China’s hospitals are a battleground — not just for the war on illness but also for the one between physicians and their patients.
If that statement seems extreme, consider these data points from state-run medical organizations:
Medical staff are attacked by patients or their relatives at a rate of once every two weeks per hospital, according to the China Hospital Association, Chinese news agencies reported.
In the last two weeks there have been at least six serious incidents, including in Guangdong Province on Oct. 21, when a Dr. Xiong Xuming was left with a damaged eye and ruptured spleen after being beaten up by a patient’s relatives for refusing to allow them into the intensive care unit, and in Zhejiang Province on Oct. 25, when Dr. Wang Yunjie was stabbed to death by a patient unhappy with his treatment.
Since 2002, attacks have risen by an average of nearly 23 percent a year, the China Hospital Management Society said in a paper published in December in Chinese Community Doctors, a medical journal.
On Thursday, Prime Minister Li Keqiang addressed the issue, in a sign that the Chinese government is seriously concerned by the mounting violence.
Mr. Li was “paying utmost attention” to the situation and had written “important comments” requesting all government departments to take seriously the problem of conflict between doctors and patients, according to a post on the government’s official Tencent Weibo, or microblog, account. He had ordered government departments to take measures to “protect medical order,” it said.
The reasons for the problems in China’s health care system are, by now, well known: a widespread lack of trust in doctors and hospital administrators, the high cost of care, long waiting times and short appointments — and corruption, at every level. A public that lacks basic knowledge about medical problems and outcomes is also a factor, commentators say.
But why turn to violence? One reason is illness can bankrupt a family. People who exhaust their savings on care want to see positive results and blame doctors when that’s not possible, commentators say.
While violent incidents in major cities and well-known hospitals receive the greatest attention, the problem is actually more severe in smaller or local hospitals, said Deng Liqiang, the head of the legal department of the Chinese Medical Doctors Association, in an interview with Yanzhao Metropolitan News, based in Shijiazhuang, the capital of Hebei Province.
“It’s not hard to discover that third-tier hospitals and regional medical centers are the disaster ground for medical conflicts,” said Mr. Deng.
Underfunding by the government is a major problem, Mr. Deng said.One of my pen pals in China is married to an ex-doctor. He too came in for threats and decided medicine was too hazardous, so he's now teaching history in a local college.
The public health implications of violence against doctors are obvious. Thirty years of prosperity have both enriched and stressed the population, and the country has seen a rapid increase in "mass incidents"—90,000 in 2006 and an estimated 127,000 in 2008. This is why the authorities are cool to the idea of allowing greater freedom of speech; it's all they can do just to keep the lid on.
That violence is occurring in the "third-tier" hospitals is also alarming because those are likely where the first cases of a major influenza outbreak are likely to turn up (or not, if the patients' families can't afford treatment). A demoralized and underfunded health system is almost a guarantee that such an outbreak will soon be out of control.