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Will Doctor-patient 'Contracts' Bolster Chinese Healthcare?

The Chinese government plans to promote community clinics in 200 pilot cities by encouraging patients to enter into contracts with teams of community-level doctors, but the public distrusts the quality of bottom-tier clinical care

By Xie Ying Updated Jun.11

As Chinese medical specialists and the best medical equipment are generally found only in the country's top-tier hospitals, patients would rather wait for hours for a chance at an appointment at the big hospitals than go to community clinics. Therefore, when the healthcare reform office of China’s State Council published on Monday a guidance document on using "contracts" to build up community-level medical services in 200 pilot cities, the public questioned the move harshly.  
According to the document, this pilot program aims to ease the pressure on top-tier hospitals by redistributing their patients to community-level clinics. It encourages community residents to enter into contracts that say they will receive medical care from a specific community medical team of their choosing. Team members will include family doctors, nurses, healthcare consultants and even psychologists. The contracts will last for a year, at which time patients can switch medical teams. To incentivize patient participation in this program, people with contracts will receive some preferential treatment. For example, a certain percentage of appointments with specialists will have to go to those with contracts. 
The government believes that this program will allow patients to get better services more efficiently, but the public remains skeptical. Some doubters are worried about the price and many others have questioned the quality of community-level medical care.  
"Few good doctors are willing to work at bottom-tier hospitals and clinics due to low salaries and poor facilities," said one netizen. Another commented: "If you don't agree with the doctor you signed with, you can't switch, can you? Regardless of whether or not we sign, you can't deprive patients of the right to choose their doctors."  
Many netizens expressed that the success of this pilot program depends on whether or not the government will figure out a way to more fairly distribute high-quality doctors and resources. They have called upon the government to publicize the details of this program's implementation as soon as possible.