The work by the developing primary care team in China: a survey in two cities

China introduced general practice into Beijing, the capital city, in 1986, and into Tianjin, a neighbouring large industrial city, in 1992. The original healthcare system was not designed on the model of today’s general practice in Western countries. Therefore, China is converting resources in the existing system into general practice and is training the medical teams for further development. For a few years, large cities in China have been running small sized primary care clinics in communes for primary medical care and disease surveillance. These clinics are often sited among residential units in communes with a moderately sized stable population. Each clinic is staffed by a team of five to six health workers headed by a doctor from the nearby regional hospital. Most regional hospitals also run out-patient clinics that are aimed largely at curative care of a more mobile population. Some hospitals reserve a number of beds for patients admitted through commune clinics. China has a primary care team slightly different from those of other countries. The team consists of nurses and different grades of doctors. Some doctors are graduates from university medical schools while some are high school graduates with 3 years of health/medical education and some receive 5 years of health/medical education after 3 years of high school. A small number of doctors have training in both Western and traditional Chinese medicine. The Training Centre of General Practice in Beijing has been running in-service training courses for members of the primary care teams in China since 1991. There are plans to introduce full-time post-graduate vocational training and professional examinations in the near future. Patients in large cities may choose different types of medical care under various types of medical insurance. The insurance may be paid by the individuals (private funding),