Rural doctors pressured by medical reform

NANCHANG - Rural doctor Zhang Hua has found it increasingly difficult to run his village clinic over the past few years.

"We can hardly make ends meet," said Zhang, 40, the youngest doctor at a clinic in the village of Lishan in East China's Jiangxi province.

Zhang was honored as an outstanding rural doctor by the Ministry of Health in 2010, partly because of his persistence in serving the village since 1998 while most of his colleagues have chosen to work in urban hospitals.

However, Zhang has attributed the clinic's loss of income to the reform of the national medical care system, which began in 2009 to make medical services more affordable and accessible.

The reforms call for the establishment of a basic medication system, which includes a list of common drugs that must be sold at zero profit by all community-level medical and health care institutions run by the government.

However, rural clinics rely heavily on medication sales due to insufficient government subsidies.

"We have lost two-thirds of our income," said Zhang, adding that many villagers have turned to other institutions to obtain medications that are not included on the government list, as his clinic only offers common medications.

Local health care authorities provide registered rural doctors with a monthly subsidy of 750 yuan ($120); however, retired doctors receive just 65 yuan, according to Zhang.

Zhang's father has worked as a village doctor for over 40 years and is still working at the clinic.

Similar concerns, among others, were aired by rural doctors during a seminar held last week in Beijing.

Zhong Jing, a doctor from a rural area of Southwest China's Guizhou province, said rural doctors need more training, as they are finding difficulties in handling the work they are currently tasked with.

Vice-Premier Li Keqiang said at the seminar that a better mechanism for covering rural clinics' medical risks with insurance should be established. He also called for more help and support for rural doctors.

"Rural doctors are the guardians of the country's primary medical and health care system at the community level. This system cannot afford to be weakened," Li said.

Authorities introduced doctors to rural areas in the early 1960s, when doctors were in extremely short supply in the countryside. Nearly 2 million people became registered rural doctors after undergoing a short training period, rather than by obtaining a proper medical degree.

Although the effort helped to reduce child mortality rates and battle infections, it also resulted in the creation of a generation of poorly trained rural doctors.

China currently has about 1.1 million rural doctors serving some 656 million rural residents.