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在线翻译:
szdaily -> In depth -> 
Doctor-patient tension may spur medical reform
    2014-03-11  08:53    Shenzhen Daily

    ON Wednesday, the same day China’s annual parliamentary session opened in Beijing, a young doctor in the southern city of Chaozhou, Guangdong, wept while being pushed around by a 100-strong mob.

    This real-life drama was triggered by the death of a patient in the hospital’s emergency room the night before. The deceased’s family blamed the doctor on duty.

    The incident received a straightforward response from China’s health department chief Li Bin, who called it “extremely vile” at a press conference on the sidelines of the parliamentary session Thursday.

    Violent incidents between patients and medical workers, like the one in Chaozhou, have repeatedly made the news in China in the past few years. Some have resulted in the deaths or serious injury of doctors and nurses.

    Earlier this month, a couple who were both government officials were punished for beating and paralyzing a nurse at the Nanjing Stomatological Hospital in Nanjing, capital of East China’s Jiangsu Province.

    In February, a doctor from Northeast China’s Heilongjiang Province was beaten to death by a patient with a blunt bar over unsatisfactory treatment.

    The tension has drawn strong calls from legislators and political advisers at this year’s parliamentary session for actions to restore the credibility of medical workers and properly handle medical disputes.

    Shu Xiaomei, a deputy to the National People’s Congress (NPC) and pediatrician from Southwest China’s Guizhou Province, brought up the issue to Chinese President Xi Jinping when he joined the province’s legislators at a panel discussion Friday morning.

    If doctors do not feel safe at work, patients will pay the price, Shu said.

    Xi replied with promises to maintain law and order at hospitals, protect the safety of medical workers and severely punish those who cause medical workers’ harm.

    According to the National Health and Family Planning Commission, the country recorded about 70,000 medical disputes in 2013. Nationwide, medical institutions received about 7.3 billion visits from outpatients and 191 million inpatients received treatments last year.

    “In most cases, doctors and patients get on well with each other. Disputes are only a small proportion,” said Li, minister in charge of the commission.

    However, extreme cases have put heavy pressure on medical workers.

    Conflicts between patients and medical staff have become so intense that measures must be taken to protect doctors and nurses, said Zheng Shan, who is a doctor at a Shanghai-based hospital.

    Zhou Yue, who works as a nurse in Nanjing, echoes Zheng’s view.

    “Some of us are considering quitting our jobs, as working in hospitals has become a high-risk profession these days,” Zhou said.

    While doctors are fretting over their troubled relationship with patients, the latter have long complained about the unpleasant experience of seeing doctors.

    Chen Yu, who was standing in a long line to see a doctor in the Nanjing Drum Tower Hospital, said that patients like him usually have to queue for hours before having a consultation that lasts “no more than three minutes.”

    Sometimes people have to “beg” doctors to accept monetary gifts to secure proper treatment, complained another patient queuing in the same line as Chen.

    The mounting dissatisfaction has fueled surging resentment for both doctors and patients. A research report from the Chinese Hospital Association issued in December said that China recorded 40 violent incidents targeting doctors from 2003 to 2012, 11 of which happened in 2012; seven incidents resulted in deaths.

    The report showed that 90 percent of medical workers from 316 hospitals across the country confirmed in interviews that they had suffered humiliation or threats from patients.

    “When you hear several cases of patients stabbing doctors or beating nurses in a few months, it is natural for hospital staff to feel nervous and insecure,” said Jia Weiping, an NPC deputy and head of a Shanghai-based hospital.

    More than 30,000 medical workers signed a petition against violence targeting them at ememed.net, a professional medical website, between Feb. 28 and Wednesday evening.

    As urgency for change mounts, authorities at various levels are taking pains to implement measures that they hope can assuage public ire.

    In January, the Zhejiang Provincial Higher People’s Court in the eastern Zhejiang Province issued a regulation that requires hospitals to clamp down on people who disrupt order in medical institutions.

    In February, the government of the northeastern city of Harbin announced a similar crackdown, while the local public health department vowed to better supervise medical institutions and staff.

    Meanwhile, the National Health and Family Planning Commission released a circular Feb. 20 that bans doctors of second-class public hospitals and above from taking “red envelopes,” or gift money, from patients starting May 1, mandating what was once an amoral issue.

    Some legislators blamed weakness in the country’s medical system for the doctor-patient tension.

    Zhong Nanshan, a renowned pulmonologist and NPC deputy, told Xinhua that less and less communication between doctors and patients has caused tension and distrust.

    At today’s hospitals, a doctor has very little time to interact with patients, said Zhong, who is in Beijing to attend the annual parliamentary session.

    “A few words and you go. Of course, patients are not happy and do not understand (why the doctor treats their conditions this way). Then disputes come,” he said.

    Behind the curtness of doctors toward patients lies an imbalance of medical resources.

    Patients flood big public hospitals for good doctors and the latest equipment, so the time a doctor has for each patient is squeezed, said Guo Yufen, deputy head of the Health Department of northwest China’s Gansu Province. Guo is also an NPC deputy.

    Legislators called for increased government spending on public medical services, especially at small hospitals and community and village clinics.

    Medical reform is also considered a solution to the problem.

    Patients do not trust doctors partly because some of them prescribe unnecessarily expensive medicines and treatments so that they can profit, said Xie Zilong, an NPC deputy and president of a pharmacy chain.

    Such behaviors might be uprooted if public hospitals are reformed and are no longer supported by the revenue from prescriptions, Xie said.

    Lawmakers also suggested that independent mediation agencies should be introduced to handle medical disputes.

    In this year’s government work report, Premier Li Keqiang promised to deepen medical reform. The government will extend the trial reform of county-level public hospitals to 1,000 counties covering 500 million rural residents.

    The report also pledged to abolish the practice of compensating low medical service charges with high drug prices.

    Zhong said he would judge the result of the reform by three criteria: If the medical expenses are affordable to people, if the doctors and patients can interact in a positive way, and if the medical workers are satisfied with their job. “Although the expanding medical insurance coverage in China in the past years is encouraging, I would say the ongoing medical reform has made little headway based on these three aspects,” Zhong told Beijing Times yesterday.

    (Xinhua)

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