economics Paradigm Challenge

Hiring more doctors in China actually made it harder for patients to get medical care.

SSRN · March 18, 2026 · 6426311

Yang Wang, Ying Pan, Hua Jin, Hui Yang, Dehua Yu

The Takeaway

China's massive expansion of its General Practitioner workforce was negated because the new doctors are forced to spend over 40% of their time on 'compliance-driven administrative mandates.' This 'functional shortage' means that nominal staffing increases actually erased one-third of the country's clinical capacity as paperwork swallowed the new hires.

From the abstract

Background: China's primary care reform faces a critical challenge: nominal workforce expansion often masks functional capacity deficits. This study quantifies the "functional shortage" of General Practitioners (GPs) in Shanghai, investigating the structural misalignment between clinical roles and administrative mandates.<br><br>Methods: We conducted an exploratory sequential mixed-methods study within the Shanghai General Practice Research Network. Initial qualitative interviews with 22 GPs inf