The development of the clinical diagnosis and treatment technology combined with general practice and specialist in the community is an important measure to improve the comprehensive service level of community health centers (CHCs), promote the more reasonable medical order, and implement hierarchical medical system. In this article, we find that most of CHCs in the city have carried out the clinical diagnosis and treatment technology combined with general practice and specialty, by analyze the documents related to the development of community health in Shanghai and published literature, and combine the survey results of these technologies carried out by Shanghai community health centers. It has become an important strategy for CHCs to improve their clinical capacity, the development of these technologies, by focusing on common and frequently-occurring diseases in the community, and combining its own medical advantages, to select appropriate disease types. However, during the development of the clinical diagnosis and treatment technology combined with general practice and specialist, there are some difficulties, such as the lack of relevant talents in the community and awareness of some experts on community specialized services, the difficulty of in-service education of general practitioners, besides, specialized drugs in the community and brand publicity on community characteristic technologies are also indispensible. The development of the clinical diagnosis and treatment technology combined with general practice and specialist in the community needs the policy support of the health administrative department. We suggest that CHCs should carry out the training of the combination of general practice and specialist in combination with the professional development of general practitioners, increase the drugs for specialty and special disease diagnosis and treatment, propagate the community characteristic technology in multiple ways, and explore the general practice and specialist combined diagnosis and treatment mode innovatively.

发展社区全科与专科相协作的"全专结合"临床诊疗技术是提升社区卫生服务中心综合服务能级、促进就医秩序更加合理、分级诊疗制度落实的重要措施。本文通过分析上海市政府关于社区卫生发展的文件及已发表文献，结合上海市社区卫生服务中心开展全专结合的临床诊疗技术状况调研结果，发现全市大部分社区卫生服务中心均已开展全专结合临床诊疗技术；围绕社区常见病、多发病，结合自身医疗特色，筛选优势病种开展全专结合的临床诊疗技术服务成为社区卫生服务中心提高临床能力的重要举措。然而在社区全专结合的临床诊疗技术发展中，存在社区缺乏开展全专结合的临床诊疗技术人才、部分专家对社区开展专科服务认识不足、全科医生在职培训困境、社区专科药物不足、对社区特色技术的品牌宣传不够等难点。社区全专结合临床诊疗技术的发展需要卫生健康行政管理部门的政策支持，建议社区卫生服务中心结合全科医生的职业发展开展全专结合能力培训，增加专科及专病诊疗用药品种，多途径进行社区特色技术宣传，开展全专结合服务方式的探索创新。