Hong Kong people visit a doctor's clinic once a month on average - the highest rate in the world - probably because general practitioners have no incentive to maintain their patients' health, an expert said. 'Every year, outpatient attendance is eight to 12 visits for an average person in Hong Kong - it is almost once a month,' said Gabriel Leung, associate professor of community medicine at the University of Hong Kong. The estimate is based on various surveys and covers consultations at public and private outpatient clinics. With consultation fees ranging from $150 to $400, Hong Kong residents spend between $1,200 and $3,200 a year for eight clinic visits. Clinic attendance in Hong Kong is twice that of Finland and Britain, and a bit higher than Australia or Canada. The lower end of the city's estimate matches rates in South Korea, Taiwan and the US. Professor Leung said he welcomed a plan in a recent discussion paper to develop a family medicine concept to help improve what has become an unsustainable health-care system. Every family or individual would have their own family doctor, who would provide continuous care and act as gatekeepers for the hospital system, according to a Health and Medical Advisory Committee consultation paper. 'The family medicine concept is good but the financing bit is not there so it is not clear how we are going to finance it and, more importantly, how we are going to pay providers to do the right thing,' Professor Leung said. 'You cannot expect doctors to perform at a higher moral level in terms of sacrificing their income and not getting anything back.' Secretary for Health, Welfare and Food York Chow Yat-ngok, who chairs the advisory committee, said last week that safeguards were needed to prevent private doctors from exploiting their enlarged role. Professor Leung said the medical fee system in Hong Kong meant there was no reward for maintaining people's health, unlike in countries with 'good family medicine systems'. 'The only way you can generate income - and everyone needs to generate income, it's not a sin - is to have people come back to see you. 'So for example, if society is inculcated in this belief or perception that you need to see a doctor for a cold then you go see a doctor for a cold and you probably get typically three days' medicine, and then you go back for a refill at the end of that and you probably get another three days' medicine.' He suggested that doctors could become employees of group practices. 'Or there can be a mixed-funding formula: a base salary plus incentive salary for keeping your patients well.'