Study On Comparative Cognition Between Both Sides Of Doctor-patient Relationship In China

ObjectThe author intend to carry out comparative analysis on understanding between doctors and patients in the following five aspects: current situation between doctors and patients, influencing factors, the degree that both sides influenced by the physician-patient relationship, the prevention and solution methods of medical malpractice and other related issues.We combine with analysis of typical cases and interviews to find the key point of intervention and guide the sound development of physician-patient relationship, and then recommend some active and effective suggestions to improve relationship between the doctors and patients.MethodsThis paper mainly used the methods as follows: document analysis, field research method, typical case study, expert panel discussions and consultation and statistical approach. The information collected included:(1)documents domestic and abroad;(2) the questionnaires and interview results of 375 physicians and 702 family members of patients from 6 top three hospitals in Beijing,Shanghai and Chengdu.(3)49 medical malpractice cases in general office of letters department,Ministry of Health.Results1. Doctors hold a more negative attitude on concordance of physician-patient relationship The cognitive status of physician-patients in our country is diverged, and people who thought the relationship is harmonious, tense, or general take rates of 33 respectively. Among the respondents, males, elders and people live in the east had an optimistic opinion on the cognitive status of the relationship.The physicians and patients has different opinion on the relationship (P<0.01). The physicians were pessimistic and think that relationship is tight, especially to clinicians. Patients have different attitudes vary from their age, district, educational qualifications and type of services they need.2. Patients trust doctors more than doctors themselves More than 77.22% of patients express their belief in doctors, but only 45.99% of doctors suppose so (P<0.005). Among them, male, high educational qualification and clinical staffs hold a lower proportion.It shows that doctors have less confidence about their relationship with patients.3. Doctors and patients have different attitude on intended intrusion 81.19% of medical staffs think intended intrusion has a great impact on them. But 44.63% of patients consider it too difficult to evaluate, and 18.15% of patients, especially those who have better economic condition even agree with intended intrusion. Only 37.22% of patients oppose to intended intrusion.4. Doctors and patients have different opinions on the influencing factors except health care systemMedical side's order of factors is: the health care system, the media, public opinion, the patients and the doctors. And the non-clinical people consider the doctors have the most important influence. The clinical staff thought media affected so much. The order of the patients is: health care system, doctors, media, and patients, but their choices are different from area to area.5. Relationship between doctors and patients influences a lot on their behaviors Relationship between doctors and patients influences a lot on doctors'diagnostic decision, especially on clinicians'. But it has less influence on patients'behavior during the process of diagnosis and treatment. Patients'attitude varies significantly from their age, district and type of services they need.6. Evaluation on effect of different medical disputes resolution mechanisms 34.88% of the respondents consider current medical disputes resolution mechanisms useless, other 40.29%s consider them useful but not so significantly. Both doctor and patient respondents keep the same at this point. According to case analysis, these resolution mechanisms do not work so well, sometimes even make the situation worse. 7. No high opinion of effect of malpractice insurance19.61% of doctor and patient respondents know nothing about malpractice insurance, and only little difference exists in doctor and patients'knowledge about effect of malpractice insurance. It is clear that more attention should be paid on how to take the malpractice insurance into practice. 8. Quality of service is more and more important for both doctors and patientsPatients suppose that high medical technology, good service attitude and favorable hospital settings have an attraction for them. Meanwhile, doctors suppose that high medical technology, good service attitude and a short range to patients'house attract them to make their choices. However, quality of service is more and more important for both doctors and patients. As to nontechnical service quality, the interventions of doctor-patient relationship in non-technical factors were: ethics, medical services, and service price.Conclusion and Suggestion1. Both doctors and patients should be aware of what and how the different understanding exists, and doctors should play a leading role in the relationship. Meanwhile, patients must try to know more about the particularity of medical service and coordinate with doctors.2. Strengthening the broad medical environment construction, speeding up the reform of medical service, promoting the prevention and settlement mechanism of medical deputes and reducing pressure on both sides would regulate both doctors'and patients'behavior, and finally, set up an advanced mechanism to prevent and solve those medical deputes.3. Effective actions such as strengthening doctors'communication skills and increasing their knowledge of law can reduce the acknowledge gap of medical service and achieve an effective communication, and finally, set up a harmonious relationship between doctors and patients.4. Fully considering the contents of health services,and providing high quality and personalized medical service directed towards intervention point. Doctors should promote their medical technology and quality of service at the same time. What's more, they should provide personalized service varies from patients and disease.