Explaining doctor-patient disputes: Doctors are afraid that doctors will not do high-risk surgery

The doctor saves the sick and has no "deep hatred" with the patient. However, the relationship between doctors and patients is not so harmonious, and some have even reached the point where they are incompetent. What caused the mistrust between doctors and patients? Recently, the reporter went to Qilu Hospital of Shandong University and the Fifth People’s Hospital of Jinan City to experience the doctor-patient relationship and experience the process of “patient-patient disputes”.

To open a diagnostic certificate, the number of communications "rounds"

Dispute reason: I do not know to issue a letter of introduction

"A lot of patients don't know that they need to issue a letter of introduction. When they are in a hurry, we are worried. In this case, we just listen and we can't hurry. Otherwise, we won't fight it?" Qilu Hospital Patient Service Center of Shandong University is responsible for issuing diagnostic certificates. Nurse Fang Ze said.

The patient service center is responsible for the provision of services such as registration review seals (sick leave, diagnostic certification review), medical guidance, appointment consultation, and medical record copying for patients. At the same time, some complaints from patients are also accepted and processed.

At 8 am on December 15, 2011, I came to the service center. The sight in front of me caused me some surprises: The patients were filled with consultations and procedures. In the crowd, one patient shouted: "I was hospitalized in you. Why is it so troublesome to open a diagnosis? I am out of town. It is not so convenient to open an introduction letter..."

Nurse Fang Ze explained that “we have proved to be legally valid. If you want to open it, you need a letter of introduction from the relevant unit. If you cannot go back and open it, you can let your family fax the letter of introduction.”

The patient was reluctant to give up. "If I open a diagnosis to prove that it is not going to do bad things, then you will become accomplices." "Not that I do not understand. If someone takes this to defraud insurance or other illegal activities, what should we do?"

Both of you came to me and communicated several "rounds." In the end, the patient chose to call back to his hometown and let his family fax the letter of introduction.

Fang Ze said, “I have been doing this work for more than five years. This patient is not yet very difficult to do work. In fact, the patient is anxious we also understand that when training, the leadership also taught us to transpose and think about it. It's not angry to think about it."

At 11:40, the complaint phone rang and a patient complained to the registration office. “Why not register? I complained to her.” Jiang Shuiqiang, head of the patient service center, explained, “The registration office stops registration at 11:30.” “I If you come from a foreign country, can't you just hang it on me?" The patient yelled on the phone, mixed with complaints.

"Sir, don't worry. Even if it's time to hang it up, the doctor will show it to you." Jiang Shuiqiang explained a lot, but the patient insisted that the person at the registration office apologize to him. Jiang Shuiqiang called the registration team leader to explain and communicate with the patient.

Perhaps the patient had figured it out. After a few minutes, he called again and said, "There is no need to explain."

Suspected indiscriminate drug, complaint doctor

Dispute Cause: Not communicating effectively

"Look, how do you doctors order medicine here?" When I was learning how to apply for a diagnostic certificate with the staff of the patient service center, a young woman came up with her mother and shouted.

Under the persuasion of the staff, the woman’s mood was calmer. It turned out that her mother, Ms. Leung, visited the doctor the other day and the doctor opened some medicine. After getting the medicine, the woman found that there was no medicine written in the medical record and she was in her own home. “When you opened your expensive medicine, the doctor asked the old lady. But when you opened this medicine, you did not ask, although it was not expensive.”

Jiang Shuiqiang immediately contacted the doctor who sat at the time. After reading the medical records of Ms. Leong, the doctor explained that "This medicine must be eaten with it, and the medicine I prescribed is not the same as the one in your family." At this time, the mother and daughter only noticed themselves. Mistaken.

"In fact, many disputes are caused by the lack of appropriate medical knowledge of patients and the fact that doctors have not communicated well with patients." Wang Jianjun, vice president of the Fifth People's Hospital of Jinan City, who has been handling the disputes between doctors and patients for many years, said that between the doctors and the patients Information asymmetry and the patient’s high expectation of therapeutic effect are important causes of disputes between doctors and patients.

Wang Jianjun said that when many patients come to the hospital, they may be in the acute phase of the illness. Some diseases are not effective when they are treated with drugs. “Some patients have not seen a significant improvement in hospitalization for two or three days. The families are anxious. To find a hospital complaint."

"Of course, as a service industry, hospitals cannot be completely free of complaints and disputes." Wang Jianjun frankly stated that many doctor-patient disputes are caused by bad service attitudes of medical staff. "This situation should account for the majority, and very few are individual The medical staff's responsibility is not strong.No doctor is willing to cure the patient, which is not good for him. Therefore, the key is that doctors and patients can effectively communicate, so that you can avoid a lot of unnecessary disputes. ”

Some doctors are reluctant to do high-risk surgery

Dispute Cause: Fear of "doing trouble" for self-insurance

“The emergence of doctor-patient disputes is not terrible. The fear is that disputes cannot be resolved through normal channels.” Wang Jianjun said that he understands most of the patients’ struggles for their own legitimate rights and interests. However, some patients have taken measures to injure or even abuse the health care workers, which has exacerbated the distrust between doctors and patients.

Many medical personnel believe that medical disputes, especially disputes involving violent elements, are the result of a series of conflicts that have long existed in the medical system, such as “difficult and expensive”. “Now the cost of visiting the doctor is relatively high, and the drug is expensive, causing complaints from patients. If you do not achieve the desired therapeutic effect, it will inevitably spread grievances to hospitals and doctors. When our loved ones are also sick and hospitalized, we all understand.”

"Violence between doctors and patients also harms the interests of the majority of patients. If this kind of thing is too much, doctors may endanger everyone. Some doctors tend to let patients do more inspections in order to protect themselves." Dr. Lu, who has been in business for more than ten years, said, “To avoid liability, doctors have to make patients check more, so that they can avoid many risks.”

"What's more serious is that some doctors are able to hide from the more risky surgery and are reluctant to take risks." Wang Jianjun said that he is not willing to do high-risk surgery. “Not too long ago, a patient in her 90s needed an operation and said that I didn’t really want to do it at first. The patient was too old and there were other diseases. Finally, the patient’s family said, “Do it,” It doesn't matter if you do something bad."

“I was very touched at the time. It was such a patient and patient's family that gave me courage to take risks.” Although the final surgery was very smooth, Wang Jianjun was under tremendous pressure. “I couldn’t sleep until the night before the operation. ”

"This kind of distrust damages not only a certain patient, but the whole patient population." Wang Jianjun said, "If all doctors are unwilling to choose difficult, high-risk surgeries, the progress of the entire medical technology will be affected. Limit, so the ultimate damage will be everyone."

Understanding each other to trust each other

In the experience of a few days, I have a deep feeling: The doctors are all trying to treat the patient with pains, and the patient did not want to deliberately make the doctor difficult. The mutual distrust between the two parties, the lack of mutual understanding between the doctor and the patient is a "barrier" that cannot be bypassed.

The patient recorded the whole process, the family doctor stabbed the doctor, the doctor opened the “big exam”, and pushed the patient... All these are the symptoms of mutual distrust between doctors and patients. When this happens, both doctors and patients should reflect on it. The patient's distrust of the doctor, of course, has the reasons of “expensive to see a doctor, difficulty in seeing a doctor”, but the doctor is not perfect and cannot cure all diseases. At the same time, the doctor should also clearly inform the patient of every detail, such as why you should use expensive drugs, and why you should do this.

In addition to the obligation to inform, as a special service industry, doctors should understand the difficulties of patients. As Wang Jianjun, vice president of the Fifth People’s Hospital of Jinan City, said, “information is an obligation, and communication is a responsibility.” Only the doctor stands in front of the patient, understands the difficulties of the patient, fully communicates with the patient, and shares the patient’s inner fears. Truly win the trust of patients.

As patients and their families, they should also reflect and reflect on their own difficulties in understanding the doctor. Whether the question of oneself is based on the understanding of professional knowledge or just on the doctor's instinct? Is his dissatisfaction caused by the high expectations for treatment?

With the exception of the labels of medical personnel, doctors, like ordinary people, are people with blood and flesh, and they will die of old age and sickness. As a doctor, you may feel the patient's voice if you are sick. As a patient, you may also have relatives and friends who are doctors, and they may talk to them and you may feel the difficulty of the doctor. When both doctors and patients can understand each other, the harmonious doctor-patient relationship may not be far behind.