Focus
Family doctors prescribed
By Li Jiabao (China Daily)
Updated: 2010-07-19 07:58
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 Two doctors from a military medical aid team hold a free checkup of the residents at a local community in the capital. Beijing officials hope more people start going to local doctors instead of hospitals. [Zhang Bin / for China Daily] |
Patients increasingly visiting Western-style general practitioners instead of going to hospitals
The capital, together with other cities, wants to raise the wages of its community doctors in a bid to attract more medical professionals to work in neighborhood health service centers and stations.
Chen made the comments during a recent medical forum in Shanghai.
Beijing Times said that would mean the wages of community doctors would be comparable to those of teachers and civil servants.
The city wants to improve its community health service centers so they can become the first point of contact for Beijingers with health issues and an essential part of the management of chronic diseases. The elevated status of health centers in neighborhoods would make them similar to general practitioners' clinics in Western cities.
Currently, most people with an ailment travel to a hospital to consult a doctor.
"Community medicine may be the most important part of China's medical reform," said Wang Wei, dean of the School of Public Health and Family Medicine at the Capital Medical University.
Chronic diseases are becoming more prevalent in China.
Chen said China's health care system will concentrate on the prevention and treatment of chronic diseases through community hospitals.
"The treatment of chronic diseases in the future should be planned now," Chen said.
About 92 million people in China, some 9.7 percent of the population over the age of 20, suffer from diabetes, one of the most common chronic diseases, according to a recent survey from The New England Journal of Medicine (NEJM). The survey was initiated by Yang Wenying, director of the Department of Endocrinology at the China-Japan Friendship Hospital.
"In Western countries, about 50 percent of medical graduates will work as general practitioners or family doctors while general practice, or family medicine, the counterparts of China's community medicine, has become the gatekeeper of national health," Wang said.
However, in the job markets, Beijing's community hospitals, or community health centers and stations, attract far fewer medical graduates than independent hospitals.
Beijing has established a total of 351 community health service centers and 2,900 community health service stations. They are staffed by 26,000 medical workers. The community centers have been established since the capital started its community medical reforms in 2006.
The volume of people visiting community health service centers and stations has increased three-fold, to 60,000 patients.
Statistics from the Beijing Municipal Health Bureau show that, in 2009, the average salary of community medical workers was 42,000 yuan a year, the same as the average in 2006.
In comparison, the average worker's salary at non-private sector enterprises in the capital made 58,140 yuan last year.
"The wage and reputation of community health service workers are not high enough to keep fresh talent and graduates in local service stations," said Gilbert Shia, an English doctor with the Haiyuncang Community Health Service Station in Beijing's Dongcheng district.
A survey by the Beijing Municipal Health Bureau shows that 2,235 community health workers, about 10 percent of the total, have left their positions since 2007 and 67 percent of them attribute their departure to the poor salary.
In addition to the low salary, another reason for the exodus was the reputation of community medicine work and the slim chances of promotion.
"Patients show different attitudes to community health service doctors and the doctors in big hospitals because the community health service does not enjoy high social status," Shia explained.
"Beijing's community service centers and stations should try their best to retain employees, especially young people, because it takes decades for them to earn a reputation, which is what England's clinics did 60 years ago," he added.
In the past, China has focused on training specialist physicians who usually stay in big hospitals after graduation. This has led to the current situation in which patients rush to big hospitals and seek the attention of the top specialist in any given field, thus pushing up the medical costs, even though the capital enjoys priority in terms of medical resources nationwide.
Observers hope the changes to the health care system will reduce pressure on the big hospitals and build up a community-based medical network.
The plan is for many ailments to
be treated in community health stations while emergency patients will be transferred to big hospitals. They will receive part of their treatment in the big hospitals before being transferred back to the community health stations, according to an article
in China Women's News.
"It usually takes about three minutes for local residents to reach the nearest community health station and the emergency green path ensures emergency patients will be transferred to big hospitals in good time," said Ma Jia, leader of the Haiyuncang Health Service Station in Beijing's Dongcheng district.
General practice training has been carried out among community medical workers to ensure the effectiveness of the family doctor system.
Beijing Municipal Health Bureau has recruited 2,703 medical graduates and workers to bolster the community health centers and solve the shortage of family doctors.
The community doctors will all be competent in internal medicine, surgery, obstetrics and gynecology as well as the diagnosis of common diseases including diabetes, heart disease and hypertension.
"Doctors working in community health service centers and stations will experience every kind of disease and thus have a better view of medicine than the specialists at the big hospitals," Ma said. "Fresh graduates could base a very good career in community health service work."
