Qiu Hui

Most of LiuShanshan’s daysbegin with wake-up calls from strangers. At 6：30 onemorning， she woke to an anxious callfrom the mother of an 18-month- old with a fever. The motherasked Liu about the possibility of hospital services because of Liu’s history of helping patients secure outpatient assistance.

Liu has received an averageof 40 to 50 similar calls fromstrangers every day over the lasttwo months. Callers typically ask her a variety of questions related to hospital services includingappointments， registration，insurance， reimbursement，and family doctors. Afternoticing business opportunities in sophisticated proceduresmandated by various hospitals，Liu started her own “outpatientassistance” business.

New Profession

Liu Shanshan fell into theoutpatient assistance profession accidentally.

Previously， she was a business manager in a hotel in Beijing.The COVID-19 pandemicdevastated the hotel industryso much in 2020 that recoveryseemed far away. Her husband’soverseas sales numbers alsostarted shrinking. The couplemade the difficult decision toquit their jobs and return totheir hometown of Shenyang，capital of Liaoning Province innortheastern China.

In northeastern China，population aging is a pressing issue. Senior care has emerged as a booming and profitableindustry. However， gettinginvolved still required asubstantial investment. Liuset aside her ambitions to getinvolved in senior care.

Liu never intended tobecome an outpatient assistanteither. It came about due toexperience acquired by visitinga hospitalized relative inShenyang. The relative was from a neighboring city. His daughter couldn’t leave her job and travel all the way to Shenyang to staywith him. She asked Liu and her husband for assistance.

The grueling week-longexperience in hospital with her relative helped Liu realize thatseniors had major problemsvisiting hospitals without help.

She began to observe hospitalprocedures. She saw how difficult it was for elderly patients to keep up with the latest technologyapplications used in hospitals.They were often confused withhow to download a hospital app， how to register online， and howto print medical records.

Liu started wonderingabout the possibility ofprofessional assistance to solve such problems. She began tobrainstorm the idea heavily.

China is home to 190 million elderly people， many of whomsuffer from chronic diseases，according to China’s NationalHealth Commission. Theytend to visit hospitals regularly to receive medical advice，treatment， or surgery. A surveyshowed that more than 70

percent of the elderly living apart from their children had to visithospitals on their own.

Liu started believing thatoutpatient assistance would bea promising business. In April2021， she registered her company as “An’an Outpatient EscortServices.”

She simply sought to improve senior mobility. After conducting market research， Liu set theprice for her service at 198 yuan（US$30） for four hours and 298yuan （US$45） for eight hours.During this time， she would help patients see doctors and receivecheck-ups in maze-like hospitals.

“Many people don’tunderstand what we do，” said Liu. She starts the service clock themoment she receives a case. Most clients are seniors with a singlechild who lives in another city.She is often first contacted by the son or daughter living far away.She reminds clients to preparefor upcoming hospital visits and ensures they bring ID and health insurance cards. Before leavinghome， she becomes orientedwith the hospital by studyingthe layout. During visits， shestays with clients as they seedoctors to ensure the advice andprescriptions are received andfeedback can be relayed to thechildren.

Unusual ‘Business’

As she did more and morevisits， Liu began to detect thechanges in her clients’ attitudes. She once got a call about a ladywith kidney stones. The patient was in her 50s and childless，and her nephew made the callto Liu from his work desk inanother city.

During the first hospital visit when the woman discoveredLiu’s role， she went quiet. “Shefelt all alone and thought I wasjust another nameless face，”recalled Liu. Tears welled in the woman’s eyes. She explainedher duty to the patient in detailand tried to calm her down.After some time， the woman got in a better mood. After gettingdropped off， she asked Liu toaccompany her on future visits.

Outpatient assistance is no easy job. Alongside keepingclients company during hospitalvisits， Liu also provides patientswith psychological support. Running the business for half a year gaveLiu considerable experience. Shenow brings an emergency medicalkit in her backpack. She has allthe information and features ofShenyang’s hospitals memorizedas well as procedures for medicalcheck-ups such as Type B ultrasonics， gastroscopes， and blood tests.

Liu divided her entrepreneurialprocess into two stages： soft opening and fully active. During the softopening， she received one or twoorders per day， hardly enough to besustainable.

Later， a media interview of herencouraged many more potentialcustomers to learn about the newbusiness form. Liu’s business entered the active stage as her phone startedringing early each morning. About80 percent of calls were inquiriesabout what services they could offer.However， about one out of 10 placedorders for service， which was not bad for a start-up.

Liu rented an office near two majorShenyang hospitals. She was confident that the monthly rent of 2，000 yuan（US$310） would be a “profitableinvestment” because a dedicated office would make her business look morelegitimate.

Growing Industry

Actually， outpatient assistance is far from a brand new thing. Early in 2003， some domestic service companiesin Harbin started providing servicesfor the empty nest elderly， helpingoutpatient assistance emerge in China.

In 2015， the new profession received a development boost when severalO2O outpatient assistance companiesreceived financial support. However，development went stagnant due topolicy and market constraints.

The threshold to engage in theindustry is not high. Institutions and individuals share equal opportunityto secure a piece of the niche market.

On some consumption platforms，searching “outpatient assistance” will result in too many choices.

Since launching her outpatientescort service platform in April 2021，Liu Shanshan’s team has grown tothree full-time and seven part-timeemployees. Today， Liu has becomemore focused on communication andtraining. Without unified norms andstandards， practitioners depend heavily on acquiring experience throughpractice. Liu requires her employeesto have detailed information on thedestination hospital and make specific plans for each task. To ensure hospitalvisits are more comfortable andeffective， assistants are expected toprioritize the sequence of events.

China’s 2021 government workreport called for efforts to “advancecomprehensive reform of publichospitals， expand trials on setting upnational medical centers and regionalmedical centers， strengthen the ranksof general practitioners and ruraldoctors， and improve the capacity ofmedical services at the county level.”The document indicated that the tiered diagnosis and treatment system would develop at a faster pace.

During the 14th Five-Year Planperiod （2021-2025）， China will enter a stage of rapid population aging withmore than 300 million people aged60 or above. Recent construction and improvement of the urban and ruralmedical service networks has made it easier for seniors to see doctors， butroom for improvement remains.

Although the industry thresholddoesn’t seem high， practitioners takethe profession quite seriously. “Youhave to be curious and patient，” saidLiu. “Elderly clients usually need more emotional comfort while youngerclients just want company.”

Liu has ambitions to regularizethe industry. She hopes her wealthof experience helps contribute tothe establishment of professionalstandards. She is fully aware that the sector is still nascent. “I want to help more people understand what we’re doing，” she said.