor.
Xie Bailin from Beijing also found a demand market in his daily medical treatment.
He has established an escort platform to carry out escort services. Today, the company receives about 500 orders per month on average, charging 99 yuan per hour for ordinary escorts and 199 yuan per hour for professional nurses.
Xie Bailin found that for this price, the two generations have different levels of acceptance.
"Old people are reluctant to spend money. Generally, young people place orders for their parents. For them, the cost of asking for leave is higher. Therefore, many customers will greet them in advance after placing an order, and let the escort call themselves his friend."
According to Du Xiujun, a lawyer from Beijing Zhongwen Law Firm, the escorts meet the social needs of patients without relatives and friends who want to get help. When medical resources are in short supply and the overall waiting time in large and medium-sized hospitals is too long, Elderly people without their children, children whose parents are busy with work, and adults who live alone are sick, waiting in line for a doctor when they are sick has become a heavy burden, or even an impossible task. Professional medical escorts solve this problem.
He believes that the escorts who are familiar with the medical system and the hospital can use their information advantages to better help patients obtain efficient medical services, and the remote assistance and consultation service can also meet the needs of patients without long-distance travel and low-cost access to high-quality medical services. Demand for medical services.
Service content is more than just errands
Help doctors and patients build bridges of communication
"My work is mainly divided into three categories: running errands, accompanying people to see a doctor, and consulting on behalf of others." Guo Liang said, running errands is the easiest, and the common ones include sending pathology reports, taking examination results, taking medicines, or making appointments on behalf of others.
Accompanying people to see a doctor is mostly accompanied by some elderly people who are not around their children or have inconvenient legs and feet.
He drove to pick up and accompany him to the hospital for check-in, waiting, and examination, but these services accounted for less than one-third of the orders he received.
Xie Bailin's escort platform mainly undertakes this content.
In order to better accompany and take care of patients, the platform has certain requirements on the qualifications of the escorts, such as first aid skills certification, credit information, health certificates, etc.; each escort has a standard backpack, inside Equipped with emergency supplies such as bandages, band-aids, etc., and ice packs, motion sickness medicine, etc. in summer.
"Every detail has to be thought of." Xie Bailin said that at the beginning of the escort clinic, it was neglected that patients should not wear jewelry during the MRI. Later, when a patient suggested that they should make improvements immediately, they required every escort to carry them with them. Carry a small jewelry bag in case you need it.
After many years of practice, Guo Liang noticed that in Beijing, the consultation service is the most and the most complicated.
This part of the demand mainly comes from non-local patients. They yearn for better medical resources. At the same time, the medical treatment process is relatively complicated under epidemic prevention and control.
Statistics show that in 2019, more than 260 million people visited medical institutions in Beijing, of which about one-third of patients came to Beijing.
According to the "2020 National Medical Service and Quality Safety Report" issued by the National Health and Medical Commission, in 2020, the number of inpatients outside the province will reach 5.99 million in tertiary hospitals across the country. Affected by the new crown pneumonia epidemic, this huge number has decreased compared with 2018 and 2019.
"More than 80% of customers are foreigners." Guo Liang's service objects in recent years have obvious characteristics - if it is inconvenient to come to the hospital by himself due to the epidemic or physical reasons, he will send all the documents and documents to him and let him go to the hospital. Ask the doctor to get the medicine, and then send it back by express.
This type of service has higher requirements for the professionalism of the escort.
"If you help a person who sees a doctor for the first time, you need to fully understand the other party's condition, pain points, past medical history, etc., and then communicate with the doctor; if it is a patient who is reexamined, you need to prepare the other party's various inspection reports, treatment materials, fully understand the recovery situation, etc." Guo Liang said.
Therefore, he prefers to define his work as a "visit planner".
He explained to reporters: "Nowadays, doctors basically need to make an appointment. Some patients from other places go to the hospital to make an appointment for an examination but cannot do it on the same day. They can only stay there. The cost of food and accommodation is very high. My job is to help patients plan ahead. The examination appointment form is opened on behalf of the patient, and the examination can be done directly as soon as the patient arrives, and the doctor can give the result after reading it on the same day.”
In his view, the escort service starts from the moment an order is received.
He will communicate with patients in advance to understand the other party's condition and medical needs; he must also be familiar with the hospital structure, the distribution of clinics, understand the expertise of doctors, and provide patients with choices.
He has also encountered many special situations, such as a sudden illness of an elderly elderly person from other places, and he must be accompanied by a family member when he wants to come to Beijing for medical treatment.
However, for some patients and their families, the medical treatment process in Beijing Hospital is too complicated, and there are slight mistakes, which are easy to delay time.
At this time, his significance as an escort was highlighted.
After asking about the needs of patients and their families, Guo Liang will recommend departments according to the situation, tell them how to register, and remind them to bring their ID cards, negative nucleic acid test certificates and previous inspection reports.
On the day of the consultation, he helped patients and their families get numbers, set up cards, buy medical records, and then report to the triage desk on the designated floor.
After these trivial matters were resolved, he brought the patients and their families to the door of the clinic. Before entering the clinic, he helped them list the relevant conditions one by one, such as the time of onset, genetic history, current medical conditions, and requests for medical treatment in Beijing.
"In the face of the disease, very few patients and their families can explain the problem clearly." Guo Liang understands the concerns of patients and their families, and also understands that they are confused about where to go with a lot of checklists, so he will try his best to help They figured it out clearly, helped them go through the process and line up, and sent a message to let the patient go directly to the consultation room for examination after they were in line.
In the next few days, he will also pay a return visit, instructing patients and their families to pay attention to the precautions and follow-up time.
This form is also beneficial for doctors.
A doctor surnamed Liu from a tertiary hospital in Beijing has a deep understanding of this. He told reporters that he had seen some patients who were obviously looking for spinal injuries, but told the doctor that his head or heart was uncomfortable.
"This kind of consultation is really inefficient in the hospital." Dr. Liu said, but in the past two years, he has gradually come into contact with some escorts who accompany patients to see a doctor. It builds a bridge of communication between patients and doctors.”
Pricing without standard training is a misappropriation of money
Chaos occurs frequently in the early stages of development
Li Cheng, who is an escort in Chongqing, receives more help from the children of patients who are too busy with work to take care of the sick elderly; there are also many young parents who panic when their children are sick; occasionally some live alone People who are physically inconvenient and need help, or feel uncomfortable and need companionship.
He was impressed by a mother whose son suffered from severe depression and did not want anyone to accompany him to the doctor.
The mother found Li Cheng and hoped that Li Cheng would follow her son the whole time and not let him find out.
"I was like a special agent all day. When he went to see a doctor, I was responsible for taking care of everything for him and making sure that he could go to the doctor himself. For example, before he went to the consultation room, I had to go to the consultation room and the doctor in advance. Explain the situation, and after he comes out, I will find a way to go back to the consultation room, and after understanding the specific situation with the doctor, I will report to his family." Li Cheng recalled.
Through this accompanying clinic, Li Cheng saw the difficulties of a family of a depressed patient. He patiently listened to the patient's mother on the phone, comforted her, and helped her make ideas, hoping to relieve her psychological pressure as much as possible.
Although he has only been in the business for half a year, Li Cheng has cried many times, and the pain comes from strangers.
Some seriously ill patients were finally connected to a bed with his help, but they were unable to go to the operating table;
Sometimes it is also out of touch: there is a patient in his 70s, Li Cheng has accompanied him three times, from strangeness and precaution to mutual familiarity and trust. When this patient meets an acquaintance in the hospital, he will introduce to others "this is the My son", also took his hand and asked him to pay more attention to his body.
Sometimes very helpless.
Li Cheng remembered that a daughter who had worked in other places for many years once returned to her hometown and accidentally found out that her father was ill. She felt guilty, but could not stay with her parents due to work reasons. She found Li Cheng on the Internet and paid 1,000 yuan. He repeatedly told him to accompany his father to the hospital for a good check.
The escort fee is 1,000 yuan for one visit, which is a lot of income for the Chongqing escort physicians who are "200 yuan for half a day and 400 yuan for a full day".
Li Cheng saw the concern of young people for the elderly and the helplessness of not having the time and energy to take care of them, so he put forward higher professional requirements for himself.
But some people don't understand and question why he charges so high, whether he has bad intentions, and where the pricing standard comes from.
"As a low-frequency demand, although the escort service has entered the public eye, the reach is far from enough." Li Cheng believes that the escort industry is still in the early stage of development, and consumers' usage habits have not been effectively established. There is no effective supply and demand connection between the clinician and the patient, and many patients will be skeptical. Before placing an order, they will repeatedly confirm whether the person on the back of the screen is a liar or a scalper.
"After the industry becomes popular, it is not ruled out that there are people who fish in troubled waters, but our escorts are not scalpers. They just get paid by selling their time, physical strength and experience." Li Cheng said that sometimes patients ask him to help When recommending hospitals and doctors, he generally does not recommend them easily. On the one hand, he is worried about doing bad things with good intentions, and on the other hand, he is also afraid that he will become a medical trustee by accident.
On July 13, in a hospital in Beijing, the reporter randomly interviewed more than 10 patients and asked them about their views on the escort service.
Two-thirds of the patients indicated that the presence of medical escorts was necessary to provide patients with help and psychological comfort; however, another third of patients worried that some medical escorts were not professional enough and made mistakes. Or being impatient will affect one's mood instead, and the charges may also be raised on the ground. If there are too many escorts, it may even increase the flow of people in the hospital and affect the environment and order of the medical treatment.
Behind the difficulty of establishing trust is that the industry itself is currently mixed.
Guo Liang said that the charging standard for the escort service is linked to the local income level, and the price for a half-day generally ranges from 200 yuan to 500 yuan.
"Some customers will also bargain, and I will take the order when I see it is almost suitable. I live in the suburbs of Beijing, and the hospital is in the city center. It takes more than two hours to travel, and I have to bear the transportation costs myself. In fact, the profit is not very high.”
The reporter found that the relatively mature escort platform will clearly mark the price and provide services by placing orders and dispatching orders.
However, there are also freelancers who provide escort services on social platforms or second-hand market trading platforms, and prices can only be negotiated privately.
"However, some merchants compete maliciously to lower prices and disrupt the market. There are also scalpers who use the banner of escorts and claim on social platforms that they can help patients get an expert number or perform surgeries." Guo Liang said indignantly , The price of accompanying clinics fluctuates arbitrarily, and the lack of uniform standards for fees also makes him a headache.
There are also some unscrupulous institutions that seize the business opportunity to publicize the "monthly income easily exceeding 10,000 yuan" for the escorts, put out attractive advertisements to recruit escorts, but use the job introduction as a bait to conduct paid training.
"Some training courses seem to be training how to be an escort, but in fact they teach you to drain traffic, and they are all selling courses." Li Cheng signed up for the training of escorts at the beginning of his career and paid more than 2,000 yuan for the training fee. After a few class hours, he found that the gains were not great.
According to Li Cheng, the content of business training is mostly based on professional nurse courses, but also includes service procedures, rules, etc., but there are not many opportunities for these written knowledge to be used in practice. "Vocational skills mainly rely on practical accumulation." .
In addition, the businessman also promised to send him an order after the training, but in the end it didn't matter.
"Many so-called escort training platforms are just trying to make money. They advertise on social media, saying that trained trainers can easily earn 20,000 yuan a month. This kind of advertisement is completely false, just mine. From practical experience, it is basically impossible to earn 20,000 yuan a month, or very few people can do it, and it is completely impossible to easily earn 20,000 yuan." Li Cheng told reporters.
Expect standardized and professional development
The definition of identity rights and responsibilities is urgent
Hospitals are always crowded.
According to the "2019 Statistical Bulletin on the Development of my country's Health and Wellness Development" issued by the National Health Commission, in 2019, a total of 8.72 billion people visited medical and health institutions at all levels, and a resident visited an average of 6.2 times.
This is an increase of 410 million people over the previous year and more than 1 billion people over 2015.
But Li Cheng has been in the business for more than half a year, and there are not many customers, and the number of people served each month is not stable.
In April of this year, he received more than 10 customers and earned more than 1,000 yuan; in May, he received more than 8,000 yuan in income.
Guo Liang has established a stable customer acquisition channel due to his long working time.
When he is busy, he can accompany him for 4 consultations a day. He goes out at 6 in the morning and can only eat at night.
"My escort and consultation fee is 200 yuan for half a day, and the errand business is settled on a per-time basis, ranging from 100 to 200 yuan at a time. If you do well, you can earn about 10,000 yuan a month." Guo Liang said.
At first, Guo Liang felt a little embarrassed to accompany others to see a doctor and did not know how to communicate.
Later, he gradually accumulated experience and made his own judgment on some common diseases. Before the doctor gave a diagnosis and treatment plan, he made a simple analysis for the patient.
Once the doctor's statement is more consistent, then the trust between him and the patient is established.
Helping people in need and occasionally providing some professional advice - this made Guo Liang and Li Cheng see their value as escorts.
But they are also thinking: what exactly is an escort?
The specific responsibilities and categories are currently blank, not as clear as many traditional occupations. How should they be defined?
"Some escorts have obtained the so-called qualification certificate, but in fact, there is no authoritative certification for domestic escorts at present. Generally, they are paid and registered at online training institutions." Guo Liang said that he hoped that the escort would become a medical escort. Occupations with "identity cards" have a set of standardized standards and procedures to improve the overall quality and service capabilities of the escorts.
Li Cheng also pointed out that the current access threshold, service process, dispute resolution and other aspects have not yet formed a unified standard, and everything has to be explored by oneself.
Chen Sisi, who is in her second year of nursing in a university in Zhejiang, often uses her spare time to accompany her doctor.
Once, she carefully accompanied a mother-to-be for an ultrasound, and when she found out that it was two babies, she and the other were very excited.
"I feel very fulfilled to be able to apply what I have learned to help some people in need." Chen Sisi said, she also had some concerns, "What if the other party wants to hold you accountable if you slip and get injured?"
Du Xiujun reminded that the escort should be alert to the problem of assuming the responsibility of the patient for emergencies during the escort process, "because there are currently no specific regulations on the responsibilities of the escort, and there is no qualification requirement for the escort's practice. or restrictions".
"As for the responsibility for the patient's emergencies during the escort process, it still needs to be based on the agreement between the two parties on the service content. In the absence of an agreement or an unclear agreement, if the escort is at fault, it should be based on the standard of ordinary people or in accordance with the standard of ordinary people. The standard of medical staff has a great impact on the responsibility of all parties, so the professional norms and related measures of the escorts need to be improved urgently." Du Xiujun said.
Because of this, in order to prevent and control risks, Guo Liang formulated a "risk notification letter" to clarify the rights and obligations of both parties, and also purchased accidental injury insurance for patients; Li Cheng and the team agreed that medical services involve patient privacy, photos and recordings of relevant conditions. , must be destroyed in time; Xie Bailin introduced the "Blockchain Judicial Deposit System" in the company to clarify the attribution of responsibilities, make the service providers pay more attention to the responsibilities and obligations in the service process, and require both parties to sign an "informed consent form" to accompany the doctor. To avoid the controversial point of the "scalper" issue that is generally focused in the current escort market, his team does not provide appointment services.
According to Deng Liqiang, executive director of the China Society of Health Law and deputy director of Beijing Huawei Law Firm, the emergence of a new profession usually goes through the following stages: there is a demand in the market—someone meets the demand—a case arises—a professional company emerges - Promote industry norms.
"In the early stage of the development of new things, due to the lack of industry system norms and access standards, it is inevitable that practitioners will be mixed for a period of time. Basic issues such as the appointment standards, charging standards, service standards, and regulatory authorities of the escorts need to be solved as soon as possible. Only the market develops , policy guidance 'two hands' to promote the standardized development of escorts, in order to better play their social value." Deng Liqiang said.
The reporter noticed that the "14th Five-Year Plan" for Public Services includes inclusive non-essential public services into the plan, and proposes to realize payment, affordable, quality assurance, and safety supervision.
Many escorts said in an interview with reporters that they expect the professional escort industry, which integrates medical care and services, to be classified as non-essential public services, and to develop in a more standardized and professional manner.
Deng Liqiang believes that the development of the escort service industry must follow the bottom line of legal compliance, strictly review the qualifications of practitioners according to the nature of work, and establish a filing system for industry institutions and personnel; , professional ability, and moral cultivation, clarify and refine the occupation catalog and classification, as well as relevant industry norms and measures, and clarify the rights and responsibilities of practitioners.
Du Xiujun suggested that large-scale company operations should be encouraged, and the company should review the qualifications of the escorts, provide standardized services, and bear the potential risks in the service process; strengthen the advertising management of the escort market, and intensify efforts to crack down on false and exaggerated propaganda In addition, for the escorts or escort institutions that provide professional nursing services at the same time, establish a practice access system and qualification grade standards.
"It takes time to recognize. I hope that in the future, medical escorts will be as common as couriers. While standardizing and professional development, they can help more elderly people and other people in need solve the problem of inconvenient medical treatment." For the future of medical escorts , Guo Liang and Li Cheng are full of longing.
(Guo Liang, Li Cheng, An An, and Chen Sisi are all pseudonyms in the text)