Family doctors prove their worth across district
Print Edition
Pan Xiangdong is a general practitioner at Changning District’s Hongqiao Community Health Service Center after graduating from medical school at Shanghai Jiao Tong University in 2000.
He’s also one of the first family physicians in the district, responsible for the Changshun neighborhood since 2008.
The responsibility is heavy and having solid skills and knowledge is crucial. Family physicians form close ties with residents, learning about patients’ needs and bringing help to their doors.
“During the decade I gave working in community health service, there are also gains,” Pan wrote earlier in his blog. “After a while, my patients would stop and chat every time we meet. In that moment no matter whether you remember what you’ve done for them or not, you feel happy and satisfied. Their recognition for your work as well as the trust also means lots of responsibility.”
His professional ability and good service earned him 1,825 residents to sign contracts with him, with effective contract at 84.19 percent.
In Changning, there are four community health centers, four health service stations and 17 groups of family physicians who work in densely populated areas.
Changing the system
As the first district to have family physicians, only 217,000 of the 710,000 permanent residents signed contracts with 149 doctors.
“We’ve been talking about changing people’s way of getting medical services and improving trust in family doctors. The high signing rate alone won’t realize the goals for classified diagnosis and treatment,” said Jiang Ping of the district’s health and family planning commission.
A survey of Chengqiao neighborhood community showed seniors are most in need of health care services.
With that in mind, the district worked with health insurance departments on a new management model called “efficient contract,” which focuses on the needs of seniors with various chronic diseases.
Family physicians spend two days at the outpatient clinic in the community health center, two days at stations and one day for house calls.
More than half of the residents who have contracts with a family doctor resolve their basic medical needs in the community. Without the pressure of seeing more patients, doctors can focus on providing better care.
Qiu Ye is a family doctor stationed in the less populated Tiandu area that’s far from the community health center.
“In the beginning the outpatient department had few visitors and I was a bit worried,” Qiu said. “But over time we earned the trust of residents and we have patients coming over every weekday.”
The family doctor system also requires strong technical support. Remote support centers handle wound dressing, along with ECG ultrasound and radiological tests.
It means when residents take an electrocardiogram or ultrasound, the report will be confirmed remotely by expert doctors from a tertiary hospital. Last year, 38,205 people received this service.
The district has also built a bridge between general practices and specialized practices. Huadong Hospital in the district has 10 expert teams working with 10 community health centers.
The hospital also has designated reception windows for patients referred by family doctors.
General practitioners have referral notices that lead directly to higher level hospitals.
Another key issue is finalizing the list of medicines. In addition to the essential drug list, each community health center will be able to add 30 drugs according to the needs of chronic disease patients. The family doctor will file a request first, then the center will decide whether or not to stock the drug.
There’s also long term prescriptions, where patients can get a month of medicine in advance. The result shows that adding 30 more drugs will meet the needs of most residents, saving money and improving efficiency without wasting medicines.
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