China is pursuing an ambitious program of reform to improve the public healthcare system. The government has been conducting this medical reform for over a decade. Now we continue our special series to look at those efforts and achievements. Nearly half of Shanghai’s residents have signed up to a tiered medical care system. They now have access to a family doctor, a district-level hospital and a city-level hospital.

Today is a weekend, but this medical service centre is still busy. Many residents who live nearby come here to see doctors and get their medicine. 62-year-old Mr. Gong suffers from cardiovascular disease. He needs to take medicine long term to keep fit after surgery. He chooses to visit the medical service centre nearby rather than a city-level hospital.

"It usually takes me half an hour just to go to the big hospital. And let alone the waiting time. Sometimes it is hard to get a number. Now I only need five minutes to see the doctors just close to my own place. I can get all the prescription medicine from my family doctor. She can also help me to get numbers from the big hospital because family doctors enjoy the privilege that can use to their patients."

Dr. Yang is a family doctor in this community. Apart from taking care of patients who are able to see her in person, she also uses her lunch break to look after those who find it inconvenient to come to the center.

To encourage more people to join the scheme, Shanghai launched reforms of the tiered medical care pilot project.

According to the plan, the city's medical service centre is divided into three categories depending on their distance. Each category will have a bonus of 6,000, 4,000 and 2,000 yuan accordingly based on evaluations, such as workload and feedback from patients.

It's made the position a lot more attractive to doctors. Dr. Lin Hui has trained as a general practitioner for the past six years. She can choose either to stay in the medical service center or to apply for a district or a city-level hospital. But she chose to stay in this medical centre in a town.

"The new policy is very encouraging. Our medical service centre is far away from the city so it listed in category A which means if we work well we can have six thousand yuan bonus each month. It is 70-thousand yuan more than before. It is not only about the money, I think it is also a confirmation of our past work. It is very encouraging," Lin Hui, general practitioner with Datuan Medical Service Center, said.

In order to relieve hospital crowding, the family doctor program was set up to encourage patients to choose between going to a hospital for their initial diagnosis, or visiting their regular family doctor. It's part of efforts to push the tiered medical care project.

Based on the official figures last year, community level medical centres across the city provided nearly 8, 500 medical services. 57-percent of elderly people aged above sixty choose to see doctors in the community medical centres.

"We have two goal of this new round of medical reform among communities. First, we want to make the family doctor system become a more comprehensive one. Second, with the solid family doctor system we’ll be able to push forward our tiered medical care project," Wu Jinglei, director of Shanghai Health & Family Planning Commission, said.

So far, there are 5,000 general practitioners like Dr. Lin Hui across Shanghai’s remote communities. The city plans to equip all of its 240 community health centres with family doctors by the end of this year, and to require all of its residents to sign up with them by 2020.