When doctor meets micro blog(2)

More than 10 different clinical guidelines on hypertension diagnosis and treatment coexist, each of which were issued by different organizations.

In his clinical work, nearly all of the patents he sees have previously received inappropriate treatment at other medical facilities, he said.

Diagnosis and treatment of hypertension is complicated as the condition is closely associated with other underlying conditions such as diabetes and cardiovascular diseases.

Thus, measuring blood pressure is only the first step in treatment. Detecting the cause of hypertension requires a high level of expertise and clinical experience, he said.

He believes grassroots-level hospitals should serve as the foundation of hypertension intervention given the huge number of patients they see.

He is busy training such hospitals to enable them to shoulder that responsibility.

Almost every month, Yu is invited to give lectures and see patients at grassroots-level hospitals across the mainland.

Yang Xiuhua, a physician at the Xiangyang community healthcare center of Pinggu district, Beijing, said the center cooperates with the nearby Pinggu Hospital of Traditional Chinese Medicine to treat patients suffering from chronic diseases, including hypertension.

Yu has instructed and trained doctors working in suburban districts, including Pinggu, since 2003.

For cases of hypertension caused by other diseases or health conditions, or other complicated hypertension cases, Yang and her colleagues transfer the patients to the TCM hospital for treatment.

The center takes only patients whose health conditions have stabilized and who have been discharged from the hospital. It provides them long-term planned treatment, Yang said.

Healthcare workers at the center also take training courses given by doctors on managing chronic diseases.

"Hospitals at county or district- level work as links between top-level hospitals and community healthcare centers by teaching grassroots healthcare workers what they have learned from experts at top-level hospitals," Yu said.

The center has set up health profiles for more than 400 people suffering from hypertension, but the workload to keep their medical records current is "very heavy" as only three doctors work in the center, Yang said.

"We need to record their every visit to our center, or call them on the phone or even visit them at home to monitor their health conditions," she said.

Yue Xiaoli, a doctor at Jinxiang Community Healthcare Center, which services more than 20,000 people, said the center has more than 2,000 patients suffering from hypertension, less then 60 percent of whom have current health profiles.

"There are four doctors and two nurses in our healthcare center. We often work late to update the medical records in their health profiles. The workload to cover all the hypertension patients in the community is too great," she said.

"We should issue guidelines, particularly for grassroots-level hospitals," she said.