Episode 09 of Healing with Benevolence: President CAI Zhiming of Guangdong Longcheng Medical Group

In 1984, Prof. CAI Zhiming graduated and began working in Shenzhen. First just being an ordinary doctor, he continued to pursue further studies. By 1996, he was appointed as a hospital president, and has accumulated over 30 years of hospital presidency experiences by now. He was the first Chief Scientist of the National Basic Research Program of China (973 Program) in the field of synthetic biology of oncology, a National Model Worker, a winner of the 70th Anniversary Medal of the Founding of the People's Republic of China, and one of the National Outstanding Hospital Presidents. Prof. CAI has mentored over 120 graduate students, doctoral students, and postdoctoral fellows spanning all over the country, many of whom have gone on to become directors, hospital presidents, and chief scientists in national key projects. In this episode of Healing with Benevolence, Prof. CAI introduced the latest progress in the research project "Research on the Intervention of Bladder Cancer with Synthetic Biological Devices". He also shared his insights on how young doctors can succeed in scientific research, along with his unique experiences in research and training students. As Prof. CAI currently serves as the President of Guangdong Longcheng Medical Group, he also introduced the hospital's specialty—rehab medicine, with a focus on pediatric rehab and vegetative awakening therapy. In the future, he plans to establish the largest vegetative patients awakening center in the world.

1. How has your early experience shaped your achievements?

I owe much of my success to Shenzhen. When I was in college, I read newspapers from the Shenzhen Special Zone Daily in the library of the Shantou University Medical College. At that time, the newspapers were black and white, in which you could often see news from Shenzhen saying, "Shenzhen is about to become a Special Economic Zone" and "Time is money, efficiency is life." These words were very inspiring. Shenzhen's proximity to Hong Kong and Macau added to my determination to work here after graduation. So, I moved to Shenzhen at the forefront of China's Reform and Opening Up. Forty years have passed in the blink of an eye, and I’ve indeed accomplished a lot. From working as a doctor in Shenzhen, to furthering my studies in Shanghai, then earning my master's and doctoral degrees in Guangzhou, and later becoming a hospital president back in Shenzhen again. I have been a president since 1996, for 29 years by now. There aren’t many people in China, or even globally, who have served as hospital presidents for over 20 years, but I am one of them, and I have made some achievements. Whether in clinical work, scientific research, medical education, or mentoring students, I have made some contributions to the society. I am honored to have been named a National Model Worker in 2016, received the 70th Anniversary Medal of the Founding of the People's Republic of China, and recognized as one of the National Outstanding Hospital Presidents.

2. From your own experience, how important is it for a doctor to visit different hospitals or countries?

In addition to studying and working at one’s own hospital, a doctor should also make it a point to go outside and learn. For instance, it is highly beneficial for doctors in municipal hospitals to visit lower-level hospitals, go to grassroots medical institutions, and even visit rural or remote areas. It is equally important to visit higher-level hospitals in places like Guangzhou, Beijing, Shanghai, and even abroad, such as developed countries in Europe and the US, as well as Japan and Singapore, etc. It will bring great benefits. My guiding principle is to encourage young doctors to attend every conference, speak at every event, and regularly go out to see what others are doing. This allows them to absorb others’ experiences while sharing their own ideas.

3. With 29 years' experience as a hospital president, what do you believe are the key aspects of hospital management?

I have served as a hospital president for 29 years. I have never been a vice president; I went straight to the position of president and also served as the legal representative. From all these years of experience, I believe that managing a hospital is similar to managing a family or even oneself. One must be fully committed to the hospital’s work, with diligence being the top priority. At the same time, it’s important to have both a domestic and international perspective, learning from peer hospitals. We must motivate our staff to be dedicated to their work, to learning, and to cultivating a lifelong learning mindset. Moreover, treating patients like family is essential. We must focus on building the hospital’s culture, fostering work ethics, and fighting against corruption. Only then will hospitals have good reputation, medical staff be well-regarded, and patients also seek us out for medical treatments.

4. Please introduce Guangdong Longcheng Medical Group.

I have been a hospital president for 29 years, 21 of which were spent working in three public Grade-Three Class-A hospitals, and the other 7 or 8 years were dedicated to establishing a public hospital. Now, in the 29th year as a president, I am working for Guangdong Longcheng Medical Group. The group started from the Shenzhen Longcheng Hospital, a private Grade-Three Class-A hospital. In 2017, it became China’s first Grade-Three Class-A specialized rehab hospital. In 2023, it successfully passed the re-assessment for Grade-Three Class-A hospitals and is now ranked first among over 800 private hospitals in China, becoming a highly influential rehab hospital. Currently, the hospital has 700 beds and treats over 500 patients, enjoying a prominent reputation in the field of rehab medicine.

And then, another two hospitals were founded in Guangzhou, namely Guangdong Longcheng Hospital and Guangdong Longcheng Rehab Hospital, located in Zengcheng District, with a total of 3,000 beds. It is set to open on April 13, 2025.

It is truly a medical group worth dedicating efforts to and making contributions to, because it has distinctive features. It focuses on rehab medicine, which covers a wide range of areas relating to all systems of the body. Oncology, cardiovascular and cerebrovascular diseases, and other systematic conditions all require rehabilitation. Our rehab medicine now extends to pre-treatment and intra-treatment stages as well. Therefore, it is a broad field, making it an exciting area for urology specialists or experts in hospital management to explore as part of their career journey.

5. Please share some impressive cases from Guangdong Longcheng Medical Group.

I believe this hospital excels in two departments, one of which is the Pediatric Rehab Department. The department primarily treats children with autism. At its peak, it had over 100 beds, with more than 100 children, the majority of whom were from outside the local region. The families of children with autism suffer greatly, as these children can neither speak nor attend school, leaving parents extremely anxious. There are a large number of treatment methods, but many do not show effective results. Therefore, the hospital invited an expert, Prof. GONG Jianhua, who is highly skilled in treating cerebral palsy and autism. His expertise allowed him to attract many patients from far and wide. Currently, there are around 100 beds in this department this year. Next year, the hospital plans to expand it to 150-200 beds due to the significant success in treating autism patients.

Secondly, there are patients who suffer severe injuries and go into a vegetative state. For these patients, the goal is to find ways to bring them out of the coma, and even enable them to speak and see. The hospital has successfully treated 73 patients in a coma, which is also a remarkable achievement.

I am currently working on organizing the largest vegetative patient awakening center in the world in the hospital group, setting up hundreds of beds to help patients in a vegetative or unconscious state wake up through our comprehensive treatment. This field of work is very meaningful, for these patients are scattered in hospitals across China and the world, leaving a heavy burden on the hospitals. But if they are gathered in our hospital for treatment, we can offer a wide range of methods and techniques with strong expertise, enabling patients to receive the best care and treatment quickly and helping many of them gradually regain consciousness. This job can be considered an extremely challenging global issue.

6. Please tell us more about the challenges and responses in building Guangdong Longcheng Hospital from your experience in managing public and private hospitals.

There is a significant gap among hospitals under different systems. Public hospitals have their own ways of management, which are very distinguished from those of private hospitals. The goals are the same for both, which are to provide patients with medical treatment, healthcare, rehabilitation and so on, but the ways of operation differ. For example, public hospitals receive relatively substantial support from the government, including assistance with land allocation, staff recruitment, and financial resources.

Private hospitals also receive some support, but not as extensive as that for public ones. But they have their own edges in systems and mechanisms. While they have to fund themselves and pay taxes, they have flexibility in their systems and mechanisms. Public hospitals' systems tend to be more rigid, while private hospitals can quickly act on their plans, making decisions more nimbly. Therefore, I believe private hospitals and public hospitals complement each other and develop in a differentiated way. Public hospitals need to emphasize on public welfare, focus on research for major diseases, cultivate talents, etc. Private hospitals, on the other hand, should be specialized in distinct areas, offering differentiated services. I believe the overall purpose of both public and private hospitals is the same, but their focus differs. Although the transition from managing public hospitals to operating private hospitals is a significant shift, it is definitely worth experiencing in depth.

7. The project you lead, “Research on the Intervention of Bladder Cancer with Synthetic Biological Devices” is the first to focus on tumor synthetic biology in the National Basic Research Program of China (973 Program). Could you please share the latest progress of this project with us?

Synthetic biology is an emerging research field in China. I got involved in this field  relatively early. This project is the first national key research project in medical synthetic biology in China. I am also the first Chief Scientist of the 973 Program in Shenzhen.

After all these years, it has been a decade since the project was initiated in 2013. As our project was about to be completed in 2017, we wrote to the leaders of Shenzhen Government, hoping that our scientific research results could be translated into practical application and industrial production. In this regard, the government has provided substantial support.

We have established an engineering laboratory for National Innovation Center for Synthetic Biotechnology, national key laboratories and a National Biomanufacturing Industry Innovation Centre, all of which are innovation platforms for our country.  

Our team currently has more than 1,000 colleagues, and the results we have produced are probably in a leading position in the field of medical science and health worldwide.

At present, our industry is performing very well and has developed many products that meet human needs, achieving significant accomplishments in the areas including treatments for certain types of cancers and cardiovascular and cerebrovascular diseases, as well as the tracking of disease and care for patients, etc.

8. The clinical translation rate of medical research achievements in China is lower than 8%, while in Europe and the United States, the rate is around 70%. How do you think we can do better in the translation of medical scientific research achievements into practical applications?

First of all, I would like to clarify that the translation rate of China's scientific and technological achievements is not that low. In recent years, Chinese government, especially the medical system, has included the translation rate of scientific achievements into indicators for national performance evaluation, so the rate should be higher.

I think the translation rate of some scientific research achievements in China should reach above 15%-20%, and the rate abroad should not be that high either, more or less at around 50%.

Besides, as for how to improve the rate of China's scientific and technological achievements, maybe we need to select some practical patents for translation.

I believe the National Intellectual Property Administration should have a higher approval rate for truly good and core patents while maintaining strict standards and striving to improve invention patents and utility model patents.

Secondly, our government should ensure that the patents can be effectively translated by setting regulations. For instance, the national performance evaluation indicators of the healthcare system specifically listed how many scientific research results should be translated into practical applications in each hospital annually, which could significantly boosts motivation of the hospitals.

Thirdly, there should also be regulations require that the outcomes of translation must be practical products. It’s not sufficient if a product has only been tested on animals, as the application in the human body is completely different. 

Therefore, our ultimate goal is to develop products that are applicable for diagnosis and treatment, especially those can be industrialized and circulated in the market.

In this respect, some hospitals in our country have been performing very well. For instance, Shenzhen Second People's Hospital has achieved notable success in translating scientific and technological achievements.

China has a ranking of innovation translation every year, in which Shanghai, Beijing, Guangzhou, and Shenzhen have outstanding performance.

Therefore, we now require students not only to propose research topics, write papers, and complete theses, but also to focus on projects that have the potential for clinical translation. 

We emphasize that graduate students in clinical medicine should be orientated to clinical problems and produce outcomes that can address these clinical problems, which can make their work more practical and better suited to solve patients' problems. 

Therefore, by managing multiple aspects comprehensively, it will be entirely achievable to elevate the translation of scientific and technological achievements to a new level.

9. You have undertaken 18 international and national research projects, published more than 200 SCI papers, and have rich scientific research experience. How can young doctors find the right research direction for themselves? How can they achieve success in scientific research?

For those young doctors who start the clinical work after graduating from medical school, we must emphasize the importance of clinical work and patient care.

They should find out the problems which cannot be solved during the clinical work and then find solutions to these problems through critical thinking, clinical experience, and literature review.

For example, new products, new techniques, new designs, or alternative approaches, such as conventional drugs in new use, can be used to address patient issues. Therefore, if a clinical doctor wants to engage in research, it is not recommended for them to focus too much on basic research, such as conducting animal experiments or publishing papers. These tasks are better suited for institutions like research institutes or universities dedicated to pure scientific research. The research conducted by clinicians must be combined with clinical practice and patient needs, so that the outcomes are practical and useful. Therefore, I often advise my students to choose research topics that are related to clinical work, so that their works are more clinically meaningful and can better solve patients' problems.

10. Many outstanding people in the field of hospital management have been trained by you. Could you share with us your unique experience in this field?

In the past 20 years, I have supervised more than 120 master's students, doctoral students and postdoctoral students. First of all, I must do what I ask them to do first, for example, learning foreign languages, conducting experiments, reading literature, writing reviews and papers. I can do these things myself. Only when I do these things can I lead them. Second, we hold group meetings once a week, and absence of the meeting is not allowed. If someone cannot attend in person, they must attend online.

Each group meeting has a specific theme, with a presenter and a group discussion. And all attendees should speak English during the meeting, instead of Chinese. I also encourage my students to attend academic conferences. Additionally, each student should have scientific research project, including the projects of the National, Provincial and Municipal Natural Science Foundation, and should publish high-level papers with good influence, and apply for 1~2 patents. Only by achieving these goals can they graduate or complete their training. Therefore, the students I supervised are highly competent. Many institutions compete to recruit our doctoral and postdoctoral graduates, and many prestigious universities compete to accept our master’s students for further doctoral studies. We have achieved remarkable success in this regard. Some of my students have become department heads or laboratory directors, and some have become chief scientists of national key projects. There are two distinctive features in my team: one is we have two national engineering laboratories and the other is that six young talents from our team have become chief scientists of national key projects. Many have become doctoral or master’s supervisor, and some have become hospital’s president or vice president. Our students are truly making significant contributions in clinical work, teaching, and research across the country, which we are very proud of.