Families dressed in mourning clothes are a regular sight at mainland hospitals, as are attacks on doctors by disgruntled patients or their relatives.
While some are professional yi nao (medical hooligans), paid to put pressure on hospitals so that they pay compensation claims quickly, others are patients just trying to find out whether their suffering can be linked to malpractice.
A Beijing lawyer specialising in medical lawsuits says they turn to dramatic protest action because the regular, legal way for patients to seek redress is a long, bumpy road.
Zhu Yonggen, a lawyer at King Virtue Attorneys at Law, said patients were usually at a disadvantage when pursuing a lawsuit.
After the mainland's tort law, which governs legal liabilities under civil law for wrongful action, was reinforced in July last year, patients have to provide evidence that a medical blunder caused the damage they suffered. But patients lacking medical knowledge have a hard time proving they have been wronged, especially when their medical charts and records are kept in hospitals and are inaccessible.
'When legal proceedings start, the medical record should be sealed but the first reaction of a hospital is to window dress the medical records, such as describing the patient as being in a more serious condition or completing a chart. It happens in all the cases I represent, even the big, famous ones,' Zhu said.
The tort law stipulates hospitals will be held liable if medical charts are forged, fabricated or destroyed but that is often an unresolved matter of dispute.
Apart from the technical barriers, the legal process can take anything from six months to several years.
Wang Baoluo, who stabbed Xu Wen, a prominent ear, nose and throat surgeon at Beijing Tongren Hospital in September, inflicting multiple wounds to her arms, forehead, neck, back and left leg, was engaged in a lawsuit against the hospital for three years. It got bogged down in a dispute over whether his medical records were genuine.
Wang Jian, chief of general surgery at Shanghai's Renji Hospital, said many patients choose not to go through the legal process because they believe a hospital will pay more compensation if they cause unrest.
He said patients also distrust the courts and the committees of medical experts that decide malpractice cases. But Wang, a member of Shanghai's malpractice committee, said the members were impartial and did not favour hospitals or doctors.
Wang said the tense situation had a lot to do with the unbalanced allocation of medical resources which resulted in expensive and inaccessible medical care and bills that were a heavy burden for patients.
Doctors were the victims of a resentful society with low morality and a hunger for money, he said.
'Disgruntled patients blame and beat up doctors, which is unbelievable anywhere in the world,' Wang said.