如果把赤脚医生也当作全科医生，那么我国全科医生早已存在，而全科医生制度却在历史地反复着，至今才在重建。在今年4月，广州市关于以全科医生为重点的基层医疗卫生人才队伍建设实施意见的通知就提到“2012年底，实现城市每万名居民有1-2名全科医学专业的执业医师”，“到2020年，实现城乡每万名居民至少有3名全科医生”。

If the barefoot doctors also as a general practitioners,So our country general practitioners already exists,And the general practitioner system is in the historical repeatedly,So far only in reconstruction.In April this year,Guangzhou about the general practitioners is the focus of the basic medical and health personnel team construction implementation opinions to the notice"By the end of 2012,To realize the city every residents have 1 - two general medical professional practice physician","By 2020,To realize urban and rural residents per at least three general practitioners".

　　全科医生是国际通行的做法，在实践的考验中也得到了肯定。在国外听到“我约了我的医生”说的就是全科医生General Practitioner(GP)。资料显示，澳大利亚的全科医生数量约21000名，占注册医师的大部分，在社区卫生服务中，全科医生担任着“守门人”的角色，为当地居民提供健康咨询、预防保健和常见病的诊断治疗等，并对慢性病和康复病人主动追踪观察。病人大多要经过他们转诊去医院接受专科和入院治疗，出院后又继续接受他们的治疗。不难看出，澳大利亚的GP承担着重任。

General practitioners is the international prevailing practice,In the test of practice in also get the affirmation.In foreign heard"I have an appointment with my doctor"Say is General practitioners General Practitioner(GP).Data shows,Australia's general practitioners number about 21000,Accounts for most of the registered doctors,In the community health service,General practitioners holds"porter"role,For local residents, to provide health consultation/Health care and prevention of common diseases diagnosis and treatment, etc,And the chronic illness and rehabilitation patients active tracking observation.Most patients to pass their referral to the hospital to accept specialized subject and to the hospital for treatment,After discharge and continue to accept their treatment.It is easy to see,Australian GP bear the burden.

　　对于我国来说，全科医生也应该是社区居民健康的“守门人”。他们在社区为群众提供健康咨询、健康教育，突出“预防为主”的重点，另外是起到合理分诊分流病人，减少患者看病的盲目性，节省患者看病费用，真正使医疗下沉，实现“首诊在基层”的目标，以解决群众“看病难，看病贵”问题。但是，在我国，全科医生也应验了那句话“理想很丰满，现实很骨感！”首先，全科医生需求量巨大。按制度的要求，仅广东省需要2万-3万人，可目前注册者仅千人左右。广州常住人口1270万，那只有把全省的全科医生都集中到广州，才有可能达到要求。其次，全科医生的培养问题。“5+3”的培养模式是非常理想的计划，广州部分医学院校早有行动。可是，培养人才是个漫长的过程，虽然还有转岗培训更快速扩充全科医生队伍，但一时半会还难以满足需要。因此全科医生一时不可“豪华”登场，应发挥现在乡医的积极作用。

For our country,,General practitioners should also be community residents health"porter".They in the community for the masses to provide health advice/Health education,outstanding"prevention"key,In addition is a reasonable FenZhen shunt patients,To reduce the blindness of patients to see a doctor,Save patients expenses to see a doctor,Make medical sink,realize"First diagnosis in the basic unit"goal,In order to solve the"See a doctor difficult,The doctor your"problems.but,In our country,General practitioners also fulfilled the words"Ideal are very plentiful,Reality very bone!"First of all,General practitioners huge demand.According to the requirements of the system,Guangdong province only need 20000-30000 people,But at present registered person only about one thousand people.Guangzhou a permanent population of 12.7 million,The only put the province's general practitioners are concentrated to guangzhou,Can be meet the requirements.secondly,The cultivation of general practitioners problem."5 + 3"The training mode is very ideal plan,Guangzhou part of the medical colleges and universities has long action.but,Talents training is a long process,Although there are job-transfer training more rapid expansion of general practitioners team,But at that time the half will also difficult to meet the demand.Therefore a general practitioners do not"luxury"debut,Should play the positive role of medical now township.

　　说到服务人口数量问题，我们对照下意大利。意大利共有3036个值班医生服务站，共有18000名医生。在节假日、夜晚和周末可以找值班医生，下班时间找不到全科医生和儿科医生的情况下由值班医生提供服务。作为意大利国民健康保险体系的雇员，值班医生不允许另签合同。如需要，值班医生可将患者转诊至医院。或者，患者可直接去医院的急诊科。这也就是说，意大利的全科医生除了服务的人口数比我们少之外，他们还有值班医生，减少他们的工作量，从某种意义上说，全科医生还有助理，这个是我们远远比不上的。国际上第一批全科医学住院医师培训项目早在1966年在英国、加拿大等国启动，这个年代也就是我国因陋就简地开展赤脚医生制度的时期，时间发展上无差距，相反当时我们的重视程度远远超过他们。但是时过境迁，我们在否定自己的时候，别人已经大大超越我们，因此在观念上，在政府的主导下我们必须努力补课。相比公立医院改革，全科医生制度如果用心去搞的话一定比前者的效果来得快和实在！

Said to service the population problem,We control the Italian.Italy 3036 duty doctor service station,A total of 18000 doctors.During the holidays/Evening and weekend can find the doctor on duty,Quitting time can't find general practitioners and pediatric doctor's case by the doctor on duty to provide services.As the Italian national health insurance system employees,The doctor on duty don't allow another sign a contract.If need,The doctor on duty can be patient referral to a hospital.or,Patients can be directly go to a hospital emergency department.This also means,Italian general practitioners in addition to service the population of less than us outside,They have the doctor on duty,To reduce their workload,In a sense,General practitioners and assistant,This is our not far from the.The first group of international general medical resident training program in early 1966 in Britain/Canada and other countries start,This is also our country s roughing it to carry out the barefoot doctors system period,Time development no gap,Instead when we attention is far more than they.But as time passes by,We in the negative his time,The other people have been greatly beyond our,So in ideas,Under the guidance of the government, we must try to make up a missed lesson.Compared with public hospital reform,General practitioners system if work hard to make words must be better than the effect of the former faster and really!

　　全科医生直接关系到疾病的防控、民众健康水平的提高和费用的合理控制，因而除了制度的保障之外，还要提高全科医生的质量和全科医生的收入。“赤脚医生”和当今全科医生的概念发生了质的变化，假如以过去的理念与今天的财力结合在一起，我们一定可以做得很好的。赤脚医生是当地工分值最高的——这就是补偿政策和考核制度了。如果制度偏差了，就会出现出勤不出力和造假的现象。广州实行试行按年收取服务费的制度很好，它是由医保基金、基本公共卫生服务经费和签约居民个人分担。至于这三者怎么分担，全科医生的劳动价值如何衡量是很重要的。在美国，家庭医生的收入应该说是比较低的，是三口之家平均年收入的2.5倍。举个例子，宾夕法尼亚州的三口之家平均年收入是55006美元，那么宾夕法尼亚州一个家庭医生的年收入是14万美元。中国呢？据卫生部的统计数据，北京市区的三口之家平均收入是65000元人民币，北京市区的初级保健医生的平均年收入达到2.5倍，也就是16万元人民币，事实上根本不能达到。可见，中国全科医生的价值被低估了！

General practitioners directly related to the prevention and control of the disease/The public health and raising the level of reasonable control of the cost,So in addition to the security of system outside,To improve the quality of general practitioners and general practitioners income."Barefoot doctor"And today's the concept of general practitioner has had the archery target change,If in the past and the concept of today's financial resources together,We can do a good job.Barefoot doctor is the local point value of the highest - this is the compensation policy and the assessment system.If the system deviation,Will appear attendance not output and the phenomenon of cheating.Guangzhou implement trial by the year the service charge system is very good,It is made up of the medical insurance fund/Basic public health services funds and signing resident individuals share.As for these three how to share,General practitioners of labor value measure is very important.In the United States,The income of the family doctor should say is low,Is the family of three average yearly income of 2.5 times.For example,Pennsylvania 3 home average annual income is $55006,So a Pennsylvania family doctor annual income is $140000.China??According to the ministry of health statistics,Beijing downtown 3 home average income is 65000 yuan RMB,Beijing urban primary care doctor's average year income reached 2.5 times,Also is 160000 yuan RMB,In fact can't reach.visible,China's general practitioners is undervalued!

　　全科医生直接关系到疾病的防控、民众健康水平的提高和费用的合理控制，因而除了制度的保障之外，还要提高全科医生的质量和提高全科医生的收入。 (廖新波 广东省卫生厅副厅长)

General practitioners directly related to the prevention and control of the disease/The public health and raising the level of reasonable control of the cost,So in addition to the security of system outside,To improve the quality of general practitioners and improve the income of the general practitioners. (Manifold new wave "said guangdong provincial health bureau deputy director)