Construction of public medical association through sinking high-quality resources to the grass-roots level, so as to enhance their service capabilities ,to retain patients, and to promote the classification treatment, is good wishes by the administrative department of public health Subjectively. It is limited objectively. First, current organizational structure decides the majority of the current medical association can not be classified for the purpose of hierarchical diagnosis. Second, three level hospitals lack the motivation to put forward hierarchical diagnose. Third, the basic medical institutions lack enthusiasm in the absence of competitive pressure.Fourth, it’s difficult for experts of big hospitals to solve the dilemma of primary medical institutions.