Blog | Tuesday, May 12, 2015

Barefoot doctors


The venerable New England Journal of Medicine published an opinion piece about why it's important for us to learn about the history and current practices of health care in China.

Since the Communist Party declared victory in the Chinese civil war in 1949, health care in the People's Republic has undergone rapid cyclical change, mirroring the various emphases the single-party government has proffered to its people from collectivism to free market capitalism and then somewhat back again when >90% of Chinese were left uninsured in what the authors of the piece describe as a movement to create professional norms for a medical profession that have not heretofore existed in China.

A good summary of the piece describing some of the implications can be found here. Other sources report that China is planning to double the number of primary care doctors in the country by the year 2020.

One concept worth learning about if you've never heard of it: “barefoot doctors.” Founding Premier Mao Zedong unleashed these “paramedical” folks into the countryside in the 1960s to offer help with prevention and primary care. One result: a stunning drop in infant mortality. The analogue in our own age is the concept of the community health worker, something that has garnered press and continues to be an alluring possible solution to our own problems of translating medical knowledge gains out into our communities.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.