Study On The Treatment Of Doctor - Patient Disputes

The doctor-patient relationship grows more and more intense with the transition of China’s social-economic status. A basic medical service system was established in this poverty-stricken country after the foundation of People’s Republic of China. With the progress of financial advancement, the demand for medical service outmatched the supply, bringing about a medical system reform to increase the amount of medical institutes. With the economic reform since the Third Plenary Session of the 11 Central Committee of the Communist Party, medical reform continued. Medical marketization beginning from the 80s to release government budget burden, required hospitals to be self-sustaining and accelerated the worsening of doctor-patient relationship.Intense doctor-patient relationship is not uniquely Chinese, but a global issue. Compared to the newly launched research upon this issue in China, American scholars have already set up several relation models:activity-passivity, cooperation-guidance and mutual participation according to Szasz and Hollander; and engineering, priestly, collegial and contractual models according to Robert Veatch. Moreover, in western countries, inquiries have also been made about in which ways doctor and patient should communicate and how to settle medical disputes.Chapter I defines doctor-patient relationship, doctor-patient disputes, medical disputes and other relative issues, such as medical malpractice, medical negligence and complication. We deem medical disputes to be the result of different comprehensions upon outcomes of medical activities, including treatment, nursing and rehabilitation. This chapter also discusses governance and principal-agent theory.Chapter II looks upon the two parties of dispute-service provider and recipient. The progression of hospital reform, components of medical system, and transitions of hospital management policy are investigated. We conclude four stages of hospital policies. Doctor’s rights and duties are also examined. As to patients, their role, psychological activities, rights and obligations, and the history of patient’s rights movement are also discussed.Chapter III analyzes the current situation of the issue, which features with wide range, increasing incidence, large compensation and high social concern. It investigates the distinctiveness of involved parties and content of disputes. We categorize them into two kinds, one caused directly by medical activities, and the other not. Dispute is also intensified by a new group of people-medical rascals, bullying hospitals and interfering with medical service. Medical disputes impair each one--hospitals, medical workers and patients.Chapter IV examines the causing factors of the issue. Political factors include shortage of medical resource, its unreasonable distribution and poor utilization. Social causes include varied value systems in the period of social transformation, transition of social models, emergence of new medical technology and therapy. Besides, it is also originated from profit-oriented hospital management, lack of professional supervision, deficient communication between medical practitioner and patient, and incompetent physicians.Chapter V made a case study of a tertiary hospital from 2009 to 2013, the occurrence of medical disputes. First introduces the basic situation of the Institute, has carried on the analysis from the overall distribution of doctor-patient dispute, responsibility distribution of departments, complaints were main title distribution, reflect the channel and the solution of different aspects. According to the analysis of the causes and prevention of disputes are given dispute solution.Chapter VI evaluates contemporary coping strategy in China. According to the Regulations of the Handling of Medical Accidents, approaches include negotiation, administrative mediation and litigation. All playing important roles, none of them is consummate enough to resolve disputes.Chapter VII contemplates coping strategies in the United States, Japan and Germany, after summarizing their medical systems, so as to find inspiration for China. The US applies ADR (Alternative Dispute Resolution) most efficiently; Japan focuses the role of third party intervention; while Germany depends greatly on mediation boards and expert panels.Chapter VIII offers suggestion and advice on resolving the issue. Hospitals are to construct preventive systems and to promote resolving mechanisms. Government is to perform its assignment concerning medical resource investment and distribution, professional supervision and popular health care education. The media and social organizations are to witness and testify medical incidents and to play a positive role in guiding public opinion. In addition, third party mediation mechanisms require to be investigated and tested, as well as the establishment of medical liability insurance system.