Oct 30, 2013 07:35 PM

Closer Look: Why Patients Kill Their Doctors

People attend a memorial for slain doctor Wang Yunjie at Wenling No. 1 People's Hospital in Zhejiang

(Beijing) – Tensions are still high after a patient stabbed three doctors at Wenling No. 1 People's Hospital in the eastern province of Zhejiang.

The attack happened on the morning of October 25. One of the wounded, Dr. Wang Yunjie, later died. Medical workers at the hospital protested on October 27, calling for their safety to be guaranteed.

Attacks on doctors have become increasingly common in China. Two years ago a doctor at Beijing Tongren Hospital was fatally stabbed. At the time Caixin published a story headlined: "The Doctor-Patient War." Some readers said this headline was an exaggeration, but that view cannot be argued now.

Why have patients and doctors, whose common enemy is disease, become bitter enemies? Why are patients resorting to violence against their medical saviors?

On the surface, the knife-wielding murderer is to blame. Many have been found to have histories of personal problems and paranoia.

But there are deeper reasons. Amid economic growth and technological advances made in recent years, some in society have high expectations for the medical services they deserve. In their view, a doctor should be able to cure a disease after a trip to the hospital.

What they do not understand is that medicine is still an extremely complex field. Many treatments involve risks, and failures are not necessarily the doctor's fault. As one veteran doctor said: "Too many promises have been made regarding modern medical treatment of diseases."

Sometimes doctors cannot live up to those expectations. To go one step further, the public's lack of understanding regarding how the medical field operates has created a mistrust of medical professionals.

The patient in the Wenling stabbings had been diagnosed with chronic sinusitis and a deviated septum, the thin wall between the nostrils. The hospital said doctors performed successful surgery.

However, the patient believed doctors erred because the symptoms were in his right nostril but surgeons entered from the left. A doctor said that those concerns were misplaced. "For a case like his, the surgery always enters from the left nostril. This is true of surgery procedures all around the country."

In the Tongren Hospital attack in September 2011, a patient also believed – wrongly – that his operation had been botched. In that case, the patient underwent throat surgery but thought the doctor had misled him. Much of the misunderstanding was due to the patient's lack of medical knowledge. For this, he stabbed the doctor 17 times.

Poor communication between doctors and patients is exacerbating the issue. In the Tongren stabbing, the attacker's family felt the doctor and hospital showed poor attitudes. Family members said the patient was unable to contact the doctor before the surgery.

In these doctor-patient conflicts, information is asymmetric. Many patients do not understand the situation and deal with anxiety when making their decisions. Doctors should show more patience and provide more complete explanations to ease patient concerns. This would be very effective in ending the disputes.

Then again, China's good hospitals and good doctors are also the world's busiest and most overworked. Estimates say that a good doctor in China will see 70 to 80 patients a day, spending only about five or six minutes with each one. Under these circumstances, how can we expect doctors to fully and calmly answer every question from every patient?

Another reason that these conflicts have become a major problem is a shortage of high-quality medical resources. In order to pursue good treatments, most patients rush to the large hospitals in big cities. Hence, these hospitals are overcrowded and smaller ones are empty.

Meanwhile, medical expenses increase annually. The phrase "I cannot afford to get sick" has become a grim reality for many people. With a limited level of social security, many patients have to give up everything they have for the care they need.

It is unsurprising, then, that people will get angry when they feel their treatment is not satisfactory and they have trouble communicating with doctors.

Despite the launch of health care reforms five years ago, the doctor-patient conflict has intensified. The failure to address this issue is a failure of the reforms.

The solution to the problem lies in accelerating the pace of progress. The medical market must give greater access to private players and allow more competition. Ultimately, the supply of medical resources must be expanded so more people can get the quality treatments they want.

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