Institute for Western Surgery Offers Unique Experience for Surgeons

For many Americans living abroad, access to the kind of surgical care they are accustomed to can be limited. In China, state-run healthcare systems often mean long lines and waiting periods for surgeries. At the same time, surgeons in China are eager to learn advanced Western techniques, such as minimally-invasive surgery. Very few opportunities existed for patients and surgeons alike until now.

Enter the Institute for Western Surgery. Scott Rein, president of the Institute for Western Surgery and its U.S. affiliate, Strategic Outpatient Solutions, and a group of nurses, surgeons and other medical staff are working side-by-side with Chinese surgeons and surgical staff to introduce a unique environment for patients to receive care and Chinese surgeons to learn about new Western techniques.

Gold-medal idea
Prior to the 2008 Beijing Olympics, Mr. Rein worked with a group in China to establish an ASC. But he abandoned the project after additional research. "The same conditions that allowed ASCs to grow in the United States weren't present in China," he says.

However, the interest in bringing Western surgical practices to China was very strong, mainly due the prevalence of American and European ex-patriots living in the country. Opportunity came in the form of the U.S. Olympic Committee.

"Typically, when the U.S. Olympic Committee sets up operations for the Olympic Games in a developing country, they have access to an army base or can arrange with the host country to have a military vehicle on site to create a remote clinic or take injured athletes to a U.S. base," Mr. Rein says. "This was not permitted in Beijing."

Mr. Rein and his team, lead by sports medicine physician James Andrews, MD, organized the Urgent Orthopedic Program ( The group partnered with a local hospital in Beijing and ensured that the local operating rooms were set up and staffed with a world class surgical team throughout the Olympic Games.

Further, the Urgent Orthopedic Program co-sponsored a lecture series for Chinese surgeons. "We had been told some negative things about the level of interest from the Chinese surgeons," Mr. Rein says. "In reality, they were very involved, and we saw a thirst for modern techniques, minimally-invasive surgery especially."

This response encouraged Mr. Rein and his team to bring these techniques to surgeons and to ex-pats living in China.

Bringing together East and West

Since May 2008, Mr. Rein has traveled throughout China to evaluate the facilities. He found a surprisingly magnificent, state-run hospital in Guangzhou, which is located in Southern China, that was fully equipped with state-of-the-art surgical and imaging equipment.

"The hospital had the equipment, but their surgeons did not have the advantage of access to the latest approaches to surgery," Mr. Rein says. Additionally, Mr. Rein found that 200 of the Fortune 500 companies had offices in Guangzhou, which could only mean that Western surgical services would be in high demand.

"Many patients living in China are faced with a tough decision. They can either seek treatment in a country where the average length of a hospital stay is 11 nights or fly back to the United States," Mr. Rein says. "It creates a less than ideal situation with their families and friends living abroad, too, and when they return to China, they are 8,000 miles away from follow-up care."

Another barrier for foreigners seeking care in China is language. Mr. Rein notes that although many Westerners living in the country know the language well enough to conduct business or communicate with friends, describing medical terms and problems in Chinese is still difficult. Conversely, many Chinese physicians' English is not fluent enough to communicate the patient's problems.

The Institute for Western Surgery aims to alleviate both of these problems. Mr. Rein and his team have entered into an 11-year agreement with the hospital to train their surgical department for free. U.S. surgeons, nurses, anesthesiologists and other surgical staff work side-by-side with their Chinese counterparts to treat Western patients living abroad.

U.S. surgeons come to the Institute for a monthly rotation. They train staff for 10-14 days. They also lecture and have the opportunity to sightsee during their stay. Although the surgeons are not paid to train the Chinese staff, Mr. Rein says expenses are covered to bring the surgeons over from the U.S., and they are given a stipend to accommodate for the time they must take off from their regular practice.

The American surgeons also bring in the tradition of efficiency that has been seen in surgery centers and other facilities. The team is also working hard to establish policies and procedures that help to aid in this efficiency. Although same-day surgery may not be currently feasible in China, Mr. Rein says that they are hoping to cut the average 11-day stay in their hospital partner by more than half.

Aside from surgical training, the U.S. staff members at the Institute for Western Surgery are teaching their Chinese counterparts a new approach to patient care. Mr. Rein, who has a background in developing and managing ASCs, says the staff takes a page from this patient-centered model of care.

"The nursing staff is focused on the patient experience," he says. "We try to ameliorate the typical experience of waiting in a line, paying a fee, receiving care, waiting in another line and paying a fee. We have tried to introduce a customer service attitude among our staff that results in an outstanding patient experience," he says.

The nursing staff is also vital to improving the communication gap between foreign patients and their Chinese surgical team. "We have a full-time nurse at the Institute who is both training nurses and is helping the surgeons and staff members improve their "medical" English and better understand the problems of their ex-pat patients," Mr. Rein says.

Need for good surgeons
Because of previous relationships and experience during the 2008 Olympic Games, orthopedic surgeons were the first to come to the Institute for Western Surgery. Dr. Andrews and physical therapist Kevin Wilk were among the first to help develop protocols for care and aftercare of patients treated at the Institute.

While the Institute is always seeking great orthopedists, Mr. Rein is currently looking for experienced gastroenterologists to come over from the United States. "We are looking for leading surgeons with an interest in an amazing experience," he says.

Mr. Rein is also looking for other surgical specialists, including general surgeons, ENT surgeons, retina surgeons and pain management and spine surgeons.

Surgeons interested in learning more about this opportunity may contact Mr. Rein at

Learn more about the Western Institute for Surgery

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