Case Sharing

Preface

Thirty Years as a Physician, Finally Confronting the Pain of Powerlessness

      I am Xia Bang'en, a licensed physician specializing in TCM oncology with thirty years of medical practice. Having witnessed countless cycles of life and death, and the vitality that Traditional Chinese Medicine (TCM) has created in critical and severe cases, I have always firmly believed in saving lives with a healer's benevolent heart. Yet, on March 10, when Ms. Luo insisted on being discharged against medical advice, I felt a profound sense of helplessness. I write this article solely to document the desperate plight of this 47-year-old woman, and to ask a question on behalf of her, the countless patients like her, and the grassroots TCM hospitals constrained by medical insurance policies: Where is the way forward for Traditional Chinese Medicine?

First Encounter: A Glimmer of Hope Amidst Despair Through TCM

      On March 6, 2026, Ms. Luo, who had worked in Fenghua for 20 years (originally from Guizhou Province), was supported by her family as she walked into our hospital. Her face was sallow, her body emaciated to the point of disfigurement, and every step was accompanied by suppressed groans; her eyes were filled with despair. Diagnosed with pancreatic cancer six months prior, her condition was already terminal, with systemic metastasis, complicated by diabetes, severe constipation, intense pain, and abdominal infection. She had previously undergone chemoembolization at a major hospital in Hangzhou, but the results were poor and her condition continued to deteriorate, leading her to seek TCM treatment at our hospital.

      Seeing such a severe case, the tenderest part of my heart was touched; no matter how difficult, I had to try. I developed a personalized treatment plan for her, balancing anti-cancer detoxification, Qi tonification and Spleen strengthening, pain relief, and bowel moistening, combined with symptomatic nursing to do everything possible to alleviate her suffering. Fortunately, after three days of taking herbal decoctions, Ms. Luo’s symptoms were effectively relieved. She no longer relied on potent analgesics, her constipation improved, her mental state brightened, and she was able to consume small amounts of liquid food.

Turning Point: TCM Shows Efficacy, Yet She Insists on Abandoning Treatment

      Unexpectedly, at this very moment, she resolutely requested discharge, her eyes full of guilt and helplessness, unwilling to explain why. After questioning her family, I learned of their immense suffering. Ms. Luo was the sole pillar of her household, struggling to support a completely paralyzed husband unable to care for himself and six children. The youngest child was still an infant, and the eldest was not yet fully independent; the fourth child had once attempted suicide due to the unbearable family burden, and though saved, it left an indelible scar on the family. To pay for her husband’s treatment, fund her children’s education, and sustain her own life, the family’s savings had long been exhausted. Furthermore, her employment contract stipulated social security contributions tied to attendance: for every day she missed work, her employer reduced her contribution by 40 yuan. Her discharge was never a voluntary abandonment of treatment, but rather being forced into a corner by life itself.

Questioning: Medical Insurance Constraints Create a Dual Dilemma for Grassroots TCM Hospitals and Patients

      As a hospital with distinct TCM characteristics, since our trial operation began in June 2024, we have upheld the mission of "everything for life" to relieve patient suffering. Despite our best efforts, we have only been able to secure the following for patients: outpatient TCM prescriptions for cancer patients are reimbursed at a mere 30 yuan per dose under medical insurance, with any excess costs borne entirely out-of-pocket by the patient.

      Such medical insurance rules not only undermine the healthcare rights granted to citizens by the state but also severely hinder the normal operations of numerous grassroots TCM hospitals. In the case of hospitalized patients like Ms. Luo, although some inpatient expenses could be reimbursed, she remained unable to afford subsequent outpatient costs. She had no choice but to reluctantly abandon treatment, choosing instead to risk her life to continue working after discharge. Watching her frail silhouette, my heart ached. She was only 47 years old, and her condition had just begun to improve; if she had persisted with medication, she might have accompanied her children for a few more years and cared for her husband a little longer. But reality ruthlessly severed her lifeline. In thirty years of practice, I have seen many cancer patients facing financial hardship, but Ms. Luo epitomizes the convergence of severe illness and poverty, heavy family burdens and despair, and medical insurance restrictions. I cannot help but ask: Where is the way out for Ms. Luo, trapped in the abyss of cancer? And where is the way out for TCM hospitals mired in operational difficulties?

A Plea: TCM Should Not Be Subject to "One-Size-Fits-All" Policies; Patients Need a Lifeline

      Inherited over thousands of years, TCM possesses unique advantages in treating difficult and critical illnesses and alleviating patient suffering. However, due to medical insurance restrictions on medication and reimbursement for grassroots TCM institutions, our hospital, having been officially open for only one year, has already had over 900,000 yuan deducted by medical insurance authorities. I am no longer able to shoulder more costs for patients, nor can I continue providing effective TCM treatment for Ms. Luo.

      I understand that medical insurance policies are formulated with overarching considerations, but what justification is there for applying a rigid, one-size-fits-all approach to TCM? How can patients like Ms. Luo access care, afford herbal medicine, and gain a glimmer of hope for survival? I only wish for more people to see her plight and the helplessness of grassroots TCM hospitals. I implore relevant authorities to introduce supportive policies for the development of TCM and resolve the difficulties patients face in accessing healthcare, so that TCM can truly help those in need.

Perseverance: A Healer’s Benevolent Heart, Hoping Glimmers Converge into Light

      A healer’s heart is benevolent, yet even healers experience moments of powerlessness. Ms. Luo’s desperation is a microcosm of countless impoverished patients with severe diseases, as well as the developmental predicament of TCM. May she find a lifeline; may TCM receive favorable policy support; may every patient be able to afford care and medication; and may the benevolent hearts of physicians illuminate the path forward for patients.

      I am Xia Bang'en. I will remain true to my original aspiration, doing everything within my power to assist every critically ill patient who seeks help, and I will continue to raise my voice for the development of TCM and for patients' rights to healthcare.

Author: Zhou Zhibin

Honors of the Xiabang Medical Team

① Director of the TCM Liver Disease and Oncology Branch of the Zhejiang Provincial Association for Folk Traditional Chinese Medicine Research and Development; Deputy Director of the Folk Characteristic Diagnosis and Treatment Technology Branch of the Zhejiang Society of Traditional Chinese Medicine.

② The Major TCM Research Project of Zhejiang Province, "Study on the Efficacy and Mechanism of Smilax Glabra Compound in Liver Failure," achieved significant clinical breakthroughs and passed acceptance verification, reducing the 24-week mortality rate of acute-on-chronic liver failure to 19.2%.

③ Research on innovative TCM drugs for the treatment of acute (subacute) liver failure has been included in the Vanguard Plan for Major Technological Breakthroughs of the Zhejiang Provincial Department of Science and Technology.

④ A clinical protocol for TCM-dominant treatment of malignant lymphoma has been incorporated into the Clinical Research Plan of Zhejiang Provincial Administration of Traditional Chinese Medicine.

⑤ Collaborated with the Academy of TCM Sciences at Zhejiang Chinese Medical University to jointly establish the Research Center for TCM Diagnosis and Treatment of Difficult Diseases.

⑥ With strong support from a group of top domestic scientists in the field of TCM, the Ningbo Xiabang TCM Industry Development Guidance Committee was established.

Kind Reminder: This article presents a real clinical case and is intended solely for medical education and reference purposes; it does not constitute diagnostic or therapeutic advice.

If you have similar conditions, please visit a hospital for an in-person consultation and individualized syndrome-based treatment.