Violence against doctors in China

Violence against doctors and other medical malpractitioners in China has been reported as an increasing problem.[1] National Ministry of Health statistics indicate that the number of violent incidents against hospitals and medical staff increased from about 10,000 in 2005 to more than 17,000 in 2010.[2] A survey by the Chinese Hospital Association reported an average of 27.3 assaults per hospital per year in 2012, up from 20.6 assaults per hospital per year in 2006.[3] In 2012, an editorial in The Lancet described the situation as a "crisis" for the practice of medicine in China.[4]

Causes

Many of the reported attacks on Chinese medical practitioners have been by patients or their family members who were dissatisfied with the care they received.[1] In one widely publicized incident in March 2012, a patient suffering from ankylosing spondylitis and tuberculosis used a knife to attack several doctors in Harbin after the patient was refused a drug treatment that he had requested. One doctor who had not been involved in the patient's case died.[1] In August 2012, the family and friends of a patient who died in surgery in southern Nanchang started a "full-scale melee" that involved more than 100 hospital personnel; the hospital staff armed themselves with sticks and mace for self-protection.[2] In November 2013 several hundred doctors and nurses protested at the No. 1 People's Hospital in Wenling after a patient dissatisfied with his sinus surgery overpowered security personnel and stabbed three doctors.[5]

Violence may stem from patient dissatisfaction with care, costs associated with insurance premiums, unrealistic expectations, and overworked and underpaid hospital staff,[1] as well as the rising cost of health care due to the government's inability to subsidize hospital operations.[6] Lack of a third-party formal dispute resolution system in many hospitals has been suggested as a factor, and the acceptance of bribes or good-faith money in the form of red packets has been implicated.[5][7] Media coverage, and a lack of health literacy amongst the Chinese population, who may often seek unnecessary high-level care, have also been implicated.[1][8]

Yi Nao

The phenomenon of Yi Nao (Chinese: 医闹; literally: "healthcare disturbance") has been identified as a contributing factor in violence against medical personnel. Yi Nao is the organised disturbance of hospitals or medical staff, usually to obtain compensation for actual or perceived medical malpractice.[1][9] Yi Nao is usually perpetrated by organised criminal groups hired by patients or their families, although Yi Nao gangs may also solicit activity. Yi Nao has been increasing in recent years.[10] A 2013 article in the British Medical Journal describes Yi Nao gangs as consisting "largely of unemployed people with a designated leader. They threaten and assault hospital personnel, damage facilities and equipment, and prevent the normal activities of the hospital." [1][11] Citing a survey published in 2006 of 270 tertiary hospitals, over 73% of the hospitals reported experiencing Yi Nao.[1]

Response

The Chinese Medical Association has issued a statement calling for system-wide reforms to be made.[12] In October 2013 the Ministry of Public Security of the People's Republic of China advised hospitals with over 2,000 beds to hire "at least 100 security guards".[5] However, increased implementation of security guards, metal detectors, and legal threats has been criticised as failing to deal with the underlying causes of the violence.[4]

The International Business Times reported in November 2013 that hospital personnel at Zhongshan Hospital and Huashan Hospital were learning taekwondo from a martial arts instructor after a chief physician of the head of the otolaryngology department of Wenling Hospital was murdered by an angry patient in October 2013.[13]

Violence against doctors has been cited as one reason for a decrease in the popularity of medicine as a profession.[5][4]

References

  1. 1 2 3 4 5 6 7 8 Hesketh, T.; Wu, D.; Mao, L.; Ma, N. (7 September 2012). "Violence against doctors in China". BMJ 345 (sep07 1): e5730–e5730. doi:10.1136/bmj.e5730. PMID 22960376.
  2. 1 2 "Violence against doctors: Heartless attacks". The Economist. Jul 21, 2012. Retrieved 2 November 2013.
  3. ↑ Burkitt, Laurie (August 16, 2013). "Violence Against Doctors on the Rise in China". The Wall Street Journal. Retrieved 2 November 2013.
  4. 1 2 3 "Ending violence against doctors in China". The Lancet (editorial) 379 (9828): 1764. 1 May 2012. doi:10.1016/S0140-6736(12)60729-6. PMID 22579308.
  5. 1 2 3 4 Langfitt, Frank (6 November 2013). "In Violent Hospitals, China's Doctors Can Become Patients". National Public Radio. Retrieved 17 January 2014.
  6. ↑ Huang, Yanzhong (2013). Governing Health in Contemporary China. Routledge. p. 141. ISBN 0415498457.
  7. ↑ "Chinese doctors are under threat". The Lancet (Editorial) 376 (9742): 657. 1 August 2010. doi:10.1016/S0140-6736(10)61315-3. PMID 20801385.
  8. ↑ Wang, Xue-Qiang; Wang, Xiao-Tong; Zheng, Jie-Jiao (1 August 2012). "How to end violence against doctors in China". The Lancet (Letter) 380 (9842): 647–648. doi:10.1016/S0140-6736(12)61367-1. PMID 22901881.
  9. ↑ Ni Tao (May 7, 2012). "Hospital violence sign of doctor-patient strife". Shanghai Daily. china.org.cn.
  10. ↑ 广东医调委:五成现场医闹为"医闹组织"策划鼓动 (in Chinese). Nanfeng Daily. Retrieved 2 November 2013.
  11. ↑ 医闹、号贩将受治安处罚甚至被究刑责. Xinhua (in Chinese). Retrieved 2 November 2013. |first1= missing |last1= in Authors list (help)
  12. ↑ Zhang, Rui (31 October 2013). "Medical associations condemn violence against doctors". CNTV. Retrieved 2 November 2013.
  13. ↑ Tanquintic-Misa, Esther (7 November 2013). "Chinese Doctors Undergo Kung Fu Training Against Violent Patients' Attacks". International Business Times. Retrieved 17 January 2014.
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