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Family doctor concept hits home
By Xu Wenwen |
August 18, 2010, Wednesday
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Print Edition
Print Edition
Sir Run Run Shaw Hospital is cooperating with an American medical center to train Zhejiang Province physicians in family medicine. It's part of a national initiative to reform the country's health care system, reports Xu Wenwen.
Doctor Prabhat Pokhrel from America examines foreign patients at Sir Run Run Shaw Hospital, affiliated with School of Medicine, Zhejiang University in Hangzhou. It's his fourth week at the hospital. As a family doctor with more than 20 years' experience, he is here to help instruct family doctors and establish the family medicine system.
A family doctor, who treats illness for all ages and both sexes, is a fresh concept to Chinese who usually go to hospitals when they get sick. Once at hospital, the first step is to decide which department to register.
But it's not the most efficient system. For example, a stomachache can be caused by an upset stomach, indigestion or even hyperthyroidism. Thus a patient may need to register at several departments for tests before a doctor makes the correct diagnosis.
Thus the Chinese government has recently released a plan to train 60,000 family physicians nationwide in three years. Every 10,000 residents would share one or two family doctors, while every village clinic would feature one family doctor by 2013.
By the end of 2020, it is estimated 300,000 general doctors will be trained through various methods.
Currently, most Chinese doctors are specialists such as surgeons or pediatricians. Only a few hospitals feature general practitioners, and very few medical universities offer the major.
The small number of general physicians mainly work at community clinics, schools and manufacturing companies. Though they all finished medical school, only a few have received GP training in college.
In some European countries, a family doctor or family physician is equal to a general practitioner. In North America, the term general practitioner refers to those who finish medical school but did not complete a family medicine residency. Here, a family doctor refers to those with professional training, and general practitioners are those who received medical school training and do not work as specialists.
Although the GP concept started in China in the 1980s, the public doubted their medical skills and seldom visited them. The public believed in the superficial stereotype that GPs work at small clinics because they are not qualified to work in big hospitals.
The public preferred big hospitals even for minor ailments. Big hospitals soon became overcrowded and people started complaining about the long queues while doctors in grass-root clinics were under utilized.
"People love big brands, but good doctors also are there in communities," says Fang Lizheng, general practice director of Sir Run Run Shaw Hospital.
Apparently, it's a waste of resources, and the above-mentioned plan is to balance the system so that minor illnesses can be treated at clinics.
"It's time to further develop the medical system because where there is demand, there is supply," Fang says.
However, there is a long way to go since the country has few academies teaching family medicine and training a family doctor takes time.
Sir Run Run Shaw Hospital has developed long-term cooperation with a foreign academy.
As the first public hospital on the Chinese mainland accredited by the US-based Joint Commission International, the hospital cooperates with Genesys Regional Medical Center in Michigan, a center with a history of more than 80 years.
Three months ago, the two medical organizations approved a three-year program to establish a clinical training base for family doctors at Sir Run Run Shaw Hospital.
The program plans to trains 65 family doctors within three years. The doctors will be from Sir Run Run Shaw Hospital, other city hospitals and neighborhood clinics. Once trained, they will then train others in family medicine.
Doctor Pokhrel is one of several foreign instructors from Genesys. They are responsible for helping establish the system of family medicine and educate Chinese doctors. Considering they have work responsibilities in America, each foreign doctor will visit Hangzhou for two months in turn during the three-year program.
"We endeavor to find out what is needed in China," says Pokhrel.
His daily routine at the hospital includes visiting foreign patients, teaching classes in the hospital and in communities, as well as establishing Sir Run Run Shaw's family medicine program.
Doctor Zhang Lihui from a community clinic in Xiasha District has taken several classes given by the American doctor. He says he has found that the Western system of family medicine or general practice is much wider in scope than he expected. He says a Western family doctor gives patient physiological treatment coupled with psychological therapy, which is not emphasized in China.
Though more doctors and residents are aware of the significance of family medicine, to educate substantial family doctors needs time - in America, it takes eight years. So, the three-year program is only a start, the hospital says.
"We will probably continue to cooperate with Genesys beyond the three years if possible," says Sun Xiaomin, director of the Center For International Collaboration at Sir Run Run Shaw Hospital. "And to test the effectiveness of the first phase, the hospital plans to apply for ACGME accreditation in three years."
ACGME (the Accreditation Council for Graduate Medical Education) is responsible for the accreditation of post-MD medical training programs within the United States.
Doctor Prabhat Pokhrel from America examines foreign patients at Sir Run Run Shaw Hospital, affiliated with School of Medicine, Zhejiang University in Hangzhou. It's his fourth week at the hospital. As a family doctor with more than 20 years' experience, he is here to help instruct family doctors and establish the family medicine system.
A family doctor, who treats illness for all ages and both sexes, is a fresh concept to Chinese who usually go to hospitals when they get sick. Once at hospital, the first step is to decide which department to register.
But it's not the most efficient system. For example, a stomachache can be caused by an upset stomach, indigestion or even hyperthyroidism. Thus a patient may need to register at several departments for tests before a doctor makes the correct diagnosis.
Thus the Chinese government has recently released a plan to train 60,000 family physicians nationwide in three years. Every 10,000 residents would share one or two family doctors, while every village clinic would feature one family doctor by 2013.
By the end of 2020, it is estimated 300,000 general doctors will be trained through various methods.
Currently, most Chinese doctors are specialists such as surgeons or pediatricians. Only a few hospitals feature general practitioners, and very few medical universities offer the major.
The small number of general physicians mainly work at community clinics, schools and manufacturing companies. Though they all finished medical school, only a few have received GP training in college.
In some European countries, a family doctor or family physician is equal to a general practitioner. In North America, the term general practitioner refers to those who finish medical school but did not complete a family medicine residency. Here, a family doctor refers to those with professional training, and general practitioners are those who received medical school training and do not work as specialists.
Although the GP concept started in China in the 1980s, the public doubted their medical skills and seldom visited them. The public believed in the superficial stereotype that GPs work at small clinics because they are not qualified to work in big hospitals.
The public preferred big hospitals even for minor ailments. Big hospitals soon became overcrowded and people started complaining about the long queues while doctors in grass-root clinics were under utilized.
"People love big brands, but good doctors also are there in communities," says Fang Lizheng, general practice director of Sir Run Run Shaw Hospital.
Apparently, it's a waste of resources, and the above-mentioned plan is to balance the system so that minor illnesses can be treated at clinics.
"It's time to further develop the medical system because where there is demand, there is supply," Fang says.
However, there is a long way to go since the country has few academies teaching family medicine and training a family doctor takes time.
Sir Run Run Shaw Hospital has developed long-term cooperation with a foreign academy.
As the first public hospital on the Chinese mainland accredited by the US-based Joint Commission International, the hospital cooperates with Genesys Regional Medical Center in Michigan, a center with a history of more than 80 years.
Three months ago, the two medical organizations approved a three-year program to establish a clinical training base for family doctors at Sir Run Run Shaw Hospital.
The program plans to trains 65 family doctors within three years. The doctors will be from Sir Run Run Shaw Hospital, other city hospitals and neighborhood clinics. Once trained, they will then train others in family medicine.
Doctor Pokhrel is one of several foreign instructors from Genesys. They are responsible for helping establish the system of family medicine and educate Chinese doctors. Considering they have work responsibilities in America, each foreign doctor will visit Hangzhou for two months in turn during the three-year program.
"We endeavor to find out what is needed in China," says Pokhrel.
His daily routine at the hospital includes visiting foreign patients, teaching classes in the hospital and in communities, as well as establishing Sir Run Run Shaw's family medicine program.
Doctor Zhang Lihui from a community clinic in Xiasha District has taken several classes given by the American doctor. He says he has found that the Western system of family medicine or general practice is much wider in scope than he expected. He says a Western family doctor gives patient physiological treatment coupled with psychological therapy, which is not emphasized in China.
Though more doctors and residents are aware of the significance of family medicine, to educate substantial family doctors needs time - in America, it takes eight years. So, the three-year program is only a start, the hospital says.
"We will probably continue to cooperate with Genesys beyond the three years if possible," says Sun Xiaomin, director of the Center For International Collaboration at Sir Run Run Shaw Hospital. "And to test the effectiveness of the first phase, the hospital plans to apply for ACGME accreditation in three years."
ACGME (the Accreditation Council for Graduate Medical Education) is responsible for the accreditation of post-MD medical training programs within the United States.
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