Govt renews push for family doctors

Shanghai's health authority plans to expand a set of incentives designed to encourage residents to see a family doctor before heading to the city's large hospitals for treatment, health officials said at a press conference Wednesday.

The incentives aim to curb the overcrowding that many of the city's prominent hospitals have experienced in recent years. Despite the local government's efforts to encourage residents to have their basic medical needs treated by general practitioners and internists at the city's numerous community health centers, many patients remain wary of the quality of care at these facilities, which lack the cache of the large public hospitals.

"We are going to expand the family doctor system so it is in place across the city, and we will help every household obtain a family doctor by 2020," said Xu Jianguang, director of the Shanghai Municipal Health Bureau.

The incentives include allowing family doctors to give their patients referrals that allow them to see top specialists without queuing, Xu said. They will also give family doctors the ability to write larger prescriptions for patients with chronic illnesses.

The health bureau first implemented the incentives in 10 districts in April 2011 as part of a pilot program. More than 2,200 family doctors provided care for more than 3.7 million local residents, meaning each family doctor served about 1,600 patients.

Health officials found that residents still preferred going to large hospitals rather than family doctors. "Residents will gradually change their habits when they learn the benefit of the system," Xu said.

The system will give family doctors the right to refer patients to specialists at top hospitals, and will ensure that patients with referrals from their family doctors will have priority to see the specialists.

The last round of healthcare reforms allowed patients to use their government-supplied health insurance at any hospital in the city, which caused patients to flock to the most prominent hospitals, even if they only suffered from minor illnesses.

Xu said 75 percent of patients who go to top hospitals have basic illnesses that could be easily treated by a family doctor at a community health center.

Under the incentive program, family doctors will also be allowed to prescribe medication that only doctors at large hospitals could previously prescribe. "Because of regulations limiting the size of prescriptions, patients suffering from chronic diseases often have to go to a hospital three or four times a month. But after a resident signs a contract with a family doctor, he or she can get enough medication for one month with a single visit," said Huang Fengping, the health bureau's vice director.

Although the officials vowed to increase the salaries of family doctors, they did not give details at the press conference about how they would do it.

The officials said they also planned to boost the ranks of family doctors by increasing the number of medical students majoring in internal medicine. They also planned to invite hospital doctors and retired physicians to start family practices.