Research On The Predicaments Of Family Doctor Policy Implementation And Its Resolution

Since 2009,in order to meet the increasing demands of the people for medical and health services,and to solve the problems of aging of population,the change of the disease spectrum,high cost of medical treatment and unreasonable allocation of health resources,our government has issued a series of policy documents to promote the family doctor policy.The family doctor policy aims to provide community residents with timely,continuous,comprehensive and personalized contracted health care services through the platform of community health medical institutions,and family doctors will become the health gatekeeper of the residents.International experience has proved that the family doctor policy had a more significant effect in disease prevention,rehabilitation health care,as well as saving medical resources.Although the family doctor policy has a high realistic value,it still has many problems in the implementation.Based on the theory of public product,the theory of new public service and the theory of public policy implementation.Combines the text of policy with the practice of local family doctor policy,this paper studies the difficulties and causes of family doctor policy implementation to explore the ways to solve the predicaments.The study found that there are five main difficulties in family doctor policy,namely insufficient resources,goal realization predicament,interest coordination predicament,doctor incentive predicament and the policy social identity predicament.These predicaments are manifested in: firstly,eligible family doctors are extremely scarce,and the financial resources of policy implementation are obviously insufficient;secondly,the number of family doctors is not adaptable to a huge amount of work,and it is difficult to achieve the goal of policy;thirdly,hospitals fight for patients and talents with primary medical and health institutions;fourthly,the public health task of the family doctor is heavy,and the career attraction of the family doctor is low;fifthly,the social cognition and social acceptance of family doctor policy are relatively low.The main reasons for this phenomenon are as follows: The defects of the policy itself,the weak supervision and restraint mechanism of policy implementation,unsound mechanism of interest coordination between the hospital and the primary medical and health institutions,the imperfect incentive mechanism of the family doctor.Based on the predicaments of the implementation of family doctors' policies and the reasons of these predicaments,resolving the predicaments of implementing family doctors' policies should make efforts in the following three aspects to: firstly,improve the family doctor policy,improve the relevant supporting system and legal protection,and improve the feasibility of the policy objectives;secondly,strengthen the construction of family doctors,increase the financial support for the implementation of family doctors policies,and promote the construction of basic level health information service to improve the supply of policy implementation resources;thirdly,establish the system of performance evaluation and government accountability system to build an effective mechanism of policy implementation supervision and restraint;fourthly,widen the channels of interest expression in hospitals and primary medical and health institutions to promote division of labor and cooperation and improve the distribution of interests;fifthly,improve the level of income,social status and professional attraction of family doctors to improve the incentive mechanism of family doctors;sixthly,strengthen the family doctor policy propaganda,enrich the propaganda content,expand the publicity channels,correct the wrong understanding of the family doctors.