Police in hospital take temporary solution not effect a permanent cure harmonious doctor-patient how to return?

Source: China youth daily

        Early may and the department of health issued an emergency circular asking health administrative departments at all levels to coordinate the public security organ in the second class above hospital on key medical institutions set up police room.

        In recent years more than a happened "kill YiAn", not only the social impact of malignant cases public psychology, also has forced to medical health department ongoing defense upgrade. In this notice before a has required hospital room equipped with helmets, shields to defend, cross vest, length stick. April 30,, the ministry of health, joint issued an order announcements of the medical institution maintenance "for the medical institution burn spirit money, decoration mourning hall, an illegal stop corpse, all the trouble or insult, threatening behavior such as medical personnel security punishment shall be investigated for punishment even responsibility.

        May 8,, the former director of tsinghua university law school professor WangChenGuang, Beijing union medical college of education WangZhong, Beijing university professor of the China center for economic research, China's ministry of health policy and management expert commissioner of tsinghua university, who in a medical way where "lectures.

        On the above notice, WangZhong said: "this is the doctor-patient relationship the most concentrated and most serious deterioration of performance". But he thought that the hospital is not not may establish police station, "in 1998, I went to the university of southern California, Los Angeles hospital into the gate to a security, but also for 1993 because of the doctor-patient conflict three doctors were killed." LiLingZe think, in second class above a police hospital room can't solve the fundamental problem, as long as the antagonism exists, don't trust relations continue, doctor-patient conflict will occur repeatedly.

        The doctor-patient relationship why deterioration to such a degree? The root of the contradiction in where? Harmonious doctor-patient relationship how to return?

        "A doctor expensive" and "a doctor difficulty" is possible

        Medical disputes of what exactly caused? Facing this prominent contradictions, some hospitals is in itself summing-up.

        China's traditional Chinese medicine academy of sciences in Beijing hospital a data shows, the hospital in 2007 ~ 2009, 333 cases happened in medical disputes, including:

        Work responsibility and medical quality in 139 cases, accounting for 41.7%. The dispute is often shown in the medical staff sense of responsibility, the work is not meticulous, medical records, incomplete records not in time, and inform the inadequate or form now, etc.;

        Service attitude and communication in 109 cases, accounting for 32.7%. The main performance behind the service consciousness, the lack of sympathy for patients, the patients cold, hard, or with a bad mood to work;

        The hospital management 42 cases, accounting for 12.6%. Mainly reflects medical circumstances poor, process, unreasonable distribution, cause patients waiting for long time. Meet the problem solving fast lack of mechanism, various departments shuffle, small become major dispute;

        The hospital management does not arrive, the link between diagnosis and treatment, information communication cause disputes, etc. No rational drug use and check 28 patients (8.4%), dispute mainly displays in the medical staff DaChuFang, a variety of drug use at the same time, exceed dosage, super drug manual indications drug use, with patients less than communication.

        Other in 15 patients, 4.5%. Is mainly reflect the patient for some medical insurance policies, regulations in the don't understand.

        However, in guangzhou a 3 armour hospital doctor wang yunwu view, there is presentative only some of reason, she thinks, the main reason of medical disputes or high expensive "and" a doctor difficult ".

        A small cold spend thousands of dollars, the doctor over-prescribing drugs and XuKai high price of medicine is very popular. Wang yunwu in view, "a doctor your" investigate its reason is financial investment, less lead to hospitals have become income generating unit, public welfare side reflect very not obvious. "The reason why the doctor to prescribe medicine, to raise more medicine medical was the reason, doctors have no."

        The Chinese academy of social sciences researcher at the institute of industrial economy, China's economic system reform of public policy research center director that evening glow, to raise the medical and excessive use of drug inspection and medicine, suggest that the doctor's benign constraint and incentive mechanism not established. "Public hospital doctors nominal wage is very low, forcing the doctor medicine".

        10 for many years has been constantly and medical corruption in fighting the famous medical devices ChenXiaoLan fighting people tell China youth daily reporter, hospital excessive do check, a drug abuse indeed it is very common. "Excessive is to collect fees, fees and medical staff commission sheet that there is a close relationship between kickbacks, many hospitals also encourage more, the doctor to prescribe medicine, more sheet can still get drug company. Doctors kickbacks lawful income is not high, but grey income is far higher than legitimate income".

        The lecture in tsinghua university, professor who also think, stress hospital patient relationship is the problem of medical and health mechanism, in the design of the system, and the state was not assume medical health workers get decent wages duty. Some hospitals although is public, but to your own money, this is a distortion of the situation.

        Wang yunwu said, over the years, has been said to improve the doctor income, to improve the fee, change to a medical condition of the medicine, but in her eyes, and nothing changes. A Beijing 3 armour hospital doctor li and also said, "I still feel not to carry out our body, full of hot air".

        Wang yunwu in view, "a doctor your" in the question is, who will be required as services, spent money will have the result. Add the red envelope, a doctor of medicine high unspoken rule, easy to have the party with a distrust, once in diagnosis and treatment in the process to have the wrong place, it could happen medical disputes.

        She said, as long as no cure, patients and families can't understand, total feel the man to hospital, to make money, not cure is the responsibility of the hospital. "The idea is a deviation, each individual difference, a conventional therapy methods and not of all patients, some good effects are common diseases to some patient needs special treatment, medical treatment itself has a lot of unpredictability, some disease in haven't the rule of law, and in the operation and some accidents, the unpredictable risk."

        Lee and also think, save will have two consequences, one kind is life, one kind is to save died. Some people might think, spent so much money, the last RenCaiLiangKong, really hard to accept.

        In "a doctor your" at the same time, "a doctor difficult" also has many fresh cases. In 2009, Beijing 19 level 3 hospital dressed as a common experience of patients with doctor process, results, the shortest take 3 hours, and the longest spent seven hours, but the real time see only a few minutes to more than ten minutes.

        "A doctor difficult" highlights the medical resources allocation of the present situation of unbalanced, big hospital on too many patients, and some community hospitals are there. Patients have flocked to large hospital, often lead to big hospital operating over-load. Wang yunwu said, a clinic doctor morning will see QiBaShiGe number, said many, throat will say that dumb, to the last words don't even want to talk, even the toilet all can't, how can service attitude to rise? And the patient and for hours, a few minutes a few words he sent, the in the mind of course not comfortable.

        Wang yunwu said, she met patients, almost half of the second class hospitals can be in hospital or community treatment, must not to 3 armour hospital, but people don't trust, and those who feel that the local level is not high, may also have patients in hospital to eat small once suffered, do not wish to go. "I also have classmates in the community hospitals, their patients, medical records, less less and less income, experience level, so instead of a vicious cycle, more patients do not wish to go......."

        Also noted that the afterglow, the basic-level hospital hardware does have a very powerful, but this years medical institutions comprehensive reform not only didn't improve the primary hospitals service ability, but decreased. Statistical data discovery, rural hospitals and hospital MenZhenLiang declined over the past few years, the reason is a system for basic drugs cause less drug varieties, delivery slow, towns that can provide secondary hospital medical services also stopped, the second or incentive mechanism, a lot of places make payments two lines, the actual income decline.

        How to reconstruct harmonious doctor-patient relationship

        To build a harmonious doctor-patient relationship, can only hope for solving the above problems. In a hospital in the practice of police officers, Shanghai maritime law firm LiuYe medical lawyers think, police in the hospital can't solve the fundamental problem, medical disputes rather than blocking of need.

        ChenXiaoLan said: ministry of health and the ministry of public security policy is more than a police hospital and second place, that a hospital and a basic-level hospitals disregarding? This method is take temporary solution not effect a permanent cure, not advisable. "

        Horizon also think, the police won't solve the doctor-patient relationship in the source of tension.

        To better the contradiction, that evening glow, will give the doctor prescribed to solve the doctor is high, it's not reality, finance is the could not support. Feasible path is advanced step to improve the nation of medical insurance, especially low-income people medical insurance investment, then demand protects agency orgnaization negotiations with the hospital, for more pay the reform of the medical insurance system, through the health care package payment of the way constraint hospital behavior, and through the hospital management good doctor.

        At the same time that evening glow, public hospital to speed up the reform, true realization "tube do separate", the hospital independent, health authorities need to do is prevent medical disputes and management industry issues, such as strengthen supervision to the doctor, ensure the safety and quality of medical service.

        LiuYe argues that, the doctor want to rely on technology and not on the many prescriptions, do more check for dinner, should improve the value of medical technology, such as the registration fee operation to reasonable raise prices, "the services of a doctor price countries cannot too much, to intervention decided by the market. Now the biggest problem is that the doctor is not free, need geologist attached to the hospital, especially state-owned hospitals, doctors on medical technology without pricing. Doctors can't free practice, this and the doctor's nature, also not great limits the ability of the doctor. If the doctor practice, the ability of liberation doctor can release, the doctor also can greatly alleviate difficult."

        Horizon also think, if let the doctor can flow more freely, service prices become more market-oriented, the doctor take kickbacks phenomenon can decrease greatly.

        In addition, in order to better the contradiction, now a lot of places founded the people's mediation mechanism, the data shows, in April 2009, and nanjing medical disputes in the people's mediation, by the end of August 2010, received in total 2589 batch, the more than 7000 passengers, accepts the dispute 1350 pieces, 1304 pieces of success has mediation, involving the amount of about 42.79 million yuan, and through the persuade counseling, clearing up doubts to dispel doubts, allowing patients to clear the demands of 495 pieces of give up.

        In January 2010, the justice department, health department, national circ, issued the medical disputes on strengthening the people's mediation opinion "hind, all over the country were established medical disputes and the people's mediation organization.

        For mediation mechanism, tsinghua university professor WangChenGuang in lecture think, "there is a basic principle of medical disputes, encounter when, there should be a neutral third party, the doctor and patient from contrary freed, there is a misconception that the government by law society is going to court proceedings, we will vigorously promote the arbitration and the third party mediation, avoid the doctor to push the muzzle of the medical dispute".

        But the evening glow doesn't agree with this way, and will be as "more advanced elder brother method", "I feel that solve the doctor-patient conflicts or to go at this stage of the process, through to the judicial complete the judicial process so much to the medical dispute and the accident happened mechanism and harm through the case concluded. Can the litigation procedure, open medical accident appraisal committee as long as the trial procedure is open, including experts list public. I don't think the neutral to reduce".

        LiuYe also think, the medical dispute mediation committee can rise to buffer role. Can play in medical disputes mainstay function or fair and impartial judicature, including comply with the rules of evidence appraisal system. Must not for mediation and conciliation, for dimensional stability and mediation.

        He said, it is, for medical treatment appraisal conclusion, the court is often difficult to fully effective cross-examination, or form now cross-examination, basically court on appraisal conclusion as the single adopted. "The identification process to the public, appraisal conclusion to the public, expert witnesses to appear in court, cross-examined accept both doctors questions, the judge on the conclusion in the letter have initiative."

        LiuYe also believe that, nationally, judges should strengthen the ability of medical disputes. At present our country hasn't form independent judgment of medical dispute the judge group, and other countries and regions, such as Taiwan medical method is to make clear a regulation, judge medical disputes the judge to have medical background or senior judges. "Our country in Beijing, Shanghai and guangdong some court have long-term trial of medical dispute, but other judges more places judge lack of medical trial experience."

        ChenXiaoLan said, doctor-patient conflicts are largely patients and the contradiction of the hospital, but the doctor-patient relationship on the other side of the opposite, is hospital, medical institutions and medical legal laws and regulations, the health administrative department and the medical association, medicine industry institute, the commodity price departments. "These are the doctor-patient relationship in the opposite, the real change, not the doctor-patient relationship is very difficult to change the status quo."

        (the lee and shall require wang yunwu and for a pseudonym)