The Barefoot Doctors of the People's Republic of China — Some Problems

Abstract

Both Western visitors' and official Chinese accounts of China's rural health system indicate that the barefoot doctors have been an unqualified success, free from any problems. Scattered evidence in Chinese publications, however, suggests otherwise. The quality of the barefoot doctors is uneven because of their highly decentralized training and the emphasis placed on their political background. Some barefoot doctors, in spite of their lack of skills, have engaged in medical experiments without professional supervision. All are encouraged by party cadres to develop and use their own herbal medicines. Finally, low income and heavy work load may cause job dissatisfaction, leading to high turnover rates in some areas. Thus, the system of barefoot doctors, although it improved previously inadequate health care in China, is not without its disadvantages and should not necessarily be accepted as a model to emulate. (N Engl J Med 291:124–127, 1974)