Wanna be doing health in China? Beware of red flags (of the minesweeper variety), expect lots of improvisation.

A few weeks ago, a recently graduated college student wrote me an email saying that she was coming to China, and was looking for a job doing something healthcare related.  She had some contacts in Chengdu and some vague promise of a work lead though that contact had gone cold in the weeks leading up to her flight.  The lead had made some promises about giving her a large role in their organization.

My immediate advice was to scrap the Chengdu idea and go to either Shanghai or Beijing because her work lead would very likely materialize in nothing. It is my experience that any company willing to give someone straight out of college, who had never been in China, an ‘important role’ is  not worth working for.  Either the company is staffed with crooks, or with people who don’t have any idea what they are doing. In Beijing or Shanghai she would at least have the luxury of a large English speaking population to fall back on.

In this case (unfortunately, since I was/am pulling for this person) my warnings came to pass.  What happened next was a much more harrowing experience for her then any summary I give can communicate.  It is a story full of improvised plane and hotel bookings, blind meet ups, and other calculated gambles.  She describes her experiences on her blog, in a post simply titled “Chaos”.  Since, after the publication of this article she asked to remain unidentified, I will not link to the blog.   If anything it would have advantageous for people to  read the post to get a good sense of why doing your due diligence and seeking out red flags, in China (and, really, anywhere)  is important. Luckily,  readers can still look to this excellent China Law Blog article “Give China Due Diligence its Due”, which should give more than enough explanation of what due diligence is and why it is important.

That being said, I do want to highlight my favorite paragraph from the post she wrote (names from the original have been changed) simply because the red flags in this are so illustrative;

A week before I was scheduled to leave for Chengdu, the night before New Year’s Eve, I received an email from my contact there. The startup company I was to work for, XXXX, had encountered a series of issues. Their goal is to open 100 health clinics in rural areas of the Sichuan province – at international standards of care – in the next 5-10 years. ..

The first was that the doctor responsible for overseeing and training the medical staff was forced to take a one to two year leave of absence due to a family emergency.

The second was a delay in the opening of the first clinic. The executive team had sought to open this pilot clinic in September 2009. But, due to some bureaucratic issues and because they wanted to find the best possible location for this clinic, they had not yet been able to open it.

…There were a few other minor issues that combined with these two larger ones caused the Board to call an emergency meeting, culminating in a decision to cease operations, effective January 1st. This decision was quite unexpected and threw many lives, including mine, into disorder. After extensive conversations with members of the executive team, we decided that the role we had initially discussed for me was no longer plausible, and that it would be best for me to pursue an opportunity with another organization.

If the student had told me any of this prior to going to Chengdu (I don’t think she knew) I would have told her to run for the hills.  There are so many red flags in this paragraph that I could write another dozen  about them.  They are no obvious to people who haven’t been in China before, or worked with real world start ups in under regulated regions before; I’m not even sure that they are obvious to people who have had the prior experiences.  But, believe me, you should be on the look out for all of these when choosing business partners or looking for employment opportunities.  Also, it should be added, these red flags are entirely independent of how nice the people asking you to work with them might be.  If anything, when working with nice people, identify the red flags and bring them to their attention – it could bring some positive changes to the work.  If they respond negatively, then the people might not be as nice as you thought.

For now I will just list them, briefly and with minimal justification, with a promise of expanding on them later;

Flag 1: Company XXXX has no documentation online.  It has no website. It has a very sloppy website with little information.

Flag 2: 100 health clinics in 5-10 years?  Really? International Standards of Care?  So that means that they are going to be staffed with doctors and nurses?   In rural China?  Really?  We can’t even do that in the West where people actually want to go to the suburbs.

Flag 3: The team was looking to open 100 clinics but did not anticipate bureaucratic issues?   Sounds like they did not get a very good Chinese partner to me.  Maybe it has something to do with XXXX having no website having a sloppy website.

Flag 4: 100 clinics and its a start up?  really?

Flag 5: There was a single doctor assigned to training medical staff?  One doctor?  Really?

Flag 6: And this is the big one.  Giving a role to someone straight out of college with no medical/hospital experience.  You can’t overlook that one.  *It took me a lot of time to figure out that under the circumstances, my college education was not worth very much to anyone who would be worth very much to me.  In general, I found that the people reluctant to give me a lot of responsibility were the ones who had the best grasp of what they were doing.   So, for anyone fresh out of college, coming to grips with their own sense of worth in the world, remember the importance of working with people that are capable enough to give you less than what you think you can chew.

Anybody else have red flags that one should look for when looking for non-traditional work in China?  When working with start ups in unregulated regions?