Thursday, October 11, 2012

Being a Doctor in China


In 2010, the last year for which official figures are available, the health ministry says there were 17,000 protests or attacks directed against doctors or hospitals in China. The number of incidents, which continues to rise at a double-digit rate each year, may have more than doubled since 2005, official estimates indicate.

Last month the death of a woman treated for a sore throat and fever at a hospital in southern China triggered a riot of 2,000 people. Earlier in the month, four staff in the ear, nose and throat department of a private hospital in the southern city of Shenzhen were stabbed by a patient treated for allergic rhinitis.

In May a nurse was attacked in Nanjing by a woman who claimed that a Caesarean delivery at the same hospital 16 years before had harmed her sex life. And last year a Beijing doctor who had operated on a man with laryngeal cancer was stabbed by him multiple times when his cancer returned. The man sued the hospital in 2008 but knifed her before the court was able to hear the case.

Incidents like these are not just isolated acts perpetrated by those driven crazy by illness or grief. Instead they reflect widespread public anger at the high cost of medical care in China, fuelled by corruption in the medical system where many patients have to pay bribes just to secure a doctor’s appointment.

China has vastly expanded health insurance coverage in recent years, but according to a new McKinsey report, it still spends only about 5 per cent of gross domestic product on healthcare, compared with 10-12 per cent in western Europe and 15-17 per cent in the US – and far less per capita. There are not even two doctors for every 1,000 people in China – and many of them are paid only a few thousand renminbi per month.

Doctors are under intense pressure to generate extra income for their hospitals – not to mention themselves – leading patients to suspect them of practising mercenary medicine. Patients have unreasonably high expectations of the wonders of modern medicine, and the gap between rich and poor, in healthcare as in everything else, is glaring. Patients say they do not respect doctors – and many doctors say the last thing they want their children to do is study medicine

Li Huijuan is a lawyer who sits on the medical risk control and management committee of the China Association of Medical Doctors. She represents the family of Wang Hao, a trainee doctor at a hospital in northern China, who was killed recently by a 17-year-old whom he had never even treated. The assailant, who became enraged after repeated hospital visits failed to cure his tuberculosis and back problems, spent Rmb4.30 ($0.68) on a fruit knife at a nearby supermarket, and attacked the 1.8-metre tall Dr Wang because he feared the tall doctor would otherwise block his way, Ms Li said.