The Research On The Third Party Doctor-patient Dispute Mediation Process Under The Perspective Of Social Support

Doctor-patient disputes are the external manifestations of the deterioration of the relationship between doctors and patients,and usually lead to the occurrence of"medical disturbance".The frequent occurrence of the phenomenon of injuring doctors and killing doctors shows that how to effectively resolve disputes between doctors and patients,especially serious doctor-patient disputes,have become an urgent problem to be solved in the current development of China's medical and health services.The third-party mediation of disputes between doctors and patients is more efficient,economical,fair,and objective than other doctor-patient dispute resolution methods,state ministries and commissions have repeatedly issued articles affirming and promoting the development of third-party mediation in doctor-patient disputes.However,in the long-term operation of the system,such as the low degree of professionalization of mediators,low awareness of residents,limited recognition,and inadequate mediation procedures,it is difficult for third-party mediation of doctor-patient disputes to continue to play a role in doctor-patient disputes,especially those serious medical disputes with violent tendencies.Previous studies have conducted in-depth discussions on the overall operation of third-party mediation in doctor-patient disputes,and have pointed out correspondingly the third-party mediation system for doctor-patient disputes reveals deficiencies in the handling of serious disputes between doctors and patients.However,the previous studies were relatively extensive and did not dig deeper in specific aspects of the mediation process.The previous studies also did not indicate which issues led to a lower success rate in resolving serious doctor-patient disputes.Therefore,guidance on practice was not strong.This study aims to make a thorough review of the third-party mediation process of doctor-patient disputes,analyze the specific problems in the mediation process and their causes,and explore the roles that the social workers can play in the mediation process and the specific strategies that may be adopted,thereby to make up for the weaknesses in the proccss of third-party mediation in the current doctor-patient disputes,with a view to increase the success rate of mediation and build a harmonious doctor-patient relationship.This research uses the social support perspective as the theoretical framework for the study.The XM City Medical Disputes Mediation Committee was selected as a research case.The research mainly observed 48 serious doctor-patient disputes mediated by the doctor-patient dispute mediation committee of XM City from 2011 to 2017.These disputes often have medical disturbance and are guided by the doctor-patient dispute mediation committee.The research also collected policy documents,work reports,and mediation work data,including the management system of the doctor-patient dispute mediation committee of the XM City,the organization of mediation procedures,the composition of mediation experts,and methods for the use of funds,etc.In addition,the study conducted interviews with 10 persons,including the director of the Medical Dispute Resolution Committee of XM City,2 mediators,2 medical experts,3 social supervisors,and 2 legal experts.Research findings:1.Problems in the third-party mediation of doctor-patient disputes include the difficulty in establishing a trust relationship,the lack of necessary social support,a low degree of coordination with mediation experts,and the narrowness of attention in late visits,etc.;2.The causes of these problems are mainly caused by professional background restrictions that make it difficult to establish trust relationships,lack of professional skills that make it difficult to provide the necessary support,lack of balanced strength to embedding,resulting in poor mediation,and the role-specific ambiguity in roles,resulting in narrow attention.Therefore,the author combines the problems in the process of mediation of third-party doctor-patient disputes in XM City,and proposes corresponding social work to participate in third-party mediation according to the process arrangement of third-party mediation in doctor-patient disputes:1.In the mediation process of doctor-patient disputes,it is possible and necessary for the social workers to participate in the whole process of mediation as members of the mediation group.2.In the mediation process,social workers can intervene in light of the different needs of parties involved in disputes at different stages,including(1)establishing trust relationships,comprehensive needs assessment to prevent further escalation of conflicts;(2)Establish new social network linkages to reduce the intensity of conflict;(3)Help dispute parties return to community life and resolve conflicts in depth;(4)Act as a member of the mediation group,promoting the mediation process to develop in a healthy direction.3.Specific strategies that social workers can adopt when intervening in third-party crisis mediation of doctor-patient disputes include clarifying the duties of individual case managers,strengthening humanistic care,and enriching late-stage visits.The significance of this research is to sort out the third-party mediation process of doctor-patient disputes,and to excavate the specific problems and the causes of their existence.Based on this,the author explores the possibility of social workers intervening in third-party mediation.The author also proposes specific space and intervention strategies for social work to intervene in third-party mediation of doctor-patient disputes.The purpose is to make up for deficiencies in the third-party mediation process of doctor-patient disputes,improve the success rate of third-party mediation in serious doctor-patient disputes,and create a harmonious social environment.Due to limitations in research time and the author's own theoretical accomplishment and ability level,this study has the following deficiencies:including the social support network theory and research issues are not in perfect agreement;the number of interviewees is insufficient;the analysis of the mechanism of the problems in the third-party mediation of doctor-patient disputes is not comprehensive enough;the limiting factors of social work intervention in the disputes between doctors and patients are not be fined out enough.This research consists of six chapters.The first chapter "Introduction" introduces the research background and then puts forward the research questions:What is the specific process of the third-party mediation of doctor-patient disputes and what are the problems facing them;what are the causes of these problems;What is the space for social work to intervene in third-party mediation of doctor-patient dispute;At the same time,this chapter also explains the research purpose and significance of research.The second chapter "Literature Review" defines the concepts related to this research and reviews the research in related fields,including the causes of research on medical disputes;the research on the operation of third-party mediation process;the research on the Intervention of social work in doctor-patient disputes and the research on social support perspectives in social work.It is clear that this study is a mechanism-level analysis of the relevant causes of the problems in the mediation process,and explores the space for social workers to intervene in third-party mediation from the perspective of social support.The third chapter "Research and Design" takes social support theory as the theoretical framework of the study,selects the case study method in the qualitative research method as the research method,and determines the semi-structured interview method,literature method,and observation method as the data collection method.The basic situation of the research object is introduced.The fourth chapter mainly analyzes the status quo and problems of the third-party mediation of doctor-patient disputes in XM city.The fifth chapter analyzes the mechanism of the problems found in the fourth chapter and explores the social work intervention space.Chapter six "summary" introduces the research findings,the innovations of the research,and the limitations and deficiencies of the research.