Which future for doctors in China?

Abstract

Listen

Translate article

Medical practice has become a high-risk job in China. Doctors' legitimate rights and interests cannot be fully guaranteed; many are under threat of intimidation and violence, and several have been killed because of their medical activities. On Nov 29, 2012, the head of the acupuncture department of Tianjin University of Traditional Chinese Medicine, was killed in her clinic;1Moore M Female doctor axed to death in Chinese hospital. The Telegraph.http://www.telegraph.co.uk/news/worldnews/asia/china/9711408/female-doctor-axed-to-death-in-chinese-hospital.htmlDate: Nov 29, 2012Google Scholar and this is only one example of a long list. Although the Chinese Government has introduced policies to protect doctors, there are no meaningful measures at present to stop such tragedies. 12 cases of violence against doctors have been reported so far in 2013; by this time last year, 14 cases had been reported.2China Medical TribuneMedical War in 2012.http://www.cmt.com.cn/detail/111139.htmlGoogle Scholar, 3China Medical TribuneViolent events against doctors in the first half of 2013.http://www.cmt.com.cn/detail/270013.htmlGoogle Scholar What is the source of so much tension between patients and doctors? According to Therese Hesketh and colleagues,4Hesketh T Wu D Mao L Ma N Violence against doctors in China.BMJ. 2012; 345: e5730Crossref PubMed Scopus (151) Google Scholar commodification of the health-care system is the main cause of deteriorating conditions. Patients pay most treatment costs themselves; even with health insurance, the proportion and the amount of reimbursement is limited, despite efforts of the Chinese Government to improve the situation. Moreover, some hospitals are self-financing or semi self-financing, and aim to increase revenue generation. So, there might not be short-term solutions to the financial problem. Beyond that, many patients and their relatives misunderstand the medical profession. They believe that, no matter what the disease is, if they get treatment in hospital they will have a remarkable therapeutic effect or even be cured. If the treatment is not satisfactory, patients and their relatives will vent their dissatisfaction with doctors. Additionally, some media have reported false medical disputes to increase audience ratings. As for doctors, 80% describe themselves as overworked and underpaid in secondary and tertiary facilities. Even in cities, many doctors earn as little as 5000 yuan (US$780) a month or less. Senior doctors earn consultation fees of just 7 yuan ($1·14) in most hospitals. Doctors' workloads have increased, and many forgo their rest hours to serve outpatients or do operations. The recent deaths of four doctors have been attributed to overwork.5Chinese Medical Doctor AssociationFour doctors dead within a week: who will guard the physicians' health?.http://www.cmda.gov.cn/xinwen/redianxinwen/2013-07-14/12299.htmlGoogle Scholar Overworked, underpaid, and under threat, I wonder who will be the next doctors in China? I declare that I have no conflicts of interest. Human rights in ChinaOn May 14, the Information Office of the State Council—China's cabinet—published Progress in China's Human Rights in 2012. The cabinet's white paper assesses human rights achievements through the lens of development: “Development is the key to solving all existing problems and facilitating progress of human rights in China.” The report reviews economic and social achievements as progress in human rights. It also lists improvements in living standards, stresses the achievements of lifting millions of Chinese out of poverty, raising annual incomes, improving education, housing, health insurance coverage, and access to health, and decreasing mortality of children younger than 5 years ahead of the Millennium Development Goals deadline. Full-Text PDF