Tuesday, Oct 21, 2014, 5:41 PM CST – China

Commentary

Healthcare workers should not be blamed for China’s healthcare system

Violence against doctors and support staff reflects a dangerous trend among the public to direct anger at the system toward grassroots workers

In recent years, Chinese hospitals have witnessed a spike in the number of violent physical attacks on healthcare workers. In the most recent case, a Zhejiang man unhappy with the results of an operation stabbed a doctor to death and wounded two others (See: “Inevitable Brutality,” NewsChina, December 2013, Vol. 065). According to a report by the Chinese Hospital Association (CHA), on average, every public hospital in China reported 27 physical assaults on its staff in 2012.

As the risk of physical violence has become an occupational hazard, healthcare is looking like an increasingly unappealing line of work. In online forums, doctors and nurses are now circulating “safety tips” on how to deal with patients who turn violent. In a separate survey carried out by the CHA, 40 percent of doctors claimed they were considering changing professions, and 78 percent did not want their children to become healthcare professionals.

In an obituary dedicated to Wang Yunjie, the doctor killed in the attack in Zhejiang, Song Yan, a Beijing pediatrician, wrote that he hoped Wang would not become a doctor in his next life.

China’s healthcare system suffers a myriad problems – underinvestment, the massive cost of treatment for chronic conditions, a lack of access to services in many areas and issues such as over-prescription and over-treatment stemming from the need for doctors to supplement meager salaries with additional gray income, have all stretched doctor-patient relations to breaking point.

But some believe the media has also played a role in the deteriorating relationship between healthcare professionals and their patients. While State media outlets have made healthcare reform a major discussion topic since the 1990s, little has been done to improve care in China’s public hospitals. Regular reports of abuses of the system by negligent nurses and corrupt doctors have eclipsed more level-headed examination of the systemic flaws that contribute to such scandals.

This has created a precedent whereby whenever a dispute arises between a patient and a healthcare provider, the default position is to blame the provider, regardless of the context. Even when patients murder their doctors, there is often a public outpouring of sympathy for the patient, not their victim or victims. This, in turn, further fuels mistrust of the healthcare community, and leads to more disputes. Some have even turned medical disputes into lucrative sources of income, fully aware that hospitals, fearing media scrutiny and physical violence, are ever more inclined to offer a generous settlement regardless of whether or not they are at fault.

This has also meant that police are reluctant to intervene when healthcare workers face physical threats. A friend of mine, for example, a doctor, posted a former patient’s picture in an online forum to warn his colleagues that the man had regularly threatened both him and his co-workers, saying they would “all die together.”

When a hospital official called the police, however, they responded they could not take action unless the patient acted on his threat. Doctors claim this hands-off attitude has led to the phenomenon of “professional hooligans” in many localities, who can be hired to blockade hospitals, assault staff and issue threats in order to secure compensation payments for real or invented medical errors.

We must be aware that to a large extent, healthcare workers are also victims of the current system, with crushing workloads and miniscule salaries. Despite the undeniable existence of corruption, we should not demonize an entire profession for the actions of a few. While it is frustrating that problems with China’s healthcare system remain chronic, to pillory those that continue to provide care to patients, rather than those holding the power to effect real change, is simply misguided.

To fundamentally address the rising tide of violence against healthcare workers, the government must take swift action to reform the healthcare system, before it is too late.

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