Beijing to Create a General Practitioner Team
Beijing’s Programme for Implementing Incentive Mechanisms to Reform and Improve the Training and Use of GPS was issued by the General Office of the Beijing Municipal Government on October 25, 2018 to encourage more doctors to become GPS. GPS are medical doctors who treat acute and chronic illnesses and provide preventive care and health education to patients.
Recently, the Information Office of the People's Government of Beijing Municipality held a press conference on reforming and improving incentive mechanisms for training and utilising general practitioners (GPS).
GPS are medical doctors who treat acute and chronic illnesses and provide preventive care and health education to patients. GPS manage conditions that may not be obvious at an early stage of development, but which may require urgent intervention. They provide individuals and families with ongoing, comprehensive and customised medical services and play an important role in the primary medical and health system. They are honoured as guardians of people's health.
At the end of 2017, Beijing's 334 community health centres in its 16 districts had a total of 5,927 GPS, which came to only 2.7 community-based GPS for every 10,000 residents on average. Eight percent of the GPS had a master's degree and 56.5 percent a bachelor's degree; 17.4 percent were clinical associate professors and 50.4 percent were holders of the intermediate professional title. The professional level of GPS in Beijing exceeds that of the rest of the country. However, GP jobs are not attractive to new medical graduates so some positions remain vacant and the total number of GPS in the city does not meet demands. The shortage of GPS is worse in the suburban areas. The city's existing GP team is short of high level professionals,
and its medical services need be improved. There is a plan to increase the ratio of GPS in the city to three per every 10,000 residents by 2020. Beijing needs about 1,500 GPS as per its predicted population of 23 million in 2020.
The CPC Beijing Municipal Committee and the Beijing Municipal Government are involved in building the general practitioner team and have made plans related to the implementation of the State Council's decisions regarding improving grassroots medical service systems and GP teams. The committee and the government engaged the Beijing Municipal Commission of Health and Family Planning in collaboration with the Beijing Municipal Education Commission, Beijing Municipal Human Resources and Social Security Bureau, Beijing Municipal Bureau of Finance and the 16 district governments to formulate Beijing’s Programme for Implementing Incentive Mechanisms to Reform and Improve the Training and Use of GPS based on surveys and studies. The programme was issued by the General Office of the Beijing Municipal Government on October 25, 2018. It specifies goals, tasks and measures for reforming and improving the training and utilisation of GPS by adopting incentive mechanisms from 2020 to 2030.
Establishing the Health Guardian System
The first part of the programme involves establishing reform goals and improving the training and utilisation of GPS by adopting incentive mechanisms from 2020 to 2030. According to the programme, by 2020, the GP education system will be enhanced and developed based on university education, graduate education and professional education. Incentive mechanisms for grassroots medical and health institutions will come into being to flatten the income gap between the institutions and regional public hospitals and encourage more medical graduates to take GP jobs in 2020. There will be three GPS for every 10,000 residents. By 2030, this will increase to at least five qualified GPS. The demands for the creation of a healthy Beijing will be largely met based on the coordinated development of the GP team and grassroots medical and health institutions.
Enhancing the GP Team
The programme also elaborates on 12 important moves for three crucial tasks: improving the GP training system, optimising incentive mechanisms for utilising GPS and upgrading GP services.
Improvement of the GP Training System
Improving the GP training system involves three important moves. First, it is necessary to deepen the reform of GP education. Universities offering medical specialty programmes are required to explicitly create a GP discipline. Qualified grassroots practice bases will be developed into teaching bases for universities or affiliated community health service centres. GP programmes will be offered, university professors with physician certifications are encouraged to register to practise with grassroots health organisations and engage in teaching general practice at those organisations as well. Eligible GPS will be granted professional titles corresponding to their academic degrees. The newlyadded postgraduate enrolment plan will give priority to the general practice discipline, and efforts will be made to explore a path to train general practice postgraduates. In the coming eight to ten years, 1,000 university graduates and 800 junior college graduates of clinical medicine will be trained for community health service institutions and village health outlets. In the coming five to eight years, 400 students of traditional Chinese medicine ( TCM) will be trained. Second, the postgraduate education system should be improved. Efforts will be made to establish and optimise a standardised training mechanism for GPS in hospitals. Hospitals are encouraged to employ GPS. The number of GPS recruited by hospitals in 2020 will account for 20 percent of the total number of resident doctors recruited in the same year, which is covered by the standardised doctor residency training plan. Comprehensive hospitals, which are designated as the standardised doctor residency training bases and the standardised assistant GP training bases should increase aspects related to general practice diagnosis and treatment, establish the general practice discipline and reform base performance appraisal to cover the development of the general practice discipline, GP recruitment, training quality, financial support for teaching at grassroots practice bases and employment of trainees. Third, further education will be enhanced. Measures will be taken to pilot the performance appraisal system for GP jobs, enhance the united further education platform for doctors in Beijing, develop Internet plus further education and long- distance training programmes, and emphasise further education as an important condition for reemployment, professional title application and regular examinations of GPS.
Efforts will be made to expedite the training of more key GP players. By 2030, the city will establish 20 key, municipallevel general practice departments and train 30 general practice leaders, 80 leading GPS and 100 key GP players. It will also implement a grassroots GP capability improvement plan, create grassroots GP diagnosis and treatment regulations, establish four or five municipal-level further education bases for GPS and carry out GP training. Core hospitals from the regional medical consortium will each send at least five experts annually to grassroots medical and health institutions such as community health centres. Each expert will spend a total of at least two months working, teaching and training at the institutions. GPS below the clinical associate professor level will be sent to the regional medical consortium's member hospitals to study for at least one month every two years. Clinical professor candidates will have to study at least six months in a regional medical consortium's member hospital before they can be promoted from clinical associate professor.
The GP profession will be expanded to include TCM and rehabilitation medicine by organising TCM training for grassroots GPS. Doctors from various medical institutions will be encouraged
A GP explains test results to a patient.