Medical circuits to serve isolated and remote villages without resident doctors

China plans to institutionalize sending rural doctors to isolated and remote areas on a regular basis by 2025, as part of efforts to address the shortage of medical workers in the most undeveloped areas of its countryside, according to a recent circular.

For villages with small populations where recruiting a rural doctor is not viable due to limited demand, as well as for relocated communities that do not yet have their own medical facilities, local health authorities are to arrange for township-level health centers to set up a medical services circuit, and for county-level health institutions to offer technical support.

The circuit team should comprise clinical physicians, TCM doctors, nurses, public health specialists and support staff. They should offer their services at least twice a week, with each round lasting no less than half a day, according to the circular.

The circular was released by the National Health Commission in March, in conjunction with the National Administration of Traditional Chinese Medicine and the National Administration of Disease Prevention and Control.

"Medical circuit teams should arrange service hours according to the living and working habits of rural populations, to provide them with access to high-quality, basic healthcare service on their doorsteps," it stated.

In addition to circuit services, the document stated that medical workers from township-level medical institutions will be dispatched to villages with large populations that have been unable to recruit qualified rural doctors.

"Medical workers sent to village clinics should work at least five days a week, and work in the same village for no less than six consecutive months," the circular stated.

In addition, medical circuit teams and aid workers will be tasked with training local doctors to manage common and major illnesses, and will be encouraged to set up telemedicine cooperation networks to offer diagnosis and treatment to patients.

In a statement explaining the rollout of the new document, the commission said that there is currently a marked shortage in healthcare capacity in some rural regions, and becoming a rural doctor has low appeal to job seekers.

"It is likely that the previous situation of villages without local doctors could reemerge…and so we have introduced these new measures to allocate quality medical services to the grassroots level, and increase the access of rural people to convenient and affordable healthcare services," it said.

Dai Jianjun, president of the People's Hospital of Jinxiang County in Jining, Shandong province, told China Central Television that the hospital has opened outposts at 14 township-level clinics and community service centers in Jinxiang county, and regularly dispatches 56 specialists to see patients, visit wards and train rural doctors.

Zhang Xiaojuan, a doctor from the endocrinology department at Sichuan University's West China Hospital in the provincial capital of Chengdu, recently participated in a medical assistance program to a far-flung county in Sichuan's Liangshan Yi autonomous prefecture.

"Through communication with local doctors, we identified new problems, such as the importance of reminding them to identify and transfer patients with rare and chronic disease to higher-level hospitals," she said, adding that most were used to sending only patients in critical condition to larger hospitals.