村医发展历程及新时期发展路径分析

Analysis on History of Rural Doctors and Development Path in New Period

通过文献梳理和现场调查,根据重要政策或事件将乡村医生的发展历程划分为4个有代表性的时期:村医的辉煌时代、集体经济瓦解后的村医、乡(镇)村一体化后的村医和新医改后尴尬的村医群体,总结了不同时期村医相关的政策特征和制度载体、服务模式和收入结构。从乡村医生服务的目标群体和服务特征出发,探讨了乡村医生服务对村民及基层医疗卫生工作的价值,提出逐步改变乡村医生身份、持续培训和改善村卫生室设施等发展路径,以改善村医生存状况,促进农村医疗卫生工作发展。

Through literature review and filed study, this paper characterized the history of rural doctors into four typical periods, including the golden age of rural doctor, the age after collective economic, the age of integration of the villagesand towns and the age after the new healthcare reform. The different characteristics of policies, the carriers of systems, the service models of rural doctors and income constitutions were analyzed. Besides, by identifying＇the service targets and features of rural doctors＇ services, this paper discussed the important value of rural doctors＇ services for rural residents and primary health care. In the end, the authors advocated to change the identity of rural doctors, provide continuing training, promoting facility of rural clinics and improving the living status of rural doctors in order to promote the development of rural health care.