Abstract: The policy texts of the family doctor system are analyzed from the initial stage to the present with the help of the advocacy coalition framework， and an in-depth study is made on the coalition composition， belief system， policy learning and policy forum in the policy subsystem. It is found that the establishment and development of the family doctor system involves multiple subjects， and the policy change leads to the opposition between different belief systems and advocacy coalition， which hinders the development of the role of family doctors. With the further policy change， the gradual intensification of contradictions leads to the phenomenon of “signing but not agreeing”. Thus， it is suggested that the family doctor system should establish a “contractual” trust relationship between family doctors and patients， clarify the interests of family doctors and patients， cooperate with various departments to achieve positive interaction and improve institutional convergence， and emphasize the role of policy learning and policy forum so as to make the dynamic combination of family doctor system design and objectives， effectively improve the quality of the family doctor system， and promote the further development of medical and health system reforms.

Key words: family doctor; policy change;contracted services; combination of medical care and nursing