SPECIAL EDITORIAL
Global Medical Cooperation With the East and West: Achieve Excellence in Craniofacial Surgery Haisong Xu, MD, PhD
T
he medical and healthcare in China is of vital importance to its population of >1.3 billion, and is a major issue concerning its people’s well-being. Recently, the healthcare and medical education in China is undergoing changes. Since 2009, China has ignited the most significant healthcare reforms with the goal to fulfill the people’s needs and satisfaction. Through healthcare reform, the resident and fellow training system also began to change. I was lucky to experience the reformation of the healthcare and medical education, joined the new medical education training system in China, and moreover, I had the opportunity to enroll in the world-class medical training in the United States. Under the guidance of mentors in the East and West, I learned more about the plastic and the craniofacial surgery, but how we can do our best to improve the life quality of patients. The international exchanges and cooperation play an important role in the development of Chinese modern plastic and craniofacial surgery. The history of plastic surgery in China can dates back to about 17 centuries ago when Chinese ancestors documented a case of cleft lip repair, whereas the concepts of modern plastic surgery were imported from the West. In 1929, Dr Baochun Ni founded the first plastic surgery department in Shanghai after he earned his MD degree in the United States. After World War II, Dr Tisheng Chang and Dr Ruyao Song came back to China after fulfilling their plastic surgery training in the United States and established plastic surgery treatment and training center in Shanghai and Beijing, respectively. In 1948, Dr J. Webster from the United States held the first plastic surgery workshop in Shanghai, spreading pertinent knowledge and skills. These are the seeds of modern plastic surgery planted in China. During the closed-door policy in 1949 to 1979, the Chinese doctors did not have the opportunity to communicate with foreign experts and had only a few international journals to learn the latest medical developments from abroad. During this period, China’s medical development showed a slow progression. However, in Shanghai, plastic and reconstructive surgery was still gradually improved. Dr Tisheng Chang developed craniofacial surgery in 1977 after he performed the first hypertelorism case in China and then founded the first craniofacial team and center in Shanghai. During the early open period since 1979, he invited many key persons in craniofacial surgery, such as Dr Paul Tessier et al. From the Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Received May 13, 2017. Accepted for publication May 15, 2017. Address correspondence and reprint requests to Haisong Xu, MD, PhD, Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, People’s Republic of China; E-mail:
[email protected] The author reports no conflicts of interest. Copyright # 2017 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000003973
lectured and demonstrated craniofacial surgical techniques. Plastic surgeons from West countries continuously came to visit Shanghai, giving lectures about cutting-edge technologies and concepts. In 1982, Dr Tisheng Chang awarded ASPS/PSEF Maliniac Lecture, presented 1-hour lecture about the history and progress of plastic and reconstructive surgery in China, shared the experience, and let the international colleges know more about the situations in China. Dr Tisheng Chang always said: Thanks to the international teamwork and exchange endorsed the rapid development of plastic and reconstructive surgery in our centers. Nowadays, numerous workshops and seminars have been held across the country, attracting plastic surgery practitioners from all over the world to learn and share experiences. International communications helped us improve the plastic and craniofacial surgery in China and keep us following the footsteps of the development. Today, cranial and maxillofacial surgery of the Shanghai 9th people’s hospital Shanghai Jiao Tong University has a total of 3000 procedures with cleft lip and palate and craniofacial malformation every year, and the surgeons also participated in local and international craniofacial charity programs. Therefore, it also attracted to Southeast Asia international fellow doctors came here to learn and get plastic and reconstructive training. The qualities of healthcare and medical education in various parts of China are not balanced, and large city’s healthcare unable to serve the rural areas. Therefore, international craniofacial charitable programs provided contributions in rural areas as outreach programs. In China, craniofacial deformities occurred in about 35,000 children per births every year. The most common problem is cleft lip and palate. Before the healthcare reformation, most of the patients had no health insurance, and the cost needed to be selfpay. Since 1999, Smile Train and Operation Smile as charity program from United States began to serve in China’s rural areas, and start training the cleft doctors by international and local team members. Through participating in the program, partner countries have shared the knowledge, technology, and surgical skills. Subsequently, the world craniofacial foundation (WCF) from United States established the charity work in Shanghai to help patients with craniofacial malformations and funded the international training program with Shanghai Jiao Tong University School of Medicine in 2010 to train the local craniofacial surgeons. I am very lucky to be a young surgeon that completed the systematic medical education in China and luckily awarded as ASPS/ASMS/PSEF international visiting scholar supported by WCF in 2011. Also, I have the opportunities to attend the US congress such as American Society of Plastic Surgeons (ASPS), Plastic Surgery Research Council (PSRC), American Cleft Palate-Craniofacial Association (ACPA) ect. where I presented my articles and learned latest plastic and craniofacial surgery information. After returning home, I had the opportunity to join the largest craniofacial and maxillofacial surgery center in Shanghai, and strive to balance China’s medical concepts to improve the craniofacial healthcare. Therefore, I thrived to apply the model by establishing a multidisciplinary team of cranial and maxillofacial surgeons as the core facility to provide the
1396 The Journal of Craniofacial Surgery Volume 28, Number 6, September 2017 Copyright © 2017 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The Journal of Craniofacial Surgery Volume 28, Number 6, September 2017 Global Medical Cooperation With the East and the West
best treatment. I began to realize that one surgeon’s skill is only a part of the medical process; the multidisciplinary collaboration and the doctor-patient communications are also important. Although a person’s strength in a team is limited, we hope that with a little effort, both medical education and service can gradually improve, make the Chinese medical service integrated into the world. China’s healthcare system has the world’s largest number of patients. However, it still needs to correct the imbalance between medical training and quality; the medical system of the United States has high quality in the world, but it needs more efficient health system to reduce the cost to meet the medical requirements of the people. With the development of the international exchanges
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and cooperation, we hope that every country will be able to standardize the medical education follow the international standardization and provide the high quality of medical service to the patients. I would like to give the respect to the pioneer of plastic and craniofacial surgery Prof Tisheng Chang (1916 – 2015) for his efforts in the development of international exchange and paved the way to be well-known as the best plastic and reconstructive surgery center in China. Also, I would like to thank all the mentors, professors, colleagues, and fellows who strived and contributed to the development of craniofacial surgery in the East and West.
1397 Copyright © 2017 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. 2017 Mutaz B. Habal, MD