Medical disputes occur frequently. Is the main problem with the doctor or the patient?

My personal concept is 90%. Once opened, the hospital or the doctor is responsible for 90% of the responsibility, and the patient or the patient's family member is responsible for 10%. The reason is that the patient doesn’t know anything when he enters the hospital. As a vulnerable party, he basically obeys and believes every word of the doctor. How can he have the right to talk back? Even if there are a few patients or people with bad family temperament who quarrel with the doctor, it is because they are dissatisfied with the doctor because they have done so many things that they can't stand it anymore or can't tolerate it. It's normal for them to quarrel with the doctor. The patient or the patient's family members are all grandsons in front of the doctor. No one dares to argue with the doctor. Therefore, as an ordinary person, I have been in the hospital not once or twice. Based on my own feelings or what I have seen and heard, most of the responsibility must lie with the hospital or the doctor, and the patient or family members have very little responsibility.

There are three reasons for doctor-patient disputes. First of all, doctors are not immune. Many doctors who lack medical ethics intentionally or unintentionally cause unnecessary accidental casualties to patients. Some patients and their families suffer serious consequences. If you don't know about it, or you choose to settle the matter after knowing it, if you can't accept it, it will easily lead to disputes or medical trouble.

The second aspect is patients. Society is full of surprises, and both good and bad people will get sick. People who are usually picky or often dissatisfied with others in society will easily have disputes with doctors when they go to see a doctor, even if it is sometimes Don’t blame doctors for unnecessary disputes. This is increasingly the case with society's biased distrust of doctors.

The third reason is the system. There are problems in the entire medical system, from drug circulation to the diagnosis and treatment process. In recent years, anti-corruption efforts have improved compared to the past. The prices of medicines are increased one by one to reach astronomical prices for patients. It is common for doctors to receive gifts in red envelopes. Some doctors are almost businessmen. Their main purpose is to make money. They treat minor illnesses as if they are ill and cure minor illnesses... This starting point will inevitably lead to no doctor-patient disputes.

Originally, doctors saved lives and healed the wounded, and teachers taught and educated people, which were respected professions. What about now? Relevant regulatory authorities should pay attention to the underlying reasons behind the sharp increase in doctor-patient conflicts.

No matter how you answer such a question, there will be problems.

Because the answer to such an all-or-nothing question is different for everyone. This is related to his own, relatives or friends’ medical experience, and also to his perception of some cases in society. The answer may be different. There are more or less prejudices, and it will inevitably be biased or one-sided.

In recent years, the doctor-patient relationship in some places in our country has not been so harmonious. What is the problem? Chinese people have thought a lot and discussed this issue a lot, but basically there is no unified point of view. I would like to share my own views here. The relationship between doctors and patients is tense. I think the problem does not lie in medical treatment itself, but in ideological and moral issues. , Integrity level.

After decades of reform and opening up, my country's economy, society, technology and other aspects have achieved comprehensive and rapid development. However, while economic wealth is growing rapidly, some profit-seeking and profit-oriented ideas have corroded the country. In addition to the normal structure of society, the lack of basic integrity among members of society leads to extreme events that occur from time to time. In some cases, doctors are less benevolent and consider economic factors more. No matter what your situation is, if you don't have money, you will not treat the disease, and if you don't have enough money, you will stop the treatment. Everything that is wrong with the patient is the doctor's fault. He does not examine his own problems at all, and even makes some unreasonable demands. These phenomena have led to poor communication and sharp conflicts between doctors and patients.

To solve such a problem, first of all, we must start from the ideological and moral level and establish a social integrity system.

Secondly, establish and improve various rules and regulations to regulate the behavior of both doctors and patients.

Third, increase penalties for doctor-patient cases and adjust the doctor-patient relationship.

Medical disputes occur frequently. The main problem is not with doctors or patients, but with the cost of medical treatment. If the cost issue can be solved, I think medical disputes can be reduced by at least 90%.

I think this cost issue can be discussed from both the patient and doctor perspectives.

1. Patients

What do patients look forward to most when seeing a doctor? Spend less money and get better results.

If too much money is spent, patients and their families will feel stressed, and their emotions will change when they are stressed. Sometimes a small problem may be magnified and cause medical disputes. I have encountered such a thing. There was an old man who had gastric cancer. His family did not tell him the actual condition. After the operation, he always refused to cooperate with the doctor's treatment. Every time the nurse went to give him fluids, he always found fault with him and sometimes even refused the infusion. At first, everyone felt that this patient was really unreasonable. Finally, because the indwelling needle for infusion was clogged, a new indwelling needle was needed. The old man became furious and insisted that the nurse did not inject the indwelling injection properly. Although the doctors and nurses explained repeatedly, the old man refused to listen and even yelled at him in the end. Later, the family members explained the reason to us. The old man is usually very frugal. The bill for the hospitalization expenses was sent to him every day. Nothing else. In this way, everyone understands that it is all a matter of cost.

Sometimes it is difficult to say whether the curative effect is good or not. No doctor can guarantee that he will treat the patient well. Especially for surgeons, complications after surgery are unavoidable. Once complications occur, the hospitalization time will be long and the cost of treatment will be high. Patients and family members will have ideas, and medical disputes will arise. If all costs are not borne by the patient but paid by the insurance company or the government, then even if there are complications, the patient and his family will treat it rationally and wait for the condition to improve. As for who is responsible, this can be identified by an authoritative organization. , medical disputes can be greatly reduced.

2. Doctors

In addition to clinical diagnosis and treatment work, doctors also have to deal with cost issues. In today's medical environment, if a patient owes money, the doctor may have to press for payment, which may make both parties unhappy, or even turn into a medical dispute.

Every industry is the same, and the quality and level of doctors also vary. So sometimes, the fault of medical malpractice does lie with the doctor. When this happens, the patient refuses to pay for the hospitalization because it was the doctor's fault that caused the additional cost of the hospital stay. Then, hospitals and doctors have to pay for this cost. Will the doctor be emotionless? It happened that the patient was also emotional, and a medical dispute broke out. If doctors don't need to worry about costs and focus on making up for their mistakes and striving for a good result, the probability of medical disputes will be very low.

3. Summary

If medical reform can solve the cost problem and truly achieve low cost and good results, I think medical disputes can be greatly reduced.

This problem is really not a simple matter of which aspect. It cannot be said that it is the doctor's fault or the patient's fault. As the saying goes, a slap in the face can't make a difference, everything has two sides. Another important reason is the problem of the medical system.

Domestic doctors can be said to be the cheapest medical workers in the world, and every doctor is overworked. Just like this epidemic, tens of thousands of doctors from all over the country rushed to Wuhan, Hubei, regardless of their own safety to support the epidemic area. Some doctors are infected, and some doctors recover after falling down and continue to fight on the front line. But what is sad is that some doctors never get up after falling down.

Now that the epidemic is raging, there are still injuries to doctors. Before this, doctors were often injured or even killed. There are no beds for medical care, no separate wards for medical care, medical care because the attitude of the doctors is not good, medical care for patients who are not transferred to wards, etc.

If you slap someone outside, you may not only have to pay money but also be imprisoned for a few days. But when it comes to medical care, you may need to apologize verbally. Some injuries to medical staff with knives may be exempted from criminal liability as a doctor-patient dispute. Of course, the injured doctor is now in prison.

Chinese doctors see more than 100 people a day in outpatient clinics. No one dares to drink during work because they are afraid of going to the toilet.

A doctor only has a few minutes, and disputes may arise when encountering a patient who does not understand. Most hospitals wanted to keep the matter quiet, but in the end the doctor could only apologize in turn.

Of course, the problem does not all lie with the patients. It is true that some doctors have problems with their medical ethics. The attitude towards patients is bad, and some doctors even over-medicalize and increase the burden on patients. There are also times when doctors fail to explain things clearly to patients, causing misunderstandings between them.

In the current medical system, high-quality medical resources are concentrated in tertiary hospitals in big cities. Patients are concentrated in these large hospitals, while the lower secondary hospitals are empty, while the rural hospitals are sparse. This also makes it impossible to squeeze in from above, and there is nothing to do below. When resources are tight, it is naturally more likely to cause conflicts.

Therefore, there are many reasons for frequent doctor-patient disputes. It is hoped that future medical reform will gradually solve these problems, doctors and patients will understand each other, and doctor-patient disputes will no longer occur.

I am a senior chief surgeon who came from one of the top 100 hospitals in the country. I have worked in tertiary, second and first-class hospitals. I have also been in medical management for many years and have been exposed to various types of surgery. I am a patient and have dealt with various medical disputes. Let me tell you about my experience at work.

1. Sincere communication is the basis for establishing trust between doctors and patients and preventing medical disputes.

I wonder if you have noticed an interesting phenomenon: Doctors perform operations on their relatives or familiar friends. Even if the patient's recovery process is not ideal or even complications occur, he rarely listens. It was said that there was a medical dispute between the two parties. Why? Because these patients know that the doctors who treat them must be sincere in helping them and must use the best treatment methods. Even if the condition does not recover well, it is definitely a problem with the disease itself, not the doctor. And the doctor dares to use the best treatment method to treat the patient because he will not worry that the patient will complain about him. If there is enough trust between both parties, medical disputes will naturally not occur. Therefore, the degree of trust between doctors and patients is the key to preventing medical disputes. The trust between doctors and relatives, friends and patients is formed over a long period of time, and there is even a blood relationship. Not every doctor and every patient has it.

2. The doctor said: How can I do my best to my patients? Why are you still being complained?

From a humanistic point of view, in fact, any medical staff likes to cure their patients and make the operation more perfect. And they are all dedicated to helping patients. Perhaps due to lack of knowledge and experience, doctors and nurses may make inconsiderations or make mistakes. This is not what doctors and nurses want, and must be something they are ashamed of. Because of this, once a patient complains to medical staff, medical staff feel particularly aggrieved and sad. This type of medical complaint is currently the most medical dispute complaint received by the hospital. Most of the investigation results of this type of complaint are similar, that is, the doctors and nurses have tried every means to help the patient treat the disease, but because they are too busy, they have not communicated seriously with the patient, causing the patient to misunderstand. Therefore, this type of medical complaint dispute is easy to handle. Just ask the medical staff to patiently explain it to the patient, and the problem will be solved. Therefore, when doctors treat patients, they must not only heal their illnesses, but also their hearts. Only in this way can we become a good doctor who satisfies the masses.

3. What causes patients to have medical disputes with hospitals?

Due to the serious lack of popular medical knowledge in China and the complexity of disease and medical treatment, patients do not understand the true situation of disease and medical treatment. For example, how heavy and complicated is the disease? Why do complications occur? Why can't "good people" heal me when I come here? . Is it guaranteed to treat this disease in this hospital? Can hospital doctors be trusted? Which doctor is the best? Are hospital charges reasonable? Are hospital examination equipment good? The lack of this information makes patients feel insecure. For many years, in the medical system, hospitals have had a direct interest relationship with patients, which has given patients the consumer concept of whether hospitals will seek profits and defraud themselves. This further increases the crisis of trust for patients and their families.

Insufficient communication between doctors and patients, the suffering of patients and the pressure of life, as well as some media's biased propaganda, have turned this crisis of trust into conflicts between doctors and patients, leading to the outbreak of medical disputes.

4. How do European and American countries prevent medical disputes?

In European and American countries, doctors and patients both sign contracts with insurance companies and purchase insurance. Patients buy disease insurance, and doctors buy medical liability insurance. There is no direct interest relationship between doctors and patients. Both parties buy insurance through insurance companies. The insurance company benefits. In order to maximize their own interests, insurance companies have long established a mature medical credit system through medical big data to dynamically evaluate the value of each contracted doctor accurately, truthfully, objectively and fairly. This information is also used by patients. Can be consulted at any time. Therefore, patients have no fear that doctors will treat them badly for their own benefit. Therefore, in a word, the key to preventing medical disputes in European and American countries is to have a mature medical credit guarantee system recognized by both doctors and patients.

4. Winter is passing and spring is coming soon.

With the rapid development of our country's economy, the country's system is gradually improving. At present, our country's universal medical insurance system has been completed. Medical treatment charges for single diseases will soon be rolled out across the country, and medical treatment in other places will also be available. Once it is generally implemented, doctors and patients will no longer have a direct interest relationship in the future. Therefore, under this national medical security system that is comparable to, or even surpasses, Europe and the United States, patients no longer have to worry about medical staff treating them poorly. Instead, we focus on grassroots care, keeping serious illnesses within the county, medical counterpart poverty alleviation, and group-type specialist construction and regional The implementation of a series of national medical policies such as the construction of national medical centers will allow patients to no longer have to travel far and can safely seek medical treatment in their hometown. It can be said that whether it is doctors or patients, the spring of national medical care is coming.

5. How to live a warm winter before spring arrives?

Although the national universal medical insurance policy has been improved, single-disease charging has been launched in more than ten cities, and the medical counterpart poverty alleviation policy has been adhered to for many years, however, the establishment of this set of policies is comparable to Europe and the United States, and even It still takes time to surpass the national medical security system in Europe and the United States. Before the arrival of the medical spring in this country, our hospitals should strictly require medical staff: first, they must explain the condition clearly, secondly, they must care for the patient 24 hours a day, and thirdly, they must charge according to the disease type. Strictly control drugs and consumables to prevent unreasonable charges and ensure patient safety and security. In this way, I think both doctors and patients can have a nice warm winter before spring comes!

My point of view is also 9-1, but the patient’s family members are 9-1.

As a family member of a doctor, too many times my daughter-in-law comes home and complains about how uncooperative the patient is, but the doctor still has to say something. Two days ago, there was a patient with 700 inosine. He was uncooperative in various ways that day. He was rescued and admitted to the ICU the next day, but died a few days later. There are too many similar situations, and I often have to comfort my wife.

There are too many marketing accounts in China where doctors deliberately prescribe more medicines and prescribe more tests. If you think you are okay today, you will feel that the doctor deliberately deceived you.

It is not excluded that there are doctors with medical ethics in China, and there are many very responsible doctors. At the same time, for those doctors who only make money by buying medicines, let alone medical ethics, even their basic conscience has been replaced by profits. A child with skin allergy was hospitalized. When he went in, he had blood drawn for three consecutive days, and his urine and feces were tested. They said they were different test items. I can understand that. The child endured the pain and cooperated, but the result was that he was given continuous intravenous drips. I was suspended for a week, 6 to 10 hours a day, and took a lot of medicine. We all cooperated. On the fifth day, all the results came out. In the morning, the doctor came over for rounds and asked what the problem was. He said that he would not know until the attending doctor. When the attending doctor came over and asked him, he actually said that he was not sure what the cause was! ! ! He also said that he would draw blood again. I asked him, he had already done biochemistry and blood routine tests, and the results came out. Why did he still draw blood when he didn’t know the reason? Not only did he not answer, he even talked about the need for a diagnosis.

I want to continue taking blood tests after three blood tests but no results came out. I wonder, which family member would be willing? Which family member doesn’t feel heartbroken? There is another indicator. The sodium chloride is too low by 0.2. I drank 6 packs of salt water continuously, and then opened 3 more packs on the seventh day. I asked what the impact of this low value is, and why do I need to drink salt water continuously? The doctor said, "I want to help the patient have a better appetite." I really want to thank him. The child's appetite has not been bad since he was hospitalized. I told the doctor right after he was hospitalized.

What’s more, when various results come out, doctors never take the initiative to understand the reasons, and even ask them without telling them, and just prescribe medicines vigorously.

Isn’t this situation the root cause of medical trouble?

In the past, the level of medical care was low, and fevers and colds were not serious illnesses at all. A private clinic in the town would give you an injection and a prescription for a few cents, and you would be cured in half a day at most. Now you go to the hospital and you don’t care. The blood will be drawn first, and then the doctor will receive the patient, take a casual look at him, and then prescribe medicine. Two large bags of medicine, including intravenous injection, cost more than 300 yuan. Before leaving the consulting room, the doctor said, "Go back and take medicine first, and come back when you are not feeling better." He was truly a miracle doctor. He knew he would come back even before he left. After taking the prescribed medicine, his fever subsided a little in the morning, and not only did he feel better in the afternoon. No matter how much you withdraw, it still gets worse. Then I quickly went to the hospital to see a doctor. After a few casual visits, he prescribed medicine. In this way, more than 500 yuan of medicine finally cured the fever. Medicine and technology have advanced, but diseases have become difficult to treat. Is it because the efficacy of medicines has deteriorated or that doctors have buried their consciences?

Let me use a practical example for everyone to analyze and judge. Last year, because my wife often got angry, I took her to a rural hospital to see a doctor. The seemingly steady doctor first prescribed a blood test. After the test sheet came out, I asked the laboratory technician, "Do you have any questions?" The laboratory technician answered simply that there was no problem and it was normal. I took the test report to the outpatient doctor. The doctor looked at the test report and asked my wife in surprise, have you gone through menopause? Why is there something wrong with your red blood cells? You should do a CT scan! My husband couldn't hear clearly, but I could hear it clearly and almost laughed out loud. Out of respect for the doctor, I didn't object, so I let the doctor write out the examination form, and I took my wife out of the clinic. , laughed loudly, and told my wife what was going on. My wife said that this doctor might have a brain problem! The registration form clearly stated my wife's age - 69! If any doctor sees what I'm talking about, can he give me a clear explanation?

Both doctors and patients have problems. First, some doctors do not have the patience to explain the cause of the patient's disease and what needs to be paid attention to. They have a cold and disgusted face and do not feel a trace of warmth. This is the first reason for patients to feel unhappy. Second, some patients are under a lot of pressure in life and work and are not in good health or mood. If their family members are sick, they have no time to accompany them and feel distressed. There are other reasons why bad emotions have nowhere to release them. It is recommended that medical service institutions can understand the hearts of patients and their families and conduct psychological training courses for medical staff, so as to truly address the concerns of emergency patients and their families.