Causes And Preventive Measures Of Medical Disputes In A Grade-A Tertiary Traditional Chinese Medicine Hospital

Background: In recent years,medical disputes have emerged in endlessly,and vicious doctor-patient conflicts have occurred frequently.Frequent medical disputes with enormous harm disrupt the normal medical order,damage the legitimate rights and interests of both doctors and patients,and affect social harmony and stability.How to deal with medical disputes,build a harmonious doctor-patient relationship,maintain normal medical service order and legitimate rights and interests has become a serious issue in China.Preventing and resolving medical disputes and establishing a system for dealing with them have become a top priority.Therefore,in the present study,the current situation of doctor-patient relationship and the causes of medical disputes were analyzed,and corresponding countermeasures and suggestions were put forward to provide scientific basis for building harmonious doctor-patient relationship,preventing and reducing doctor-patient disputes.Methods: Firstly,we obtained the data of medical disputes from a grade-A tertiary Traditional Chinese Medicine hospital and analyzed the current situation and characteristics of medical disputes from January 2014 to December 2016.At the same time,the questionnaire of medical disputes was designed with four aspects: basic information,views on doctor-patient relationship,understanding of the causes of medical disputes and suggestions on how to solve medical disputes.560 valid questionnaires were obtained,of which 344 were from medical prescription and 216 were from patients.Lastly,combining questionnaire survey,literature survey and expert discussion,we analyzed the causes of medical disputes and put forward corresponding preventive measures.Results: The number of medical disputes was 97,92 and 77 from 2014 to 2016,with a decreasing trend,respectively,and coordination and communication in hospital were the main ways of handling disputes(accounting for 45%-58%).The number of disputes about attitude factors was still large(64,49 and 57 respectively in three years).The mainly causes of medical disputes were the irregular diagnosis and treatment process(19%-43%),medical risks and surgical complications(22%-27%).In addition,medical disputes still occurred mainly in surgery,accounting for 52.1%,63.9% and 63.7% respectively in three years.In 2016,35 departments were involved and related coverage gradually expanded.The questionnaire results showed that patients had higher satisfaction and trust in doctor-patient communication than doctors(P < 0.01).Patients were more optimistic about doctor-patient relationship than medical staff(P < 0.01),because of the high occupational risk(58.43%)and high mental stress(76.16%)in medical staff.Medical level and service attitude affected patients' choice of medical treatment(more than 70%).Difficult registration and complicated medical procedures were the most unsatisfactory places for both sides(more than 60%).In terms of the main causes of medical disputes,both doctors and patients believed that medical staff,patients and the government should take corresponding responsibilities,but there were inconsistencies in their perceptions.Doctors suggested that patients did not understand medical knowledge with high expectations and did not trust doctors because doctors had no enough time communication.However,patients claimed that doctors lacked communication skills and handling procedures of hospital accident were not perfect.Both sides believe that uneven distribution of medical resources leaded to "difficult" and "expensive" as the main macro factors.On the main preventive measures of medical disputes,the preferred solution was to seek help from hospitals or related units to solve.More than 89% of doctors and patients believed that mutual trust,mutual understanding and mutual respect were the best way to reduce medical disputes and create a good medical atmosphere.The causes of medical disputes were complex.Macroscopic factors included social environmental factors,uneven distribution of medical resources,lack of government financial input,imperfect medical security system,lack of effective supervision,incentive mechanism and negative media publicity.Medical factors included hospital management factors,medical staff factors,limitations and uncertainties of medical technology.Patient factors included insufficient understanding of medical profession,excessive burden of medical treatment,increased awareness of patient's rights protection,frequent medical disturbances,deterioration of doctor-patient relationship,lack of basic trust and so on.Therefore,efforts should be made in many ways to reduce medical disputes.The government management should strengthen macro-control of strategies,increase financial support,strengthen propaganda of laws and regulations,improve the medical security system,and standardize the correct guidance of public opinion.Medical prescription should strengthen the standardized management of hospitals,improve the professional quality and moral accomplishment of medical staff,strengthen the communication between doctors and patients,and enhance the legal consciousness of medical staff.Patient should strengthen the propaganda of law popularization and improve their own medical scientific literacy.Conclusion: At present,the medical disputes tended to be smooth,but the number of disputes remained high because of prevailing attitudes and medical irregularities.Therefore,hospitals should strengthen measures to improve doctor-patient communication,reduce doctors' mental stress and simplify the medical procedures.We hope that the government,doctors and patients will work together to build a harmonious doctor-patient relationship and prevent and reduce medical disputes through the common concern of the whole society.