China moves to protect its medical personnelBy Dominic Dietrich Oct 24, 2013 10:31AM UTC
By Dominic Dietrich
Amid a continuing rise in violence against medical staff in China, Beijing has issued a new set of hospital security guidelines which include increasing the amount of security personnel as well as scanning for weapons.
The National Health and Family Planning Commission and the Ministry of Public Security this week issued the new safety protocols. According to the Shanghai Daily, the guidelines, among other things, ask that there be an adequate ratio of security personnel to medical staff – a guard for every 33 working medical staff members.
Security doors should be installed for hospital sections such as data centers and blood and drugs storage rooms, and “high tech” alarms should be in place. The systems for handling complaints should also be improved.
The guidelines also called for the use of scanning machines to look for items such as knives. Knife attacks against medical staff have been a recurrent theme over the last few years.
Last year, Li Mengnan used a fruit knife to stab to death an intern, allegedly because he felt he had been denied treatment for a spinal condition, according to a Xinhua report. In the attack three others were injured. In 2011, a cancer patient stabbed a surgeon 17 times (the victim survived following nine hours of surgery), according to CNN. The attacker said the surgeon’s attempts to remove a laryngeal tumor in 2006 had simply made his condition worse. This was reportedly the reason for the attack.
On Monday, the family of an elderly patient who died that day allegedly assaulted three doctors in southern China’s Guangdong province, Shanghai Daily reported. There was no mention of whether a weapon was used.
Last year’s 11 most serious attacks on medical staff resulted in the deaths of seven people and left 28 others injured, the Shanghai Daily cited the National Health and Family Planning Commission as saying earlier this week.
Of those injured, 11 were patients and their coterie, 16 were medical staff and one was a security guard. Attacks occurred in eight municipalities and provinces, including the country’s capital of Beijing.
The Shanghai Daily cited the commission as saying “these cases reveal weaknesses in hospital security and measures must be taken to protect staff.”
In August, China Daily reported that the Chinese Hospital Association had released a survey which highlighted a stark rise in violence against medical personnel. In 2008, the annual average number of assaults on doctors per hospital stood at 20.6, according to the survey. By 2012 this figure had grown to 27.3. The survey was conducted nationwide at 316 hospitals.
The issue stretches back more than the last half-decade.
Chen Xiaohong, China’s vice health minister, in 2007 said that 9,831 dispute-originated attacks were reported in 2006. This was an increase from the 5,093 violent cases in 2002, Chen said. The same Xinhua piece that cited Chen also noted that in late 2006 “doctors and nurses in a south China hospital were reported to have to wear helmets to shield themselves from attacks by a group of people who had abused and tussled with them over medical disputes.”
In light of the violence, many of China’s doctors seem to be mulling an exit. The Chinese Hospital Association’s survey, according to China Daily, found that nearly 40 percent of medical staff said they plan to abandon the profession as a result of the increasing violence.
China Daily said the survey gave several reasons for the rise in violence: poor treatment, inadequate patient-doctor communication, media reports distorting the situation, expensive fees, a deficit of trust, and problems with the supply and demand of medical resources.
Wang Jin, a partner with consulting firm McKinsey & Co.’s health-care practice in China, noted that accountability is an issue. “Patients in China have no means for holding doctors accountable for their work,” The Wall Street Journal cited Wang as saying.
Many doctors, according to The Wall Street Journal, have noted that an excessive workload – resulting from a relatively low ratio of doctors to patients- is limiting the amount of face-time with patients, in turn damaging trust between the two sides. In 2010, China had 1.5 physicians per 1,000 citizens; the U.S. had 2.4, according to World Bank data. South Korea had 2.0; Japan 2.1; Australia 3.9.
When Chen spoke in 2007, he said incidents of violence are rising as “misdiagnosis and operation frauds repeatedly occurred in some local hospitals and clinics.”
The Economist last year cited corruption as one of the key issues. “Even in cities, many doctors earn as little as 5,000 yuan (US$780) each month, and supplement their wages by taking extra payments to see patients or perform operations. Others get their patients to take unnecessary tests, or prescribe expensive drugs to boost their income.” The publication noted also that disputes over malpractice compensation as well as resentment over costs of treatment play a part.
Earlier this month, CCTV cameras filmed an incident in which the family of a 22-year-old deceased patient smashed equipment in the intensive care unit of a hospital in Shanghai. Sina.com reported that the violence occurred after the patient died of kidney failure on Oct.17. The incident and its related footage was covered by several Chinese news programs. A segment of the CCTV footage is shown below.
A survey by McKinsey & Co. and reported on by The Wall Street Journal noted that 59 percent of doctors in China said they have been verbally assaulted by patients or their families (The Economist piece suggested it’s not simply family members but also sometimes hired ‘thugs’). Six percent reported being physically assaulted by patients. Nearly 6,000 physicians in 3,300 hospitals were surveyed.
Following this week’s attack, doctors at the hospital in Guangdong – the Second Affiliated Hospital of Guangzhou Medical University – posted comments on a messaging service, according to Shanghai Daily.
If their diagnoses are anything to go by (to say nothing of the surveys), improving the safety of medical staff in China’s hospitals is urgent.
“It’s time for the government to face up to and raise public awareness about this problem,” they said. “If not, there is no future for China’s health industry.”