Editor's note:

Xinhua reported in December that over 95 percent of Chinese cities had launched a program to provide family physicians, and more than 500 million people had signed a contract with a family physician, accounting for over 35 percent of the population by the end of November. The news has aroused many discussions on social media.

Song Shuli, a spokesperson with the National Health and Family Planning Commission, said a family physician is different from a private doctor. Since there is a great shortage of family physicians, they first provide service to people in greater need, including the elderly, mothers and children, the China Youth Daily reported. Song also said they are gradually improving the system of contracted family physician services at the grassroots level, which is an important part of establishing a hierarchical diagnosis and treatment system.

Metropolitan invited two family physicians at the Beijing United Family Hospital (BJU) to discuss the new trend and changes.

Chair of the Center for Family Medicine and Integrative Health Care Roo Changizi    Photo: Courtesy of BJU

Roo Changizi, chair of the Center for Family Medicine and Integrative Health Care:

Family practice is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases and parts of the body, playing a pivotal role in diagnosing and treating a wide range of diseases and maintaining the health of the individual and the community. In line with treating conditions, further emphasis is placed on promoting health, well-being and prevention.

For example, an excessive increase in body weight will increase the likelihood of diabetes, followed by high blood pressure, joint aches, poor sleep and/or sleep apnea. This causes fatigue due to inadequate oxygenation to the brain, heart and other vital organs. Fatigue causes lack of energy and inability to exercise successfully. The body then seeks "comfort food" laden with simple starches, fat and pure sugar, causing bodyweight to go up, which further increases cholesterol, bad lipids and triglycerides (fat), creating perfect conditions for heart disease and other metabolic conditions like diabetes, high cholesterol and fatty liver.

We now know that a number of cancers have a higher rate of occurrence in overweight patients. So, the focus should be on the health of the individual.

Numerous studies have shown that when individuals or communities have access to well-trained family physicians, there are fewer hospital visits, fewer hospitalizations and a quicker recovery.

The biggest challenges in Canada that are similar to China are the duration of the training and the shortage of qualified doctors.

Family physician services have been promoted in Canada for more than 50 years. In Canada, aspiring family physicians are expected to complete a residency in family medicine from an accredited university after obtaining their master's degree. After a two-year residency, graduates may apply to complete a third year, leading to a certification from the College of Family Physicians Canada in disciplines such as emergency medicine, palliative care and sports medicine.

Internal medicine physician at the Center for Family Medicine and Integrative Health Care Lucy Gao   Photo: Courtesy of BJU

Lucy Gao, internal medicine physician at the Center for Family Medicine and Integrative Health Care:

Specialist physicians and family physicians have different advantages. Compared with specialist physicians, family physicians might have a relatively wider range of knowledge. They are more likely to see the patients as a whole and make a judgment based on a comprehensive checkup and analysis of one's medical history.

At BJU, besides foreign patients, many Chinese patients with commercial medical insurance also ask to see a family physician first. Chinese patients now account for over half of the patients at our center, which shows that family medicine is being accepted by more people in China.

A family physician manages fixed patients long term, so he or she knows about them very well and does not need to ask the details of their medical history at each visit. To cultivate family physicians with the awareness of service, having enough knowledgeable and qualified physicians is one of the biggest problems that urgently needs to be solved in China.