Nothing but the best(2)

Calling for trust

Not only are the small clinics more convenient, but also the community doctors know the history of the patient better, said Cui, who has worked on a government project to reform Beijing's medical system for over a year. The reason why people still go to big hospitals for common illnesses has many aspects. The most important is people's outdated concept of a community hospital.

"Many people hold the old view that general practitioners in clinics are 'barefoot doctors' [people with minimal medical training who worked in rural villages in China in the past]," Cui said. Many still believe that Western medicine is all about how big the hospital is, said Cui, meaning that people have blind faith in advanced medical equipment and specialists.

A shortage of qualified general practitioners is another one of the urgent problems, said Cui. Many new graduates prefer to work in big hospitals rather than community clinics. And it takes about 10 years for a graduate to become a qualified, experienced general practitioner.

According to the research done by Cui and his academic team, almost 40 percent of patients at clinics are transferred to a bigger hospital, which is a much larger number compared to other countries. "Doctors don't want to take the risks," he said.

Last but not least, he says that despite some incentives, the current government guidance does not fully support the development of community hospitals.

"Almost all the governmental investment has gone to the big hospitals, which attract more talent, and have better educated specialist doctors," said Cui.

Compared to general practitioners, doctors who specialize in different areas inspire more confidence from patients, said Cui.

Developing community

In 2006, the Beijing Health Service Management Center was established. Its website also went online, allowing citizens to find out the nearest community clinic within minutes.

According to the management center, now there are 324 large clinics in Beijing, each with at least six doctors and nine nurses. And there are 1,528 smaller clinics scattered citywide, each with at least two doctors who major in general practice. A general practice training center was also built at Capital Medical University that year.

Community doctors are getting a pay hike as part of the effort to direct patients to primary hospitals. The average annual pay has risen 60,000 yuan ($9,800) since the end of 2010, The Beijing News reported. "And a minimum wage is ensured by the government," said Cui.

To encourage people to avoid jamming major hospitals, medical insurance is more generous for people who go to community clinics. The changes are showing results. In 2008, there were 14 million patients treated by community clinics. The number almost tripled in 2012.

This means that the policy to get people to community clinics is working, but there is still a long way to go.