Bei­jing to Create a Gen­eral Prac­ti­tioner Team

Beijing (English) - - CONTENTS - Trans­lated by Zhang Hong­peng Edited by Justin Davis Pho­tos by Ma Ke, Zhang Zongyun

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.

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