All the expertise and goodwill in the world is at risk of stumbling over cross-cultural issues which is why expats face this all over the world, and international private health clinics do a booming business. Private sector primary and secondary care in Beijing is provided by global risk management operators like SOS International and others, but is considered expensive. Even so, their users are not confined to expats with extravagant corporate health packages. Then again, in a medical emergency, there's no choice. Two expats were interviewed who had to have major surgery in Beijing and they report they got exceptionally good care at local hospitals with international departments. Emily Cross, an Australian living alone in Beijing, was rushed to an emergency division with acute pancreatitis. The Chinese chief surgeon carefully explained his recommendation and the basis of her decision to permit, or not, the operation. The outcome was a happy one but while recovering she was "presented with a bill which represented all of my wages for the previous year! I had to call on help from home naturally and it took over a year for the travel insurance company to refund the claim." This is a completely normal facet of transnational health bureaucracies that both private clinics and public hospitals have to deal with, not an isolated problem of Chinese health care. But Dr. Wang still thinks it needs fixing.

 The bio part of bio-psycho-social approach we don't worry about much. Both public hospitals and private clinics track, and keep on top of, the basic physical threats in a particular region: in Asia you are more likely to suffer from salmonella, or contract hepatitis A, tuberculosis, or mosquito-borne illnesses like malaria. Demographic factors also necessarily influence clinical preparedness for physical complaints; expat populations show they are of working age and often come in packs, so children and women's complaints are areas of special need.

Collectively, the Chinese medical community understands both the physical risks and the emotional (psycho-social) discomforts of its foreign guests. Where foreigners go for help now – private clinics – only small problems are addressed, and Dr. Wang would point out, in a way that carves up the patient along with the patient care. The limitations of that care and the costs are reportedly the subjects of frequent complaints by expats. But Dr. Wang's proposal for a new international hospital is not just based on problems with capacity issues, bureaucratic holdups or whopping bills. Sure, foreigners who come to his hospital now are often anxious about things like difficulties with third-party payment systems and health insurance protocols, but his focus is the quality of care they get on Chinese soil.

Twenty-first century medicine, he says, is embodied in an approach that uses a number of medical traditions, a kind of medical multiverse that acknowledges how different cultures approach illness. At the same time, a common philosophy governs treatment.  This is more patient-oriented than the typical Western focus on biology, thanks to inclusion of those psycho-social dimensions. Wang wants care components based on various cultural, religious and philosophical systems, as is appropriate for the patient.  That could be shamanic traditions, Ayurvedic or Chinese medicine; in fact whatever belief systems reach the whole patient figures prominently, because these factors power his or her recovery. His new center will also use the best of the West, the scientific, technological tools of modern medicine, but governed by an ethos to do less.

Here is where Minimally Invasive Medicine (MIM) becomes central to Dr. Wang's approach. Characterized by the use of techniques such as laparoscopy, endoscopy and interventional ultrasound procedures, MIM usually results in less pain, less scarring, a more rapid recovery time, lower complication rates, shorter hospitalization, and reduced health care costs. The theory of Minimally Invasive Medicine Wang espouses (as opposed to its practice) was formulated in 2003.  In practice, MIM and those all important psycho-social approaches it can be bound to, will deliver cultural sensitivity and cost-effectiveness.  

Above all, detemination of treatment is based on cooperation between different systems, not competition. So this is a medicine that cures what ails foreigner and Chinese alike, and furthermore, is sensitive to individual need. This approach is for every urbanite, stresses Wang, because quality health care is intimately associated with issues of a city's habitability and quality of life.

The good doctor Wang is a patriot but has been an expat himself – getting his medical degree in Hamburg, Germany and his PhD in the Netherlands before returning to China in 1997. His model for One World, One Medicine has long been incubating in his career. The concept for a clinic-hospital-hotel expands on what he currently practices at Beijing Chuiyangliu Hospital. It was presented at the 2010 Beijing CBD International Medical Health Policy Forum, and government funding is being sought. If a medical multiverse isn't inspiring enough, perhaps capacity issues will tug on the public purse strings.  "This city only has 17 hospitals or international departments," Wang comments, "which is far from enough to handle the 110,000 foreigners permanently living in Beijing." Apart from long-term foreign residents and students, short-term traffic alone is an indicator of need; according to statistics from the Beijing Capital International Airport obtained by the Global Times, 68.65 million foreigners make short visits or stays in Beijing every year. 

Meanwhile, what's happening to the foreigner who needs treatment for psychological and emotional problems? This definitely requires a practitioner who speaks your language.

The unease that becomes the disease of a stranger in a strange land has many faces and is vaguely labeled "culture shock" or the "discontent of trailing spouses." Physical manifestations of culture shock can include panic attacks, sleeping and eating disorders, depression, and alcoholism; there is even a growing legion of shopaholics. More than a few people are showing up in psychologists' offices with phobias about traffic or crowds. In the case of "Third Culture kids," being brought up in expat communities, it's usually acting out, poor grades and substance abuse that are the common indicators of failure to adapt.

The irony is even the happy expat, perpetually high on the excitement and challenge of China, can be a walking health risk."Receptivity to newness, change and excitement makes you think you are happy and entertained," confides a private clinic staff member, "but can become an addiction" to stress responses like adrenalin highs and the steroid-producing anger associated with unpredictable and often frustrating environments.

Relationships of all kinds can be casualties too, and affect the well-being of foreign residents. Canadian Rik Ruiter, Psych.D, runs the Marriage and Family Counselling Center in Beijing, and did the same in Korea for five years in the late '90s; he was the only English-speaking psychologist in that country and people came to him from all over to Seoul to be treated. Likewise, all marriages are under a certain amount of stress in New China, he believes. The roots of tension in the expat marriage are predictable. Essentially, less well-adjusted "trailing spouses" are fighting loneliness and isolation, at the root of which is the sense that they don't belong. Often the spouse travels or works long hours, so they are functionally single parents. They recoil from making friends because they and the potential pals will likely move on, so the attitude is "why bother?" Sometimes the marriage falls apart. Back at home, they no longer fit in either.