Explaining medical disputes in Chinese public hospitals: the doctor–patient relationship and its implications for health policy reforms

2016 ◽  
Vol 11 (4) ◽  
pp. 359-378 ◽  
Author(s):  
Alex Jingwei He ◽  
Jiwei Qian
Keyword(s):  
Medical Profession ◽  
Legal Framework ◽  
Public Hospitals ◽  
Primary Data ◽  
Patient Relationship ◽  
Policy Reforms ◽  
Doctor Patient Relationship ◽  
Medical Disputes ◽  
Heavy Workload ◽  
Chinese Public

AbstractIn recent years China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. This is the result of a confluence of inappropriate incentives in the health system, the consequent distorted behaviors of physicians, mounting social distrust of the medical profession, and institutional failures of the legal framework. The detrimental effects of the damaged doctor–patient relationship have begun to emerge, calling for rigorous study and serious policy intervention. Using a sequential exploratory design, this article seeks to explain medical disputes in Chinese public hospitals with primary data collected from Shenzhen City. The analysis finds that medical disputes of various forms are disturbingly widespread and reveals that inappropriate internal incentives in hospitals and the heavy workload of physicians undermine the quality of clinical encounters, which easily triggers disputes. Empirically, a heavy workload is associated with a larger number of disputes. A greater number of disputes are associated with higher-level hospitals, which can afford larger financial settlements. The resolution of disputes via the legal channel appears to be unpopular. This article argues that restoring a healthy doctor–patient relationship is no less important than other institutional aspects of health care reform.

scholarly journals What Influences Doctors’ Perceptions of The Doctor–Patient Relationship? — A National Cross-Sectional Study in China

2020 ◽  
Author(s):  
Shiyang Liu ◽  
Linlin Hu ◽  
Shichao Wu ◽  
Yuanli Liu
Keyword(s):  
Work Experience ◽  
Cross Sectional Study ◽  
Chinese Government ◽  
Patient Relationship ◽  
Work Experiences ◽  
Security Measures ◽  
Sectional Study ◽  
Doctor Patient Relationship ◽  
Cross Sectional ◽  
Medical Disputes

Abstract Background: Tense doctor–patient relationships have become a great challenge for the Chinese government due to their high incidence rate and negative social impact. This study aimed at exploring the factors influencing doctors’ perceptions of the doctor–patient relationship.Methods: We conducted a national cross-sectional study in 136 tertiary grade-A hospitals in China. A total of 19,774 doctors reported their perceptions of the doctor–patient relationship over the last two years, as well as sociodemographic factors, work experience, and hospital security measures. A logistic-regression model was used to identify factors significantly associated with doctors’ perceptions of the doctor–patient relationship.Results: Doctors’ perceptions of the doctor–patient relationship were relatively negative. Region, hospital type, gender, age, and income influenced these perceptions. With regard to doctors' work experience, those with excessive workloads, those who had experienced medical disputes, and those who did not have enough communication time with patients tended to report more-negative perceptions of the doctor–patient relationship. In terms of hospital security measures, doctors working in hospitals with effective precautions, in-place security staff, and medical-liability insurance purchased for medical staff tended to report more-positive perceptions of this relationship.Conclusion: Doctors’ work experiences and hospital security measures both played essential roles in improving doctors' perceptions of the doctor–patient relationship. On the part of doctors, improving their communication skills and providing adequate communication were beneficial to their perceived relationships with patients. On the part of hospitals, reducing doctors’ workloads, preventing medical disputes, and increasing job security and organizational support are potential ways to improve doctors' perceptions of these relationships.Practice implications：This study provided evidence and advice for Chinese government, as well as Chinese hospitals, to improve doctors’ perceptions of the doctor-patient relationship by measures of enhancing doctors’ work experiences and hospital security.

scholarly journals Independent Medical Examinations: Facts and Fallacies

2009 ◽  
Vol 5;12 (5;9) ◽  
pp. 811-818
Author(s):  
Paul Ky
Keyword(s):  
The United States ◽  
Legal Framework ◽  
Patient Relationship ◽  
Injured Worker ◽  
Legal Process ◽  
Doctor Patient Relationship ◽  
Social Controversy ◽  
Independent Medical Examinations ◽  
Independent Medical Examination ◽  
Medical Examinations

Background: Independent Medical Examinations (IMEs) have protected the rights of workers in the United States since the first laws protecting employees were established in the early 1900s. There have been many social advancements and a great collective struggle over the last 100 years that have ultimately lead to justice for the injured or disabled worker. Objective: We describe the origins of the IME as well as the evolution of both medical and social processes that have provided the legal framework for the correct practice of IMEs. This article will summarize the current medical principles, legal process, and social controversy embodying the modern IME. Discussion: Medical professionals must adhere to the same principles of impartial and ethical conduct that they uphold in general patient care when dealing with IMEs. Although previously controversial, it is now clear following successful litigation of many physician examiners that at least a ‘limited doctor-patient relationship’ is created during an IME. Limitations: The limitations of this manuscript include a paucity of the literature, lack of IME updates, and certain conflicts with guidelines by various organizations. Conclusion: IMEs represent a valuable mechanism for determining alleged impairment and/or disability. In the current economic environment of declining reimbursement to physicians, IMEs exist outside the scope of traditional payment methods and offer competitive compensation. Key words: Independent Medical Examination, disability, impairment, worker’s compensation, injured worker, disabled worker, doctor-patient relationship

A Cognitive Research on Doctor Metaphor and Doctor-Patient Relationship Metaphor

2021 ◽  
Author(s):  
Youwen Yang ◽  
Xie Jia ◽  
Xu Meirongzi
Keyword(s):  
Social Issue ◽  
Cognitive Linguistics ◽  
Current Situation ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Medical Experience ◽  
Cognitive Research ◽  
Medical Disputes ◽  
Similarities And Differences ◽  
Short Time

Abstract From the perspective of "conceptual metaphor" in cognitive linguistics, 11 kinds of doctor metaphors and 6 kinds of doctor-patient relationship metaphors are reached by a tentative study. Based on nearly 300 questionnaires and interviews with 20 doctors and patients, this paper discusses and analyzes: 1) the current situation of doctor-patient relationship; 2) the understanding of "doctor metaphor" and "doctor-patient relationship metaphor" from both perspectives of doctors and patients, and finds out the similarities and differences; 3) the collection of doctor's description of doctor occupation and patient's description of medical experience, and with the combination of 1) and 2), this paper suggests the measures to alleviate the medical disputes. Medical conflict is a perpetual and intricate social issue, which involves doctor, patient, hospital, government and etc. It is not supposed to be solved in a short time, whereas requires the endeavor of generation after generation.

scholarly journals Doctors in Chinese public hospitals: demonstration of their professional identities

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhanming Liang ◽  
Min Xu ◽  
Guowei Liu ◽  
Yongli Zhou ◽  
Peter F Howard
Keyword(s):  
Professional Identity ◽  
Medical Profession ◽  
Diagnostic Procedures ◽  
Public Hospitals ◽  
Ethical Practice ◽  
Medical Graduates ◽  
Ethical Decisions ◽  
Treatment Plans ◽  
High Standards ◽  
Chinese Public

Abstract Background An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession. Methods A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Findings In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients’ views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment. Conclusions Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended.

Psychiatry and the Role of the General Practitioner

1972 ◽  
Vol 3 (4) ◽  
pp. 287-301 ◽  
Author(s):  
E. D. Wittkower ◽  
W. J. Stauble
Keyword(s):  
General Practitioner ◽  
Medical Profession ◽  
Physical Illness ◽  
Wide Field ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Balint Groups ◽  
Whole Person ◽  
Emotional Conflicts

The psychiatric role of the general practitioner covers a wide field and depends crucially upon his efforts to understand himself, his patient, and the doctor-patient relationship. The patient must be approached in terms of how he is affected emotionally by physical illness, and how his state of physical health is affected by his emotions. His behavior during initial stages of physical illness, his reaction to the diagnosis, and his feelings and interactions during the full-blown stages of illness are important areas for the doctor to explore in order to deal more effectively with a patient's withdrawal, depression, narcissism, frustration, or anxiety. The doctor must also explore his own motivations for choosing the medical profession in order to implement his role in caring for patients. Each of the models of the doctor-patient relationship–activity-passivity, guidance-cooperation, mutual participation-requires different degrees of emotional involvement on the part of the doctor. An understanding of the psychodynamics of this relationship, involving the attitudes and conflicts of both members, can help the general practitioner to handle effectively and successfully his patients in everyday practice. Practical suggestions are made for teaching psychological concepts to general physicians: improved courses in psychiatry in medical schools, emphasizing the “whole person” approach; ongoing seminars for doctors in practice–“Balint Groups”–in which the aim is to understand the nature of the patient's emotional conflicts, the doctor-patient relationship, and the part the doctor plays in it; refresher courses; and consultations with psychiatrists.

scholarly journals Patient Satisfaction with Orthodontic Treatment Received in Public and Private Hospitals in Dammam, Saudi Arabia

2018 ◽  
Vol 6 (8) ◽  
pp. 1492-1497
Author(s):  
Abdulwahab Aljughaiman ◽  
Ali Alshammari ◽  
Abdullah Althumairi ◽  
Abdulaziz Alshammari ◽  
Naif Almasoud ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Patient Satisfaction ◽  
Orthodontic Treatment ◽  
Public Hospitals ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Private Hospitals ◽  
Public And Private ◽  
Validated Questionnaire ◽  
Public And Private Hospitals

BACKGROUND: The demand for orthodontic treatment is on the rise, and there are high patient expectations for improved dentofacial appearance. Patient satisfaction with orthodontic treatment is associated with improving treatment outcomes.OBJECTIVE: To evaluate patient satisfaction with orthodontic treatment received in public and private hospitals.MATERIAL AND METHODS: This cross-sectional study was conducted on a calculated sample of patients who received orthodontic treatment in public and private hospitals in Dammam, Saudi Arabia. A validated questionnaire (five-point Likert scale) was used to assess patient satisfaction with orthodontic treatment.RESULTS: A total of 229 out of 243 patients completed the survey (response rate = 94.2%). The mean age of the participants was 22.69 ± 6.34 years. More females (65.5%) than males (34.5%) participated in the study. The participants gave the highest satisfaction score to the doctor-patient relationship (mean score 4.33). This was followed by dentofacial improvement (mean score 4.23), dental functions (mean score 4.20), and psychosocial improvement (mean score 3.94). The participants provided significantly more positive perspective about doctor-patient relationship in public than private hospitals (P = 0.014). The patients treated in private hospitals were more satisfied with dental functions domain than those who received treatment in public hospitals (P = 0.023). The patients treated by public orthodontists were significantly more satisfied with other domains (situational aspect and residual category) than by the private orthodontists.CONCLUSION: The doctor-patient relationship was the most important factor in satisfaction with orthodontic treatment. Overall, patients treated in public hospitals were more satisfied with orthodontic treatment than those in private hospitals.

Sign in / Sign up

Export Citation Format

Share Document