I doubt many readers know that next May 19 is World Family Doctor Day, but it means a lot to me. I’m spending more of my clinical time teaching China’s first generation of family doctors, and it’s an honor to be a part of this momentous change in China. It was also a great honor last year for me to be chosen for a book by WONCA, the World Organization of Family Doctors. Entitled Family Doctors in the Field, it highlights stories of family doctors across the globe who are pushing for environmental health. I completely agree when they say, “as family doctors we see the direct links between the environment and the health of our patients and our communities every day.” You can read the PDF e-book here, and below is my interview in the book.
How did you become interested in environmental issues?
I became very interested in environmental issues here in Beijing almost by necessity. Before Beijing, I had lived in California’s Sonoma county, where life is almost a paradise of blue skies, world class wines, and organic farms dotting the hills. But here in Beijing, environmental concerns such air pollution and food safety have been dominant issues during all of my years here, and the public outcry in China continues to increase. As a family medicine doctor biking to work and trying to raise a newborn child, I have always felt an urgency to understand pollution’s effects on my own family as well as my larger community. So I started to research air pollution, and I’ve used the pulpit of social media, leveraging my credibility as a family doctor, to educate people across China (and the world) about air pollution. Hundreds of thousands of people have read my advice from my wellness blog at as well as my microblog
on Sina Weibo, plus my New York Times China edition health column. I’ve also given many lectures to the community to raise awareness, as well as via articles and interviews in newspapers, magazines, radio and TV both here and internationally, including
a TEDx talk.
What are your main clinical interests in Environmental Health?
I’ve always aimed to increase public awareness all over China about the evidence- based risks of air pollution, and to dispel the many misconceptions and myths about pollution and how to fight it. But I’ve also tried hard to give people hope, to offer practical and evidence-based advice on how to combat pollution and still thrive wherever you live.
My main focus has been protecting children from air pollution, as there is fair evidence of potentially permanent harm in this vulnerable group. I’ve focused on using social media to educate parents about the dangers of pollution, including tips on how to protect their children. My key answers are always to consider indoor air purifiers; avoid the worst days outside; and consider a properly fitted N95 mask if they must go outside.
We can’t forget about school time, of course. Through my efforts, many schools now have started to enforce air pollution action plans, where they limit student activities based on the hourly AQI. While this originally was implemented in international schools in Beijing, now this model is spreading all over China, often from parent demands as they print out my research and show to the school boards. Now that most cities in China now have hourly AQI updates, it’s now much easier for all school communities to start enacting such action plans to protect their students.
Because of these strict action plans causing many days of cancelled outdoor activities, some schools in Beijing have taken dramatic steps by building enormous protective domes over their sports fields, enabling children to play outside even on the worst days. While I think this approach is too expensive for most public schools, this controversial approach has sparked a very welcome debate across China about indoor air pollution safety, and awareness of HEPA air purifiers is skyrocketing.
Parents and other readers are always concerned about which, if any, indoor air purifier they may need, and I’ve helped provide real world data via my own personal testing of indoor air purifiers, publishing the data on my websites. This data has now been read hundreds of thousands of times across the world, providing concerned readers very practical data about whether or not an air purifier may be helpful for them.
Pollution masks are also a major topic of discussion now, especially this year with the multiple highly publicized air pollution spikes across China. Again with this issue, I’ve used my public voice to spread evidence-based awareness about air pollution masks, and whether or not they may be useful against pollution. My reviews and the resulting discussions again have been read by hundreds of thousands of people in China.
The other major environmental issue for most people in China regards food safety. Just as with air pollution, people in China are hungry for trustworthy advice on how to eat healthy foods, and again via all my social media outlets I’ve provided much information
about healthy, safe foods. But I’ve also raised awareness about the even more important food issues of proper nutrition, cutting back on salt, and focusing on fruits and vegetables.
Where to next?
There are so many public health issues in China that one could address! And social media in China has proven to be an amazingly powerful tool for tackling these issues. A doctor like myself can help educate millions of people all across China about car seats
for infants; bike helmets for everyone; education about toddler formula versus milk; the list can go on.
One fascinating angle of all this is that China doesn’t even yet have a true concept of family medicine, as primary care is just at the beginning stages across China. Almost no one has a “regular doctor” they have followed for years; so via my writing I also am helping to educate the community as to the true function of family medicine: prevention, education, and wellness for the entire community, not just the patients that walk in our doors.
My hospital chain, United Family Healthcare, is taking this concept of primary care further than any private organization in China. We’ve just started our own family medicine fellowship training program, and we also teach interns and residents. We now provide a crucial role model and training center for China’s top medical students who are interested in family medicine but never previously had a proper outpatient clinic staffed by board certified family doctors. We are all very excited to be at the forefront of educating China’s first crop of board certified family medicine doctors.
I hope my example — of using social media to have a major impact on public health far greater than just my clinic — can provide inspiration and guidance for other family doctors across the world. Your patients are online already — reach out to them!
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