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Mercenary healthcare endangers doctors’ lives
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Over the past month, at least six attacks on doctors have been reported within 10 days, leaving one dead and several others badly injured.
On October 27, staff at the No. 1 People’s Hospital of Wenling City, Zhejiang Province, took to the street to protest the killing of Dr Wang Yunjie, a colleague. They guarded Wang’s body and refused to disperse in a stand-off with police. Some doctors staged a sit-in, raising placards denouncing violence against medical workers.
It all started two days earlier, when a disgruntled patient who believed his surgery had been botched stabbed three doctors at the Wenling hospital.
The dramatic sight of doctors guarding the body of their slain colleague reminded people of the stunts often performed by families of patients who died after treatment. To wring higher compensation from hospitals, relatives occasionally exhibit the bodies of patients they claim died as a result of medical malpractice.
The spate of deadly attacks has caused heightened concerns by authorities. But concerns alone are not enough, for similar attacks keep taking place, a sign of patient-doctor strife.
Although the authorities and media have been calling for less antagonism and more trust, it is obvious that the distrust between doctors and patients runs deep and increasingly is boiling over into murderous anger.
The discord is rooted in the healthcare system itself.
Under the pre-reform system, doctors’ wages were paid by the state, and hospitals were not burdened by the need to turn a profit. It was a time when doctors could treat patients without any mercenary agenda.
The reform that started in the 1990s largely cut off government financial support to Chinese hospitals and left them to fend for themselves. Doctors learned to cope by prescribing overpriced, unnecessary medicine and ordering expensive tests. Their reputation suffered as a result.
The worst effect of leaving hospitals to the mercy of market forces is the murderously strained doctor-patient relationship. Convinced that they are mistreated and squeezed, patients lacking legal recourse desperately seek revenge. Any small signs of doctors’ “indifference” or “apathy” could trigger bloodshed.
Beefed up security
With their lives in danger, doctors propose increasing hospital security. For instance, it was proposed to post a guard for every 20 beds at a hospital in Jining, Shandong Province.
Some hospitals even hope for an in-house police presence.
The higher occupational risks of practicing medicine have severe psychological consequences.
Doctors wary of risks in treating patients tend to be more conservative and fearful of attempting complicated surgeries. Patients stand to lose from their cynicism and risk aversion.
If anything, blind faith in market fundamentalism has only succeeded in pitting doctors against patients. Calling for more understanding is clearly meaningless when the stakes are this high.
The fundamental way to ease tensions is to debunk the myths about market forces and reconsider the ongoing healthcare reform.
In fact, initiatives are now being taken in many places to restore some of the features of the old healthcare services.
At the heart of them is the resumption of government subsidies to hospitals.
The market-oriented healthcare reform has been increasingly an object of criticism for soaring medical costs and poisoned doctor-patient relationship.
If that earlier reform was driven by economic expediency and the desire to shed the healthcare burden, now is the time for governments, far more awash in cash now, to reassume that responsibility.
No one is so naive as to hope for an outright return to the age of free healthcare, but hospitals’ operational model needs to change. Doctors need to stop living off the staggering profits of medicine to win back trust and respect.
As the Beijing Times asked in an article, “How should doctors earn their bread? Through skills and better service,” it answered. Right now some doctors are paid disproportionately low wages compared with their enormous and stressful work load.
Contrary to the popular misconception that all doctors are rich and privileged, most of them have low income and social status. This writer once interviewed a head of a Class-C hospital (community hospital) in Shanghai and was told that low-level doctors are paid only 4,000 to 5,000 yuan (US$833) a month. They don’t fit the image of those who become filthy rich by fleecing patients.
Market credo
People’s Daily also weighed in on Wednesday, saying that doctors all over the world earn their livelihoods through medical expertise. An exception is their Chinese counterparts, who are more like salesmen of pharmaceuticals, which naturally hurts their trustworthiness. This is less a question of ethics than a flaw of the system, the paper concluded.
As in the West, medicine has been an esteemed profession in China since time immemorial. It was only after the bungled healthcare reform that the once widely respected profession became much-maligned.
It would be tragic if doctors’ supposed aspiration to ease pain and save lives were reduced to the humble hope of “going home alive after work.” Before long, the mediocrity of many doctors will be the bane of the whole society.
Our reformers had hoped to improve medical services by pushing through Western-style reforms in the health sector.
Their efforts are replete with failures. And the failures will continue to cost us if young people are discouraged from practicing medicine because of the unrelenting violence against doctors. By then, will we be forced to import doctors to redeem the earlier failures?
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