Mediation, not more security, the cure for hospital violence in China

Defusing conflict between patients and doctors seen as the better way to tackle a long-standing problem in mainland medicine

PUBLISHED : Sunday, 03 November, 2013, 4:51am
UPDATED : Monday, 04 November, 2013, 12:35pm

Two attacks on doctors - one fatal - have prompted a fresh round of reflection in the mainland media on the long-standing problem of patient-doctor conflicts.

On October 21, a Guangzhou doctor suffered eye injuries and a ruptured spleen after being beaten up by a patient's relatives. Four days later, a patient attacked three doctors at Wenling No1 People's Hospital in Zhejiang with a knife and hammer, killing the facility's ear, nose and throat chief.

As is often the case, dissatisfaction over the handling of their illnesses seemed to be at the root of patients' decisions to act out. But so far the government has focused on improving hospital security rather than quieting anger.

The day after the Guangzhou attack, the National Health and Family Planning Commission and the Ministry of Public Security jointly issued guidelines saying hospitals should have at least one security guard for every 20 beds.

That failed to satisfy many mainland newspapers, such as the Southern Metropolis Daily, which called the security measures "simple and crude". It advocated a better mediation system to defuse conflicts between patients and doctors before they turn violent.

"[Hospitals] could avoid most conflicts if they expended more effort mediating and guiding - instead of providing no care to the patient and his family - after a dispute occurs," the paper said.

Indeed, the paper warned, increased security could actually increase tension by driving a bigger wedge between patients and medical staff.

Shenzhen's Daily Sunshine agreed that arming hospitals was not working. It suggested that more hospitals follow the example of the University of Hong Kong-Shenzhen Hospital, which has set up a patient relations department to receive complaints and resolve disputes.

"Apparently dealing with complaints is much more powerful than having security checks," the paper said.

Similarly, The Beijing News called on health authorities to simplify complaint procedures so disputes can be handled more quickly. If violence did break out, they should launch investigations to determine the cause, it said.

Newspapers noted that misunderstandings were at the centre of much hospital violence.

An analysis by the Legal Evening News found that many of the recent attacks involved patients or relatives from remote rural areas. Many are already under high stress, having arrived in a big, strange city, unsure of how they were going to pay for expensive medical treatment.

Some patients have unrealistic expectations for modern medicine. Others fail to understand the doctors' methods.

The Legal Evening News said health authorities and media outlets should provide the public with more health knowledge to help them understand that "doctors are not gods". "If more patients can get high-quality medical services and have health insurance near their homes, they would have more hope and peace of mind," it argued.

Patients are also inclined to be suspicious of doctors' motives because of the widespread problem of medical staff accepting bribes in exchange for prescriptions and treatments. The Guangzhou Daily said the problem of patient attacks could only be solved through a sweeping overhaul of the health care system. It said charges for nursing, diagnosis and treatment were too low at most mainland hospitals, forcing staff to earn extra money on the side. "It's of great necessity to let doctors earn a living by their own skills so that patients respect their work," the paper said.

News portal Ifeng.com said the media was partly to blame for patient-doctor tensions. It said reports of doctors taking commissions and cash gifts - some false or groundless - had ruined the reputation of the medical industry.