Health Care Transformation in Contemporary China by Jiong Tu

Author:Jiong Tu
Language: eng
Format: epub, pdf
Publisher: Springer Singapore, Singapore

5.1 Gifting: An Individual Technique for Better Care

5.1.1 Changing Gift Practice3

Traditionally, patients would send gifts to doctors after treatment to express satisfaction of good care, and to show their gratitude of being cured from a difficult illness. In Riverside County, the gifts could be home-made food, local products, plaques (paibian) or silk pennants (jinqi), with patients’ appreciative words accompanying them. Patients’ families sometimes set off firecrackers in front of doctors’ clinics as thanks, which recognise a doctor’s professional skills and ethics, and also broadcast his or her good name in the community. Gifts such as plaques and silk pennants, hang on the clinic wall (see Figs. 5.1 and 5.2), are like licences, awards, or certificates doctors display in their clinic, retaining an aura of cultural legitimacy and ‘an echo of the symbols with which figures of traditional authority surrounded themselves’ (Giddens 1994: 89). These gifts, a mixture of material and symbolic rewards, serve as an expression of gratitude and recognition, and play an important role to connect guanxi and renqing—the long-term cultivation of relationships in a local community.4 There were few cash gifts from patients to doctors. Sometimes even medical fees were paid in the form of red-packets in which patients’ families put money according to their economic condition. Poor families gave material products (such as rice, grain, and noodles) to substitute for the medical fee. In the local renqing society, doctors were regarded as morally responsible and having obligations within the moral economy of gift. Gifting in the traditional context constituted a part of moral economy, a system that was ‘embedded’ (Polanyi 1944) in a local society, allowing people both rich and poor to get certain health care.

Fig. 5.1Gift from patient—red silk banner (jinqi)

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