Changjiang Business Daily reported that the top three hospitals called for radical legislation, and Hubei has set up a special agency to coordinate disputes
□ Our reporter Hu Meng
Nowadays, "hard medical trouble", such as smashing hospitals and setting up mourning halls, is becoming less and less because they will be punished. However, "soft medical trouble", such as continuous "rights protection", "bed crushing", long-term "occupation" of medical offices, and online rumors spreading, continues to rise.
Last month, a chief physician in Sichuan chose to commit suicide because of physical and mental fatigue. Previously, a patient had been in bed for 9 months because of dissatisfaction with treatment, and had a bad attitude towards the physician and colleagues during this period. Experts chose to end their lives due to pressure, which caused strong repercussions in the industry. Many doctors said they were cold hearted about this "soft medical trouble".
The Changjiang Business Daily reporter found that this new form of medical trouble made medical staff unbearable. Some hospitals lost money with the attitude of pacifying people. They expected to establish and improve relevant laws and regulations to solve the problem according to law.
"Now the court attaches great importance to doctor-patient disputes. There are also mediation procedures, and the speed of adjudication is fast if mediation fails." In the face of the current situation of "soft medical trouble", Li Haifu, a lawyer from Wuhan Jinwei Law Firm, reminded that both hospitals and patients should change their concept of dealing with disputes, use legal means to solve problems, and resolve conflicts in a civilized manner.
Group Images of "Soft Medical Troupe"
What is the current situation of "soft medical trouble"?
Deng Liqiang, director of the Legal Affairs Department of the Chinese Medical Doctor Association, defined four forms of "soft medical trouble": 1. sitting outside the hospital consulting room every day, telling patients about the "bad behavior" of doctors in the consulting room; 2. Write letters to the media from time to time, or magnify untrue information on the Internet through We Media or forums; 3. Constantly use the fabricated information to report the problems of the hospital president or doctor to the hospital's superior unit; 4. Do not discharge the press.
In recent years, the Health and Family Planning Commission of Hubei Province has also received reports from many hospitals on how to deal with "soft medical trouble".
Four years ago, Wuhan citizen Wang Dada dizzy He went to the emergency department of a tertiary hospital near his home. After various examinations, the doctor found that Father Wang had no organic substance STD He advised him to go home and have a good rest. But Father Wang didn't agree, and he strongly asked the doctor to give him fluids, otherwise he would make a scene. In desperation, the doctor prescribed a small amount of vitamin C injection. Father Wang was satisfied to go home when he saw the injection. But soon, he found the medical department of the hospital and said that he had been home since he got the injection in the hospital Neurasthenia , felt dizzy and uncomfortable, and thought that there must be something wrong with the needle in the hospital, and asked for compensation.
After receiving the complaint, the medical department of the hospital began to enter the investigation procedure. It was found that the hospital was not at fault, and he was not satisfied after explaining to Father Wang many times. "Come to the hospital almost every day and make a scene in the medical department, or stand at the door of the emergency department and ask other patients to leave quickly." The medical staff of the hospital said helplessly. In the past four years, Father Wang not only stopped at the door of the medical department for a long time, but also went to the petition room of the health administrative department to complain and call the media for many times, but the hospital was really not wrong after the investigation by the relevant departments. "You are all a gang, cheating us common people." This is a phrase that Wang Dada often says.
On May 19, when a reporter from the Changjiang Business Daily saw Father Wang still hovering at the door of the medical department with a plastic bag, the hospital said that if Father Wang did not believe the results of various investigations, he could go through the judicial process and let the court decide through litigation, but Father Wang firmly said: "The identification is also false, and I have no money to sue."
There is no physical conflict, nor is there anything in the hospital. Relying on "relying" is also a common way for some patients. The 68 year old father Li died last November because heart disease In hospital, the doctor found that he was slightly cerebral infarction Phenomenon, it is recommended to go to the outpatient department for drug treatment after discharge, but Li refused to leave the hospital, saying that he should cure the disease thoroughly in the hospital before leaving, otherwise, the hospital will not act, and requests to be transferred to the Department of Neurology. But the doctor thought that Li Dadi had no symptoms of disease, and only needed to take antihypertensive drugs regularly and follow up if he felt unwell, but Li did not accept this treatment plan.
In desperation, the hospital had to continue to let him stay in hospital, but for the principle of treatment, they could not give him injections, and could only remind him to take medicine on time every day. Father Li occupied a bed and only paid for bed and nursing every day for six months. "We can't scold him, on the contrary, we must greet him with a smile every day to meet his requirements." The head nurse of the department said, finally, Dad Li saw that every day there were extra beds in the corridor, and he was embarrassed to leave the hospital.
"If you don't solve the problem, I will send all the content online." In the face of this "threat", the medical staff of a specialized hospital said that they had been "numb". Now there are many patients who can use the network, and the network has become a platform for patients to "soft doctor". Ms. Zhou, 40 years old, believed that the hospital had medical errors due to her anaphylactic rash after injection. After investigation, the hospital believed that Ms. Zhou's anaphylactic rash was an adverse drug reaction caused by an individual, not a fault in the hospital's medical procedures, nor a drug quality problem. However, due to human morality, the hospital agreed to provide Ms. Zhou with follow-up free anti allergy treatment.
However, Ms. Zhou was not satisfied and didn't ask for anything. She just told the hospital that she would publish these on online forums, microblogs and WeChat, and @ all major media. "We have no way to deal with such patients. She has the freedom to release information, but ordinary people will not investigate. They think it must be the hospital's fault." The medical staff said that after the various "We Media" in recent years, patients often threaten the hospital in this way, which requires too much follow-up work. In order to maintain the reputation of the hospital, they still need to make remedies.
The "soft spot" that doctors and patients cannot cope with
What is the attitude of hospitals in the face of "soft medical trouble"?
The reporter of Changjiang Business Daily investigated three public hospitals and one private hospital this time. The head of the hospital said the same thing: "More is better than less. If you can pacify people, you can't make things big." The head of a top three hospital said that patients do not hit or hit doctors, and there is no crime. At least it is impossible to call the police to catch them, They spend time and energy, even sit still, track and wait. Some do not take action, and some lobby other patients outside the consulting room, which does not constitute a crime. Neither the hospital nor the public security organ can do anything against them.
"Sometimes hospitals have no choice but to compensate for what should not be compensated." In four hospitals, the person in charge mentioned this. According to statistics, only 20% - 30% of the medical disputes compensated are really hospital medical faults, while others will be compensated if the amount is not huge and the medical trouble lasts for a long time. The relevant person in charge even said that some patients with "soft medical trouble" even told other patients that they had obtained compensation through "unremitting" medical trouble, and the hospital would certainly pay for it if it went on like this.
The reporter learned that patients who choose "soft medical trouble" generally do not go through the litigation process.
Li Haifu, a lawyer from Wuhan Jinwei Law Firm, told the reporter that he had received many consultations on medical disputes. Most of the patients only asked their lawyers in detail about their own affairs before they heard that the judicial process was complicated and took a long time, and they had to pay their own lawyers' fees. More than 90% of the patients withdrew. He said that there were three main reasons why the patients they contacted generally chose "soft medical trouble". First, they were unwilling to go through the judicial process and pay their own money; Second, the hospital has no or little fault, and patients can not get or receive little compensation through litigation; Third, patients believe that hospitals have money and are afraid of making trouble and reporting. Compensation through trouble is fast and high.
During the interview, the reporter of Changjiang Business Daily found that most patients did not know which way to go in case of medical disputes. "I only know that either I can find a lawyer or a hospital, but generally I will find a hospital first." The patient, Miss Zhang, said that, in fact, as early as the end of 2011, Hubei began to set up a people's mediation committee at the grass-roots level, but patients often said that they did not know where to find mediation, and did not trust the mediation links.
The Medical Affairs Office of the Health and Family Planning Commission of Hubei Province told the reporter of the Changjiang Business Daily that in case of medical disputes, patients should take the following legitimate and reasonable ways to solve them: after the occurrence of medical disputes, both parties can choose to negotiate on their own, or they can choose to apply for mediation in writing to the people's mediation committee for medical disputes where the medical institution is located; If they are unwilling to consult or mediate, or if consultation or mediation fails, they can apply to the health and family planning department for administrative settlement of medical accident disputes, or file a lawsuit to the people's court. The people's mediation committee for medical disputes acts as a third-party mediation institution.
The reporter learned from the Health and Family Planning Commission of Hubei Province that last month, the Health and Family Planning Commission of Hubei Province, the Provincial Department of Justice, the Provincial Department of Finance and the Insurance Regulatory Bureau of Hubei Province jointly established the Hubei Medical Dispute Mediation Committee as a third-party organization to help patients and hospitals mediate medical disputes. The Committee has an expert pool of more than 500 people, including medical, legal and other experts, The introduction of medical liability insurance compensation does not charge any fees to patients. For the first time, we mediated a medical dispute that lasted for one and a half years, and finally determined that the hospital compensated the patients through the investigation and identification of eight experts in various fields. It only took half a month to solve the problem, and both doctors and patients were satisfied with the result.
Improve laws and regulations
Civilized resolution of contradictions
Is "soft medical trouble" really against the law? Lawyer Li Haifu said that patients and their families' awareness of protecting their rights has gradually improved, but they generally choose "soft medical trouble" because they are afraid of being involved in criminal offences. However, they do not know that some "soft medical trouble" is also illegal, such as waiting in the consulting room to intercept other patients and writing threatening letters. If the circumstances seriously violate the Public Security Management Punishment Law, the soft medical trouble can be detained or fined. If the "soft medical trouble" has an impact on the reputation of the hospital, which is a civil infringement, the hospital can ask it to apologize and compensate for losses. Generally, if false information is published on the network, it may be infringing. Some hospitals sued the bed pressing patients and applied to the court for compulsory execution after winning the lawsuit. Even though the bed pressing patients were unwilling, some even locked themselves in the hospital bed and refused to leave the hospital, but they were still forced to carry home by the bailiffs who saw off the chains.
Although there are administrative laws and regulations for public security to follow, the hospitals interviewed generally believe that it is difficult to have laws to follow in the actual situation, because "soft medical trouble" will also be avoided, and the form adopted is more "soft" and hidden. Therefore, it is hoped that relevant departments will formulate laws and regulations for these specific acts, protect the personal safety and legitimate rights and interests of medical personnel, and take disciplinary measures against those who clearly disrupt the medical order.
Many hospital leaders also said that improving the doctor-patient relationship can be achieved through service attitude, vigorously promoting "smiling" services, requiring medical staff to face patients gently and smile, patiently explain to patients, and improve service quality. In addition, because medicine is a field of serious information asymmetry, which is easy to cause misunderstanding of patients or high expectations for treatment results, medical personnel should not rush to the right to know of patients because they are busy.
According to the relevant person in charge of the Medical Affairs Office of the Health and Family Planning Commission of Hubei Province, our province has cracked down on medical troubles through various means such as the establishment of Ping An Hospital, and required hospitals to comprehensively promote information disclosure, consciously accept the supervision of the masses, carry out in-depth and detailed publicity and education on law popularization, guide the masses to reasonably reflect their demands, and completely reverse the bad phenomenon of "big trouble, small trouble, small compensation, no trouble, no compensation".
The person in charge believed that we should improve the long-term mechanism of "three mediations and one insurance", further improve the complaint management system in the hospital, vigorously promote the construction of the people's mediation mechanism, actively cooperate with the court for unsuccessful mediation, cooperate in judicial mediation according to procedures and requirements, and continue to promote the construction of the medical liability insurance system, Encourage all regions to actively explore effective practices such as regional unified insurance and competitive negotiation, and constantly improve the coverage of medical risk sharing mechanism. By the end of this year, the participation rate of medical liability insurance of public tertiary hospitals in Hubei Province should reach 100%, and that of secondary general hospitals should reach 90%.
(Zhou Wenzhao and Wang Fang also contributed to this article)
