Some people who are Hong Kong immigrants in Great Britain are susceptible to stomach problems, colds, and skin problems precipitated by changes in food and climate. They are usually advised to reduce fruit consumption and keep themselves warm. With the support of the internet and Britain’s postal delivery system, Hongkongers now have greater access to Chinese medicine.
Dr. Franky Fan Chung-yin set up the “Chinese medicine practitioners’ Information website for British Hongkongers” for Hong Kong immigrants seeking the services of a Chinese medicine practitioner from Hong King, .
Dr. Fan was a registered Traditional Chinese Medicine (TCM) practitioner in Hong Kong. When he and his family moved to the United Kingdom last year, it did not initially occur to him to carry on his TCM practice there. Southampton, a rather remote port city, was their new home, and it would be quite costly to set up and run a physical clinic there.
But the isolation policy during the COVID-19 pandemic changed people’s lives. Working from home became the norm and that included doctors switching to online consultations in order to reduce exposure to infection.
“You can say the epidemic changed my pattern of examining patients. After coming here, some Hongkongers contacted and consulted me with regard to health issues. Seeing these demands I opened a video teleclinic to see patients."
The COVID-19 virus variants, Delta and Omicron, were rampant when Dr. Fan relocated to England. Many Hongkongers moving there were infected but there was no effective cure. Once infected, one could only hope to alleviate symptoms and any residual effects after recovery. Dr. Fan, therefore, received many inquiries for help.
“Many patients had chronic diseases before coming down with COVID-19. Western doctors usually prescribe one medicine for an [each] illness. When there are many illnesses going on at the same time it will become very complicated. To facilitate recovery, Chinese medicine practitioners adopt a more holistic approach and don't just target one particular aspect.”
Dr. Fan applied Chinese medicine practice to fine-tune patients’ bodies and matched their needs with different herbs. The outcome proved to be effective. He built up a good reputation in just a few months, and this in turn, seeded the notion to open a clinic.
Dr. Fan graduated from the School of Chinese Medicine at the Chinese University of Hong Kong in 2007. He was inspired by his grandfather who had practiced TCM all his life in Guangzhou.
Dr. Fan later came to realize that in Great Britain there were many acupuncture clinics but few internal medicine ones. “Local Britons don’t trust Chinese internal medicine a lot. They mainly visited acupuncturists. Moreover, the cost of purchasing Chinese herbs in the UK is one to two times higher than in Hong Kong, but the profit is only one-third of that in Hong Kong. The operating cost of running an internal medicine clinic is higher.”
He came to the conclusion, after computing the cost and the possible number of visiting patients, that opening a physical clinic as soon as he landed in Britain was not realistic.
After moving to the UK, Dr. Fan joined some local Hongkonger events to understand the needs of the new immigrants. “Many enquired about what soups to make, or how to treat their skin problems. I advised them on some food therapy solutions, as well as slapping meridians and acupressure points.”
Dr. Fan got to know more patients but they were scattered in different cities around Britain. Some of the Hongkongers who used to consult Chinese medicine practitioners in the past, were not familiar with the environment in Britain. They said they treasured the opportunity to meet him.
As the COVID-19 pandemic got worse, Dr. Fan received more and more requests for help. So he tried videoconferencing to see patients and make diagnoses. The outcome was not bad. He further learned that England’s postal system usually delivered parcels by the next day. Patients thus could get the required medicine in a timely fashion.
Chinese medicine practitioners in general examine patients using the “Four Diagnostic Methods:” observation, auscultation (listening to heart and lungs with a stethoscope) and olfaction, asking questions, and feeling the pulse. A combined use of the four methods can help practitioners verify their findings. By videoconferencing examination, although olfaction and pulse feeling were not possible, Dr. Fan found that a diagnosis could be made by observation and inquiry. The result was basically accurate, even though it took a longer time than an in-person examination.
Dr. Fan asked patients to provide photos of themselves taken in natural light. He could then make a more accurate diagnosis based on the patient’s complexion. On top of this, he also listened closely to patients when they talked.
“Apart from taking note of the symptoms described, I would judge whether the patient’s ‘qi’ is ample (how vibrant the voice was). I would observe how alert his/her eyes are and how lucid the train of thought is. I refer to these to come up with a judgment on the patient's physical conditions.”
Besides the patients with chronic diseases, Dr. Fan found many Hong Kong immigrants came to consult him on digestive issues. He remarked that in the first six months after arriving, the probability of getting sick was higher than at any other time due to poor adjustment to the new environment and climate.
Many Hong Kong immigrants ate fruit non-stop when they first moved to England and found a lot of low-priced but tasty fruits available. Dr. Fan advised against such overconsumption: “Consuming too many fruits, especially those with high sugar content, such as strawberries and grapes, is not good for our stomach.”
There was also a wide range of convenience foods that were ready to serve using a microwave or an oven. A lot of deep-fried food were relatively cheap but tasty. If Hong Kong immigrants did not know how to exercise restraint in eating, they would be susceptible to stomach problems.
Psychological pressure also led to health issues. Dr. Fan said, “After relocation to Britain Hongkongers tended to feel pressured and feel down, which caused symptoms such as upset stomach and irregular menstruation.”
British weather can be windy, bleak, and cold, and Hong Kong immigrants tended to catch colds when they failed to keep themselves warm. Quite a few came to consult Dr. Fan about skin problems. They had the problem when they lived in Hong Kong, but it became worse in England. But not everyone’s problem was the same, Dr. Fan said, for people have different constitutions.
Dr. Fan believes that in treating an illness, Chinese medicine aims at providing a comprehensive solution to fine-tune the patient’s body. Therefore every aspect about a patient has to be covered before a practitioner can help alleviate the patient’s symptoms or even eventually cure him.
England has no regulatory body to govern Chinese medicine practitioners right now, so setting up a clinic can be relatively quick and uncomplicated, without too many restrictions.
“In terms of operating, there is no tax relief, nor inclusion into the National Health Service (NHS). We thus don’t have any patient referral from the NHS. Patients have to pay out of their own pocket, as our service is not covered by insurance.”
In his clinic in Hong Kong, the patients Dr. Fan met were ordinary people. In his mind, everyone should be able to afford to see a doctor. Consulting a Chinese medicine practitioner or consuming Chinese medicine should never be seen as a luxury. He hoped to bring the “neighbour-friendly price” common in neighbourhoods of the New Territories (a region in Hong Kong) to England.
“Fortunately I am well acquainted with a batch of suppliers, which facilitated me buying Chinese herbs from Hong Kong and prescribing herbs. Currently, a clinic consultation costs £10 ($11.50). As for the medicines, the dosage depends on the patient’s needs. Currently the basic medicine expense is around £8 ($12.64). With the £5 ($5.75) delivery fee added in, the expense for a five-day dosage of medicine is around £55 (about $63), pretty close to the ‘neighbour-friendly price’ in Yuen Long, Tseung Kwan O [neighbourhoods in Hong Kong]. My main goal is that everyone can afford seeing me, and my priority is the Hongkongers in England.”
Dr Fan opted for videoconferencing to meet patients in order to maintain patient flow, and enable him to serve patients throughout the UK rather than limited him to people who live close his location. He showed a map that was marked with the locations of his patients. In just one year Dr. Fan had treated over 1,000 patients and issued over 2,000 prescriptions.
“This was because I saw a lot of people who were in need of help. I also hope that, by taking the first step, I can change some people’s impression about consulting a Chinese medicine practitioner in Britain. When we have more patient sources, we can take in [hire] more Chinese medicine practitioners so that some experienced practitioners can extend their career in Britain.”
Dr. Fan encourages fellow TCM practitioners to maintain their career in Britain and to not feel discouraged: "From last November till now, I have been fully booked. There is a great demand for internal medicine. However, there is a limit to the number of patients I can meet each day. After all, examining through video conferencing takes more time. The patient will have to wait for a long time [to get an appointment]. If time slots are filled up his illness could get worse because of the delay. That’s what causes me the most anxiety. We need more experienced practitioners to join us.”
TCM Link is an online network gathering information on available Hong Kong Chinese medicine practitioners, who have relocated to the UK.