HAVING a family doctor is not a new thing anymore in Hangzhou. Over the last two months, more than 250,000 residents have signed contracts with about 700 general practitioners.
The project named “Providing Medical and Nursing Services for the Aged in Hangzhou Urban Area” has been up and running since October and is the first of its kind on the Chinese mainland. The GPs are based in community clinics.
Wang Fang, a GP at Meizheng Bridge Community Clinic, said, “I keep telling all my new patients: ‘After signing the contract, I will be your family doctor. I will do routine health checks and follow-up. If you have any non-emergency illness, come to me first and I will check if it is necessary for you to go to a large hospital to see a specialist’.”
She has about 300 patients and keeps their medical records online, which can also be accessed by doctors at the city’s main hospitals.
All Hangzhou urban residents with social medical insurance are able to go to any community clinic to sign a contract with a family doctor. Now is a promotion period but the project formally starts on January 1, 2015.
During next year’s trial period residents do not need to pay anything for the service. After that the annual contract will cost 120 yuan (US$19.44) although the government will cover 108 yuan for each person to sign up with a family doctor. Patients will still have to pay for any medication prescribed by the doctor.
Given that one doctor manages hundreds of patients, only the disabled and paralyzed or those who are too sick to move can have home visits by GPs.
One of the main goals of the project is to reduce the burden on large hospitals.
“It is a trend to steer patients who are not extremely sick to clinics and free up resources at hospitals,” said Zheng Xianlan, a nurse at Meizheng Bridge Community Clinic. “Large hospitals obviously have too many patients.”
Wang said patients can save time by seeing a family doctor when they are not seriously sick.
An added benefit of the GP system is that if a patient needs to see a specialist, the family doctor can book an appointment, which beats waiting in line for hours.
General practitioner Yuan Xianghong, who works at Yuewang Road Community Clinic, said last month he sent one of his patients to a hospital for surgery. Yuan said the 65-year-old man surnamed Shen had an irregular heartbeat, including a three-second period where it didn’t beat once.
While the old man hesitated, Yuan contacted an expert at Zhejiang No. 2 People’s Hospital who strongly recommended Shen have surgery.
“It is a typical example,” said Yuan. “In most Chinese hospitals there are so many departments and patients need to decide on their own which one to get to. But if they see a GP first, they will have more information and know exactly which department to visit.”
However, there are still some wrinkles to be worked out with the family doctor system. For starters, a GP can have a maximum of 1,500 patients. More than 85 percent of seniors expect home visits by family doctors, according to a Qianjiang Evening News survey.
Health authorities admit the system needs improvement but add that they are committed to making it work.
“Maybe in the future every household will have a health monitoring device and these wearable devices will help family doctors,” said Teng Jianrong, director of the Hangzhou Health and Family Planning Commission.
The city has also been promoting a series of “smart medical treatment” strategies for the past two years.
This includes making appointments with doctors online, picking up medical test results at machines and hospitalized patients receiving text messages of their daily fees.
“According to our figures, ‘smart medical treatment’ saves an average of one hour for each patient,” said Teng.
Source: Shanghai Daily