Dr. Alexander Lin, center, and members of his staff stand by the bed of the last baby he delivered at Jiahui International Hospital in Shanghai, China. By the end of his three years there, the program had expanded to 18 doctors providing OB/GYN services and about 100 babies delivered each month. (Alexander Lin)

The chance to develop a women’s health program in China from virtually the ground up led a Chicago area doctor to a three-year adventure.

“It was a fantastic opportunity,” said Dr. Alexander Lin, who now is medical director for women’s health at Northwestern Medicine Palos Hospital and sees patients in Mokena.

Lin, who worked for Northwestern’s OB-GYN program at Prentice Women’s Hospital in downtown Chicago for nearly 25 years, said “in a mature health care system like Northwestern, at some point in time everything is kind of done.” Although doctors have an impact on individual lives and try to improve current practices, “It’s certainly not building something brand new.”

So he signed a three-year contract in 2018 with Jiahui Health to be chairman and executive director of its women’s health program, which required him to develop a team of doctors, nurses and other staff members.

“Somebody was saying ‘Alex, I’ve built this 500-bed hospital, and there’s a lot of families in Shanghai who are looking for a better way of getting health care. Our hospital is going to be built from the foundation: women’s health and cancer,’” he said.

Lin’s parents were born in Shanghai but have lived in the United States since 1963, and though his roots had something to do with his decision, “mostly it was because of the mission of what this organization wanted to do and it was truly a medical startup.”

Lin had his work cut out for him, because there was only one other OB-GYN doctor at Jiahui International Hospital when he arrived. He needed to recruit other doctors and staff and create a set of policies and procedures that would work for a private health care system in a country where most people are used to a public health care system.

One of the biggest changes involved creating a new mindset among employees.

“All of them, to a person, were proud that they saw 80 to 100 people a day,” Lin said. “They are professionals at doing an encounter in three minutes. That’s not the kind of health care that we want to provide.”

Dr. Alexander Lin, left, leads his team of medical professionals in a training exercise at Jiahui International Hospital in Shanghai, China. (Alexander Lin)

Business development also was difficult. “It’s a very immature market in terms of private, large evidence-based health care,” he said. Although lots of little private clinics for treatment in dermatology and dental care existed, an entire system with “integrated breast health, gynecology and infertility” did not.

In addition, there were no private hospitals as big as Jiahui International, so there were “no professional administrators” and no electronic records system that could handle the hospital and its need for bilingual representation.

“Jiahui decided to develop its own medical records system because there was nothing that could do the things that we needed it to do. … A system where doctors are seeing 80 to 100 patients a day — there’s no patient portal” that could accommodate that, Lin said.

It also was challenging to deal with the Chinese government.

“We were the competition. The officials who came and inspected us and granted us the licensing, they were the chairs of the departments of the hospitals in Shanghai from which we were taking the well-to-do patients,” he said.

Although Lin arrived July 1, 2018, it took six months for the hospital to earn a license to deliver babies. “But in all honesty, we probably needed that time to train midwives, labor and delivery nurses, to recruit good anesthesia and to get everyone familiar with the policies and procedures,” he said. “For six months we just did mock drills. I would make up patients, make up scenarios and take our team through those scenarios. We did start to see newly pregnant women who wouldn’t deliver for a while.”

He and his staff also developed patient education materials in English and Chinese. He said that 80% of patients were Chinese and 20% were expats, “Germans, Canadians, Brits, you name it.”

Lin is proud of what he was able to accomplish during his time in China. “From literally nothing, we were able to build the most preferred women’s health program in Shanghai in three years. We went from nothing to over 100 deliveries a month. Despite a historic decline in birthrate in China and Shanghai, it was the only program in Shanghai to continue year on year growth, with growth exceeding 100% of the prior year.”

The hospital also had the lowest cesarean section rate in Shanghai “by a large margin” at 26 or 27%, compared to the other hospitals that had a rate of 50%, Lin said, and with the help of other Northwestern Medicine consultants, they “built the most sophisticated IVF center in Shanghai.” Before he left China, Lin helped deliver one of the babies conceived at the center.

Dr. Alexander Lin takes a selfie with the first mother and baby who he helped deliver during his three years in Shanghai, China. (Alexander Lin)

They also “established a new way of delivering health care in Shanghai based on building relationships with patients and their families,” including being able to provide a program that wasn’t just delivering babies but screening for cancer, offering breast care and “everything you need in a private health care setting but in an evidence-based way.”

During his time in China, he and his wife knew they’d be doing long-distance commuting and he knew he’d be working 24/7. The first year, they saw each other for a week every two or three months.

Once COVID-19 hit, however, China had very strict travel restrictions, including quarantining for two weeks in a government hotel.

“You can’t open the door or leave except when they called you for your food outside. So to see my wife for one week, it would cost me at least three weeks. And my wife is American, she doesn’t speak any Chinese. For her to come and visit and be stuck in two weeks’ quarantine, there’s no way that she would do that.”

That meant Lin and his wife saw each other only once for seven days in the last two years of his contract.

He originally agreed to extend his contract another three years. “Because the government was so pleased with what we did, they wanted to build an even bigger hospital in Beijing. I was planning on staying and heading that project as well.”

But with the pandemic, his plans changed.

“The Shanghai project was done. I had groomed a successor to take over. Beijing will have to wait or someone else will do that,” he said.

The doctor’s “passion and commitment” made him a natural for his new role as medical director of women’s health for the South Region of Northwestern medicine, said Kelli Doyle, vice president of Northwestern Medicine Regional Medical Group. “He just really understands the unique needs of the patient population that he serves.

“Dr. Lin has a great reputation of being a fantastic physician. ... His unique experience that he had with his position in China will really benefit our women’s health development in the southwest suburbs,” she continued.

Doyle said having Lin in place will allow Northwestern Medicine to expand obstetrics care at its new facility in Mokena, which will go live in July. It will offer obstetrics, gynecology, maternal-fetal medicine, laboratory facilities and ultrasound.

One of the things Lin hopes to bring from China to his new role is a focus on nutritional health, especially in pregnancy.

“There’s a lot higher percentage in China (of patients) starting off at the correct BMI. Here, there’s a lot of work to be done,” he said. “The biggest reason people die in pregnancy and childbirth in the US is uncontrolled bleeding, cardiovascular disease/hypertension and DVTs — thrombosis and pulmonary embolisms in pregnancy — and all of those things go up when you’re obese.”

At Lin’s hospital in Shanghai, everybody has an initial evaluation for nutrition in pregnancy because it is part of the prenatal package they pay for. “How feasible will it be to provide better nutritional information for our patients here, to reduce complications of childbirth?” he wondered.

Melinda Moore is a freelance reporter for the Daily Southtown.