The most eye-catching items in Yan Li's nine-square-meter office are piles and piles of case histories on her narrow table and a makeshift bed for patients in this community of 10,150 people from 4,083 households. Yan Li, a 27-year-old doctor in a community health clinic in Xicheng District of downtown Beijing, said 300 of the 1,000 cases were "active," which means the patients visit the clinic regularly as per their doctors' instructions. Yan is so familiar with these documents that people will be amazed by the speed with which she can locate a specific case history.

Of course, Yan knows the patients even better. On a typical working day recently, she saw eight patients in the morning, ranging in age from 55 to 83 years old, and suffering from chronic diseases.

Throughout the morning, Yan talked slowly and loudly to her patients, repeating herself often. Spending 20 to 25 minutes on each patient, she hardly stopped for a break. But, she said, the time she got with every patient is what distinguished her from her peers in big hospitals. "People always complain about doctors' nonchalant three-minute talk in big hospitals, yet I can understand their difficulties; after all, they have long queues of patients waiting outside the door," said Yan Li.

China is ending a 20-year-old medical reform that has been "basically unsuccessful" as concluded by a two-year study by a think tank under the State Council released last July. In 2000, the country bore the humiliation of being ranked 188 among 191 countries by the World Health Organization in terms of the fairness of medical resources. The Chinese Government is changing course toward a community-based health care network consisting of tens of thousands of doctors like Yan Li to serve the health needs of its urban population.

After reading a blood test report, Yan praised a 59-year-old diabetes patient for controlling his blood glucose level well and asked her details of her diet control that she could share with other patients. An 82-year-old victim of heart disease, who came for regular medication for blood pressure control, grumbled about his wife's reluctance to go to hospital for a blood test despite the symptoms of diabetes. Listening to the old man complaining about the tension over disagreements, Yan said the wife might be suffering from depression and suggested she should be taken to see a professional psychiatrist. Lu Fengzhang, 75, who has been suffering from heart disease and diabetes for years, came for a blood test. Based on his weight and height, Yan calculated the amount of rice Lu could take every day and instructed him to eat more vegetables. Before Lu left, Yan told him that she would call to inform him of the time of an upcoming lecture on stroke prevention.