Toward doctor-patient rapport

These facts reflect a rather antagonistic environment within the medical profession. Worse, the doctor-patient relationship in the past decade has deteriorated from mistrust to conflicts leading to outright violence, and even murder.

Being the target of pervasive resentment, doctors on the Chinese mainland too are the losers. Compared with their peers in Hong Kong and Taiwan, and East Asian countries, mainland doctors are poorly paid. Several surveys show that doctors are unhappy with their income and heavy workload. Trained in medical school to be "angels in white", they have to face the hard realities in hospitals. It's no longer a secret that many doctors supplement their incomes from various sources, including red packets (hongbao), commissions on drugs and kickbacks (huikou), contributing further to the deterioration in medical practices and loss of patients' trust.

I was part of a survey on doctors in two provinces in December. Strikingly, 54.3 percent and 23.9 percent of the respondents described the current doctor-patient relationship as "tense" and "very tense". It was also disturbing to know that more than half the doctors surveyed had had at least one medical dispute with a patient in the past year. More startlingly, nearly 25 percent of the doctors had been physically assaulted by patients or their family members in the past year.

The mainland is in the midst of its ambitious national healthcare reform, and the initiative is on the right track. But the bloody violence targeting doctors sends an alarming signal to policymakers. And the problem cannot be solved until the healthcare reform addresses the root causes of the tension.

The government has to take decisive action to ameliorate these tensions and rebuild a healthy mode of interaction between doctors and patients. But this is easier said than done, because the existing situation mirrors the systematic dysfunction of the entire healthcare system rather than just the low trust between isolated individuals.

Nevertheless, several intermediary instruments are available for policymakers to consider, such as the adoption of medical malpractice insurance, participation of professional social workers in conflict management and using patient satisfaction surveys as a basis for distributing bonuses among medical workers.

The author is assistant professor at the Department of Asian and Policy Studies, Hong Kong Institute of Education.