Bridging gap with trust: Family doctors bring more Chinese to health management

Wu Guixia goes to the same consulting room in Desheng Community Health Service Center in Xicheng District, Beijing, nearly every month.

Wu, 60, pays her monthly visit to Gao Fengjuan, who is a general practitioner (GP) at the community health service center. She has been Wu's family doctor for about three years.

"Dr. Gao patiently listens to my problems, clearly explains how to take my medicine, and keeps track of my health. It makes me feel at ease," said Wu.

Wu is one of about 600 of Gao's patients. Gao is supported by experienced doctors from a nearby major hospital, a nurse and a pharmacist.

Gao's practice was set up in 2012. It is now one of seven in Desheng Community Health Service Center.

In overcrowded major hospitals, doctors are often too busy to fully connect with patients. But in community health service centers, with less patients, family doctors have more time for each visit.

"We family doctors pay attention to not only residents' diseases or symptoms but also their general health status," Gao said.

This holistic approach means that rather than simply "treating diseases," Gao uses the power of communication, and connection, to track the health and mental well-being of her patients.

"The customers talk with me about their life status, families and share their experiences with me," Gao said, "It is this relationship between patients and doctors that I value the most."

BRIDGING GAP

Four years ago, Gao was asked to establish "a pioneering family doctor studio."

Neither Gao nor her colleagues had the slightest idea what a "family doctor" was. Luckily, Gao had recently been in the U.K. to attend a GP training course at the University of Birmingham and she was able to share her experience with her colleagues.

Many of her colleagues had worked at health clinics across China, and so one question kept being asked; "What is so special and different about a family doctor studio?"

Ma Pengtao is Gao's clinic partner in the studio. She explained the main difference; "We collect detailed health information from each customer from the very start. Then we regularly trace their health and offer advice about how they could lead healthier lives, such as drinking less or exercising more," Ma said.

She talked about one patient who, due to alcohol dependency, had liver problems.

"I called him every other week to check up on him, making sure he was eating healthily and hadn't fallen off the wagon."

GPs are becoming the first port of call for patients, freeing up hospitals for emergency or specialist care.

The "Healthy China 2030" guideline, released in 2016, promised that the country's medical system will put more focus on prevention rather than treatment. Family clinics, and doctors like Gao, are on the front line of this fight, taking care of patients and identifying symptoms that might have been ignored in the past.

"People would often not pay much attention to early warning signs, and only see doctors when they had no other option," she said.

MORE TO GO

Currently, Gao sees about 50 people a day. Xicheng District, which was home to about 1.3 million people by the end of 2015, now has about 100 practices like Gao's,

According to the National Health and Family Planning Commission (NHFPC), China wants 30 percent of the urban population and 60 percent of priority groups, including seniors, pregnant women and patients with chronic diseases, covered by family practices in 2017.

The relatively low salary of family doctors compared with specialists at major hospitals, however, remains a challenge and must be addressed.

In Desheng Community Health Service Center, He Zhihong, deputy director of the center, explained that its doctors are paid bonuses related to the number of patients and their service quality.

"Every month we poll our patients about their satisfaction with the doctors," He said. "We want those who work better to be better paid."

Gao suggested a service fee might also be effective.

"If a family doctor receives a service fee from each patient, it will it generate more income and work as an incentive," she said.

In fact, such service fee has been launched in several areas in China.

In Xiamen in southeast China's Fujian Province, a family doctor receives a service fee of 120 yuan (17.45 U.S. dollars) for each patient per year, of which the customer only pays 20 yuan, and the rest is paid by health insurance and public health service budget.

During a national health conference earlier this month, the NHFPC chief Li Bin said the government will adjust family doctors' service fees, increase their income and provide more opportunities for their promotion and advancement in the years ahead. Endi