Family doctors the future of China's healthcare system

BEIJING -- Getting medical treatment has become much more convenient for Wei Xianfang since she joined a family doctor program.

"Going to the village clinic to see the doctor was such a hassle for me in the past, but since I signed a contract with Dr. Liu, whenever I feel under the weather, I can just call her and make an appointment," said Wei, who lives in Sixian Village, Luzhai County in south China's Guangxi Zhuang Autonomous Region.

Liu helped her with inflammation after she accidentally fell on the floor and injured her leg last week. Liu also gave her a blood pressure test and has regularly reminded her to take her medicine after she was diagnosed with high blood pressure in a routine medical exam a year ago.

Going to the doctor has long been a headache for Chinese people. With the country's large population and its limited and unbalanced distribution of health care resources, hospitals are always swarming with patients, leading to long wait times and an unpleasant environment.

Family doctors devote themselves to continuing and comprehensive health care for patients of all ages. Family doctor programs have been introduced in several provinces and regions to ease the pressure on big hospitals and ensure equal opportunity for people to receive medical treatment.

In 2013, Luzhai County was selected as the pilot zone for the family doctor program in Guangxi. Under the system, rural families sign contracts with general practitioners in rural township clinics. The doctors offer one-on-one service for patients, providing basic medical care as well as health consultations.

The program aims to provide better medical service to rural people and encourages people to seek medical care at grassroots medical institutions, reducing the pressure on hospitals in cities.

Statistics show that from 2009 to 2014, government spending on health amounted to 4 trillion yuan ($620 billion), 1.2 trillion yuan of which came from the central government.

Like Liu, many doctors in community hospitals have joined the family doctor program to better serve local patients.

"My phone was on 24/7 during the Spring Festival holiday in case any of my patients had an emergency or a health question," said Zhu Lan, a doctor in a community medical center on Xieshi Street in Xuhui District, Shanghai.

Shanghai started experimenting with a family doctor program in 2011.

Zhu, one of the first doctors to join the program, has signed with 1,060 families living along the street so far.

In Xi'an City in Shaanxi Province, more than 2.5 million local residents have signed up with family doctors, and in Liaoning Province, more than half of the rural population has joined the family doctor program.

Ali Health, Alibaba's health care subsidiary, launched a mobile application in Beijing to connect doctors from grassroots medical institutions and nearby residents. Patients can simply pick up their phones to interact with a doctor.

In the proposal for the 13th Five-year plan covering 2016 to 2020, the central government vowed to build a "healthy China" by reforming its health system, building a basic health care system covering both the urban and rural areas and a modern management system for hospitals.

It called for improving distribution of health resources and basic services, promoting health resources at the rural and grassroots level, developing telemedicine, and promoting family doctors and electronic health records.

According to Dong Fang, head of the grassroots health services office of the Health and Family Planning Commission of Liaoning Province, family doctors can diagnose and treat common diseases such as a cold or cough, and help patients recovering after major surgery at big hospitals.

"Family doctors have provided local residents with better medical services and also encouraged better use of China's limited health resources," said Fu Hongpeng, researcher with China National Health Development Research Center.

According to Fu, family doctors have partly filled the gap between the the large number of patients and limited hospitals.

Zhu Lan has become friends with many of her patients since becoming a family doctor. Many longtime patients who have moved out of the neighborhood still come to her for treatment.

"They trust me," said Zhu. "The tension between doctors and patients will be eased when trust is built."

"I will keep being a family doctor, and I believe it is the future trend for China's health care system," she added.

Li Bin, head of China's Health and Family Planning Commission, said that the government is making efforts to provide each Chinese family a family doctor by 2020.