The doctor-patient relationship is an eternal topic and a “summer and winter table” of complex social contradictions. The essence of the doctor-patient relationship is a community of interests. Because “doctors” and “patients” share the common goal of overcoming diseases and recovering as soon as possible, and overcoming diseases depends not only on doctors’ excellent medical skills, but also on patients’ confidence and active cooperation in overcoming diseases. It is the joint responsibility of the doctor and the patient to fight against the disease, and only when the doctor and the patient cooperate together and actively treat the disease can we achieve better treatment results. The patient’s wish for recovery is realized through the medical doctor, and the medical doctor deepens his or her understanding and knowledge of medical science and improves his or her treatment skills in the process of treating the disease. In the face of disease, medical practitioners are allies and a united front, encouraging each other to overcome the disease together.
In the Tang Dynasty, Sun Simiao, the king of medicine, was out to collect medicine when he came across a female tiger with her mouth open, and his attendants thought that the tiger wanted to devour people and fled, but Sun Simiao saw that the tiger had an unspeakable disease. It turned out that the female tiger was stuck in the throat by a long bone and came to stop the road to seek medical help. Sun Simiao took out the foreign body for her and the tiger left gladly. A few days later, Sun Simiao passed by this place on his way back, and the tiger and her cubs were waiting by the roadside to greet him. This story illustrates at least two truths: first, even if a man-eating tiger is ill, a doctor should treat it with kindness and justice, not to mention a sick person; second, even a man-eating tiger is grateful to the doctor who relieves it of its illness and responds politely.
In a sense, mutual respect, mutual cooperation and interdependence are the most basic features of the doctor-patient relationship. At present, the doctor-patient relationship in China is generally harmonious, which is the mainstream of the doctor-patient relationship in China. However, we also need to see soberly that there are local disharmony in the mainstream of harmony. The doctor-patient relationship, like other social interpersonal relationships, there is a certain amount of disharmony is normal, but in some places there are serious tensions between doctors and patients, and even conflicts between doctors and patients, there are complex economic and social roots.
1, there is a contradiction between the ability to provide medical services and the growing health needs of the people. For a long time, China’s medical and health resources allocation is unreasonable, the quality of service and medical conditions of grassroots medical and health institutions can not meet the basic medical needs of the masses, resulting in the masses have to see the big urban hospitals. The disorderly flow of patients has caused urban hospitals to be overloaded, and there is a general phenomenon of “long queues for registration, payment and examination, but only five minutes for medical treatment”. At the same time, doctors have to see dozens of patients in a day and must make examinations, diagnoses and treatments as soon as possible, so they are so busy that they do not even have time to go to the toilet, much less have time to explain patiently to patients. Under the heavy task and pressure, doctors are prone to the problem of inappropriate communication and explanation to patients, leading to misunderstanding and conflicts between doctors and patients, which is often the most direct “fuse” affecting the doctor-patient relationship.
2, the public welfare requirements of medical institutions and the contradiction between the management system and operating mechanism. Modern medicine is a composite discipline that integrates science, engineering technology and humanistic care. Its complexity determines the inevitability of information asymmetry between doctors and patients, and this situation also exists in many other industries. In the early days of the founding of New China, when medical care was a purely public service, doctors’ salaries and wages were effectively guaranteed and they were able to devote themselves to treating patients, and were therefore generally respected by patients. In recent years, however, due to the serious lack of government investment, coupled with the low price of medical services, the development and construction of hospitals and operating costs mainly rely on medical services to generate revenue to solve the problem, so that hospitals gradually deviate from the goal of public welfare, the emergence of profit-seeking tendencies, medical services are gradually given a consumer and market color, the result is to increase the direct economic burden of patients, resulting in the patient’s distrust of doctors and hospitals. It can be seen that the irrationality of the institutional mechanism has caused the dilution of the public welfare of medical institutions and the confrontation between medical and cunning parties in terms of economic interests, which has become the fundamental cause affecting the doctor-patient relationship.
3, there is a contradiction between the development of the medical security system and the affordability of the people. With the development of medicine, its ability to save lives has increased significantly, at the same time, the cost of treating diseases is also rising rapidly, the economic risk caused by disease is the vast majority of members of society can not bear alone, and thus the birth of the social security system, its form can be different, supplementing the demand side or supply side or both, but the purpose is the same, is to ensure that the masses can afford to see a doctor, pay the bill. At present, China’s basic medical security system is not yet complete, the level of protection is not high enough to meet the needs of the people to see a doctor. When the medical security system is not perfect, medical staff and hospitals must directly face the patient’s questions about the high cost of medical care, and become the “scapegoat” for the imperfect medical security system.
4, there is a contradiction between the limited development of medical technology and the infinite expectations of patients. Although the development of modern medicine has advanced rapidly, but there are still many unconquered problems, technical limitations and individual differences in patients, the effectiveness of many diseases is difficult to predict. However, patients still lack risk awareness of medical services and have high expectations of treatment results, believing that if they enter a hospital, they will be cured, and if they spend money, they should be cured, and if they fail to achieve the desired results, they blame the hospital and medical staff. The difference in the perception of direct results between doctors and patients, especially the high expectations of patients and their families for the results of treatment, has become the “accelerant” affecting the doctor-patient relationship.
5. There is a contradiction between the high-risk nature of the medical industry and the lack of an effective medical risk-sharing mechanism. The complexity and unpredictability of diseases and the limitations of medical science determine that the medical industry is a high-risk industry with a certain probability of errors and even accidents in practice. Such risks are also necessary for the medical profession to take, as they are the only way to save lives, without which medical technology cannot progress. But it is also a risk that the medical profession cannot bear. At present, the mechanism of sharing and solving medical risks through effective ways such as medical liability insurance has not yet been formed. Once medical disputes arise, patients’ spearheads will point directly at hospitals and medical staff, even leading to direct conflicts between doctors and patients, which is one of the important reasons affecting the healthy development of doctor-patient relationship.
6. There is a contradiction between the imperfection of medical dispute handling mechanism and the demand of people’s demands. Due to the high cost of resorting to the law to resolve medical disputes, the procedure is more complicated, coupled with the ambiguity and lack of relevant laws and regulations in China, in recent years, the trend of medical disputes resolved through legal channels is declining, replaced by the “farce” approach, and even rely on violence to resolve medical disputes, into the “no farce Not to compensate, the more trouble the more compensation, the more compensation the more trouble” circle, the national “medical trouble” is generated in this context. If this phenomenon is not stopped in a timely and strong, often leading to escalation of medical disputes, and ultimately brewed. It should also be pointed out that there are a few hospitals in patient safety and medical quality management deficiencies, individual medical staff work carelessly, poor sense of responsibility led to medical errors and accidents, damage to patients’ health and even life, which is not tolerated by society.
The purpose of deepening the reform of the medical and health system is to establish a basic medical and health system with Chinese characteristics and to ensure that urban and rural residents enjoy safe, effective, convenient and inexpensive basic medical and health services in a fair manner, which is the fundamental solution to the current conflict between doctors and patients and the way to long-term security. Due to the asymmetry of medical service information, medical institutions and medical personnel are the leading aspects in resolving the discordant factors. The health department, as the competent department of medical and health care, should take the opportunity to deepen the reform of the medical and health system, vigorously strengthen the construction of industry style, and effectively improve medical services, and actively work with all relevant departments to jointly promote the construction of a healthy and harmonious doctor-patient relationship.
Play a leading role in government, improve the mechanism of the medical and health system.
1, strengthen the government’s public service and social management functions. This plays a key role in eliminating the negative impact of information asymmetry between doctors and patients. Prevent information asymmetry between doctors and patients to evolve into “unfair” to patients, must rely on government regulation, medical insurance constraints and industry self-regulation.
2, increase government investment, convert the operating mechanism, strengthen the public hospital’s public service function, maintain the public welfare nature of the hospital, from the institutional mechanism to gradually eliminate the confrontation and conflict between doctors and patients in the economic interests.
3, into the scientific development of medical and health care, adjust medical resources, optimize the structure of services, vigorously develop rural and urban community health, expand the effective supply of medical services, to alleviate the contradiction between supply and demand of medical cunning side.
4, improve the medical insurance system, the establishment of demand-side supply-side “double insurance”. Adjust the standard of medical damage compensation, change the compensation payment method, from hospital compensation to insurance company claims, and build a quiet and harmonious hospital treatment environment.
5, appropriate to improve the treatment of medical personnel, especially grass-roots medical personnel.
Strengthen the construction of medical ethics and medical style, strengthen the management of medical services.
1, to strengthen medical humanities education, from the source to guide and train medical staff in line with the requirements of modern medicine ideology and value orientation.
2, the serious implementation of the medical ethics assessment system, the study reflects the views of patients and evaluation of the assessment methods, the establishment of effective incentives and restraint mechanisms for medical personnel, and seriously investigate and deal with serious harm to the interests of the public unethical wind.
3, to strictly regulate medical services. Negligent management of medical institutions, medical accidents are frequent, to suspend the practice activities or even revoke the license to practice. Establish a long-term mechanism for medical quality and safety management, improve service quality, promote medical safety, eliminate medical errors, and technically reduce the occurrence of medical disputes.
4, improve the transparency of medical service information. Medical staff should take the initiative to understand patients’ needs, grasp patients’ expectations and doubts about medical services, improve the awareness and skills of communication with patients, and strive to reduce the mistrust caused by serious information asymmetry between doctors and patients.
Improve the mechanism for handling doctor-patient disputes and create a good practice environment and medical environment.
1. Consultative settlement by the medical sly parties themselves. Negotiated settlement has the advantages of low cost and high efficiency. The agreement reached through consultation is often more durable and easier to be voluntarily fulfilled by the parties.
2, the introduction of third-party mediation mechanism, the doctor-patient disputes into the standardized settlement channels, so that medical institutions from the heavy disposal of doctor-patient disputes.
3.Resolving disputes through legal channels is the final solution for all medical disputes. Medical disputes that do not want to be solved through mediation or are not satisfied with the results of mediation can be solved by means of medical litigation.
4, open up a “green channel” for handling medical disputes, simplify procedures and improve efficiency. Such as exploring the establishment of medical accident identification arbitration system, the medical accident dispute cases, the establishment of off-site identification system, to ensure the scientific and fairness of technical identification. Strengthen public education, and strive to create a good atmosphere of public opinion.
Building a harmonious doctor-patient relationship is, in the final analysis, to safeguard the interests of the doctor-patient side. The news media should, from the height of maintaining stability and promoting harmony, adhere to positive guidance, promote the main theme, adhere to the comprehensive, objective, fair and scientific principles of news reporting, create a good atmosphere of public opinion in the whole society respecting science, life and the legitimate rights and interests of the medical cunning party, and promote mutual understanding between doctors and patients.