A disturbing trend is underway. According to an editorial in the latest edition of The Lancet, there is a surge in patient violence against doctors in Chinese hospitals. Root causes include “poor investment in the health system and in training and paying doctors, which can lead to medical errors, corruption, and poor communication between health professionals and patients.” The Lancet also highlights societal factors such as “negative media reports about doctors, poor public understanding of medicine, unrealistic patient expectations about treatments, and catastrophic out-of-pocket health-care expenses for families.”
The government response – announced through the Ministry of Health and the Ministry of Public Security in response to the latest incident in which a patient stabbed a male intern to death in Harbin – was to step up police security in hospitals and criminally charge “people who disrupt the daily operation of hospitals, carry dangerous materials, or threaten medical staff”.
As the editorial points out, this is a short-term solution that does not touch upon the more systemic causes of patient discontent. According to a doctor working in an HIV/AIDS hospital near Kunming, Yunnan Province, her unit is only covered by a handful of doctors and two nurses. She lamented the limited amount of time doctors have to spend with each patient. This hospital is one of the few hospitals with specialized HIV/AIDS services in Yunnan and handles cases from all over the province. Each of these doctors may see up to 60 patients per day. During a 9 hour work day, that’s roughly 6 patients per hour with only about 10 minutes with each of them. To provide better services, the hospital needs to work with social workers, NGOs and people that are educated in counseling and can respond clearly and patiently to the questions and issues patients face. With more holistic and individualized support, hospitals can link patients to existing social services and help them through new challenges.
For HIV/AIDS there is evidence that many NGOs already have the capacity to provide these support services– including but not limited to voluntary counseling and testing (VCT). Targeted training will be needed to build the skills of patient rights groups in other areas, as well as extend and sustain the support networks already available. Another important part of creating positive change for patients and hospital staff will be to assign funding for hospitals in China to hire social workers and NGOs as partners.
