article public from the micro-letter number: everyone – Tencent News (ipress), author: Enron < / p>
On the morning of December 28, Zhao Ning, director of the Department of Regulations of the National Health and Medical Commission, said in response to a question about the injury medical incident at the General Aviation Hospital, “This matter is not a medical dispute, but a very serious criminal offence. “
In fact, from the inadequate disclosure of all the facts so far, the nature of this incident first has the universality of criminal offenses, and also has some special characteristics of doctor-patient conflicts, otherwise, Does not cause such strong social attention.
In memory, the last public opinion storm caused by the conflict between doctors and patients occurred in January 2016. At that time, Ms. Yang, an elderly maternal, died after rescue in the Third Hospital of Beijing Medical University. A “red head file” was sent to the Third Hospital of Beijing Medical University, asking to investigate the cause of the death, and the family members of the deceased had reportedly smashed the hospital. This doctor-patient dispute, which was referred to by netizens as the “top-level medical trouble incident,” was finally pushed to legal channels.
Today, four years later, the conflict between doctors and patients has once again aroused strong concern, and the protagonist of the tragedy has been replaced by Ms. Yang, a 34-year-old patient, with Dr. Yang, 51. In the past four years, the medical system, the medical insurance system, the ecology of public opinion, and the way of communication have changed the special factors that constitute doctor-patient issues, and many general and deep-seated factors that affect the doctor-patient relationship have not changed. In fact, many of these factors are not only unique to the medical community, they are not even unique to China.
Here, we republish this article on Tencent Everyone. At that time, this article took a deep look at the evolution of doctor-patient relationship in China over the past decade and the factors behind it. Now that four years have passed, we hope that both doctors and patients can think and explore together, not to let the relationship between doctors and patients continue to tear, and not to have the next extreme event at the cost of life.
Ten Years of Violence in Doctor-patient Relationship in China (text):
Published: 2016
One
A winter night ten years ago, I took a taxi to the gate of Beijing’s Ziyu Villa, and Weng Qiang sent a car with a police light to pick me up at his residence. I was surprised to find that the middle-aged businessman was naked, walking anxiously back and forth between the two houses, constantly answering calls, and loudly responding to calls from reporters across the country. Although I interviewed him as agreed, he didn’t have time to sit down and talk to me that night. Later, he hurriedly said to me, “I’m going to have a large press conference!” He sent me all night waiting with this sentence. When I left, he suggested that my report be called “The Black Curtain Under White.” Weng Qiang is the son of Weng Wenhui, the deceased, in the “Hazard Medical Expense Case of the Second Hospital of Harbin Medical College” that has caused a sensation throughout the country. At that time, the media used the terrifying statement that “the total cost of hospitalization for 67 days was 5.5 million yuan” to describe the incident, which ignited the anger of the medical community and resentment about “difficult to see and expensive to see a doctor”.
I entered the Purple Jade Villa that night and two times later. I saw Weng Qiang always planning in the eyes of the storm and mobilizing various media. His impulses at that time left me a deep impression.
Sure enough, the Ministry of Health and the State Council Rectification Office finally announced the joint investigation team of the Central Discipline Inspection Commission, the Ministry of Supervision, the Ministry of Health, and the Heilongjiang Provincial Discipline Inspection Commission on Harbin Doctor II under the title of “Dedicated Loyal Guards to Maintain the Health of the People”. The court’s investigation and punishment of disciplinary violations. A total of more than ten people from the party’s party committee secretary and dean to the direct parties were dismissed and their doctors’ licenses revoked. After nearly half a year of disputes between doctors and patients, this case gradually came to an end after arousing widespread public opinion and attracting high-level attention. However, although the label “astronomical medical expenses” is sensational enough, it is far from enough to reveal the truth.
“Confusion in hospital management, incomplete rules and regulations, and ineffective supervision”, “Deep education in medical ethics, corrupt medical ethics, and weak legal consciousness”-such conclusions may deviate from the nature of the facts. A more in-depth investigation found that although the Second Hospital of Harbin Medical School has various defects in the medical treatment of Weng Wenhui, a 75-year-old end-stage malignant lymphoma patient, another version of the story is that the family members of patients affected the Lead the medical process, spend huge sums of money, mobilize a large number of medical resources, and strive to rescue patients. This process is considered a very unusual special treatment locally.
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According to the eyewitness description of the details, when the patient was transferred to the hospital, “the lengthened Lincoln car and several Mercedes-Benz and Audi cars on the small road only 200 meters between the two buildings blocked the intersection, respectively.” In addition, a basic fact is that during the 67 days of patient hospitalization, more than 20 experts from Beijing and Harbin formed a “super consultation team” and conducted more than 100 consultations. In the report materials of Harbin Second Hospital, it was clearly pointed out that consultation experts were mostly invited by Weng Qiang.
In Beijing, I interviewed several of the well-known experts, and more experts were very secretive about this special medical activity in which I participated. Most media are not interested in pursuing more facts. Weng Qiang’s “breaking news” and public resentment formed a strong resonance at the time, causing a huge storm, engulfing reporters while chasing the hospital, while also completing the “shadowing” of the entire medical community The collective vent.
A media wrote at the beginning of the report: “At 5 am today, after waiting for more than ten hours, at the Ziyu Mountain Resort Hotel in the northern suburbs of Beijing, our reporter finally saw ‘Harbin sky-high medical expenses The key figure of the incident was Weng Qiang. He was the main payer of 5.5 million medical expenses. “Ten years ago, WeChat and Weibo did not exist. Weng Qiang was the only” V “in the incident. At that time, not only did the Harbin Second Hospital and the medical staff involved have no opportunity to appeal, and very few media had in-depth investigation of complex facts. Officials finally determined that “the case of sky-high medical expenses is a typical violation of the law and discipline that seriously damages the interests of the masses, and seriously damaged the image of the health industry.”
In fact, out of consideration of the complex background of the incident, the ultimate treatment of this extremely special medical case of the Second Hospital of Harbin Medical Center is mainly to calm the general vendetta sentiment.
二
After that interview, my views on medicine and news have changed a lot. As for medical treatment, I deeply appreciate the high professional threshold and low social threshold in this industry. The so-called high professional threshold refers to the fact that practitioners need to pass a high level of professional training before they can get started; then they must go through a long process of practice accumulation before they can reach maturity.
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Four
The premise of the popularity of defensive medicine is that there is a serious asymmetry of information between doctors and patients, which leads to differences in the perception of disease between the doctor and the patient. Therefore, the hospital is not only a place for treating diseases and saving people, but also a place where different cognitions of diseases collide fiercely. This cognitive difference sets the stage for the widespread existence of doctor-patient conflicts.
A cognitive anthropological study believes that the basic patterns of patients’ awareness of disease include their own experience of illness, medical experience, family influence, social culture, folk disease concepts, and biomedical imagination. These factors together constitute their judgment of the disease and their expectations of diagnosis and treatment. As doctors who have received rigorous professional education, their knowledge of diseases is built on the modern medical system, eliminating personal and sociocultural factors, and occupying absolute initiative in the interaction between doctors and patients.
Although doctors have a scalpel-like calmness and profound understanding of the disease, they may also be regarded as indifferent and numb by patients in pain. Pulitzer Prize-winning American writer Jhumpa Lahiri has written a book called Interpreter of Maladies. A Chinese doctor said after reading the book,
“Disease does need to be explained, but the main point I want to make is not to tell you about the disease, but to enable the commentator and the listener to reach the same logical path in the communication process. Improve trust between doctors and patients and adherence to treatment. “The basis for eliminating cognitive differences between doctors and patients is trust and communication. Just after the killing of a medical case, a senior doctor said with emotion: It is true that there is asymmetry in information between doctors and patients, but patients in crisis cannot learn medical knowledge and conduct “fair trade” with doctors.
The doctor-patient relationship should be a trust relationship—trust and trust. From the perspective of the doctor, his interests are consistent with the patient during the diagnosis and treatment process-the common purpose is to cure the disease. Under the current “two-way conflict” mood between doctors and patients in China, “disease explanation” obviously lacks the ideal social and cultural atmosphere, thus making it an difficult task.
As an important potential cause of doctor-patient conflict, the difference in cognition of disease is a problem that doctors and patients everywhere face in the world; however, on the other hand, there are unique reasons for doctor-patient conflict. Changes in the rules of the medical industry in the mid-1980s made the operation of medical institutions mainly dependent on drug additions and service income, resulting in rising medical costs and decreasing service availability. A neurosurgery transferred to a private hospitalExperts said, “Our public hospitals are actually ‘private hospitals’. The market has an automatic adjustment mechanism. Patients suspect that you get rebates on everything.” In fact, “rebate rebates” are indeed quite equivalent among public hospital doctors. Universality, so that the medical community regards this universality as the basis for its “legitimateness”.
Participate in market-oriented operations as a public hospital-and this market is not an open market. This distorted medical service system has turned hospitals and doctors into profit-seeking entities. The doctor’s income is linked to his medical behavior, which has led to widespread over-prescribing, over-examination and over-treatment, and medical costs have risen sharply. The cost problem is a fundamental issue that causes patient dissatisfaction and doctor-patient disputes. The reason why the “Hazard Medical Second Hospital’s sky-high medical expenses case” can be easily magnified is precisely because it stamps the pain of the public “expensive medical treatment” —this situation has not changed so far. The medical practice that aims at profit-seeking has seriously shaken the foundation of patients’ respect and trust in doctors.
Medical science itself is an uncertain science. Once treatment fails, the patients and their family members suffer from illness, accumulated dissatisfaction with doctors, and the pressure to bear high costs may erupt at the same time. . Therefore, while the Chinese doctors group is benefiting from the ruled gray area, the price paid is to bear the risk of doctor-patient conflict directly. Doctors should have legitimately earned a decent income and engaged in the profession with a high level of self-esteem and ethics. However, under the abduction and temptation of distorting the rules, they often can only “make money” through improper methods. This situation, after destroying the self-esteem of an extremely sacred profession, directly disrupts the elite temperament of the doctor group, leading Structural loss of social groups.
Payroll issued by doctors of Peking Union Medical College Hospital (2011)
From the Second Harbin Medical Hospital to the Third Northern Hospital, two “atypical” doctor-patient disputes separated by a decade have been rapidly enlarged into public incidents. The reason for this is that they are used in different contexts. Complete a collective unconscious emotional vent.
Between the two events, the horizontalA ten-year “history of violence” across China’s doctor-patient relationship. The change in the medical profession from being “battered” by groups to “rebounding” by retaliation does not mean that “the era of victory for the medical profession has arrived”-at least that is what plastic surgeon Yang Zhen thinks. In fact, ten years have passed. Compared with the era of “expensive medical bills”, the root cause of the conflict between doctors and patients has not changed. Not only the medical industry is still waiting for a “surgery” like a patient who has been lying on the operating table “And the rationality, integrity, and tolerance of society has not grown.
Facing various public issues, the Internet is always full of populist attacks, and the medical community has not surpassed this model when participating in the topic of doctors and patients. As a doctor with rational spirit, Yang Zhen had his own helplessness. When observing the effects of the doctor-patient dispute between the Third Hospital of Beijing Medical University, he said, “This is an era of disorder. The game of the disorder is often a negative sum game-there is no winner.” The root of the doctor-patient conflict The solution ultimately depends on changes in the entire social environment. The result of stepping out of the “disordered era” should be a return to a “normal society”.
Achieving this seemingly simple goal requires the efforts of all members of society, and the elites obviously have greater responsibility-the medical community first needs to truly grow into the elite of the society.
Note: The original title of this article, “Ten years of doctor-patient conflicts: from the Second Harbin Medical Hospital to the Third Northern Hospital”