[Please enjoy this Tea Leaf Nation bilingual brew. The article is first shown in English, and then in the original Chinese. 亲爱的读者，欢迎享受我们的 “双语茗茶”。英文翻译在上，中文原文在下。]
“Doctor-patient relationship” is a popular term on Sina Weibo, China’s Twitter. Recently, among more than 940,000 microblogs related to this word, a new topic has emerged: Relatives of a patient in the city of Suzhou recently slapped a doctor and knocked four teeth from a security guard’s mouth after being told there were not enough hospital beds for their loved one.
This was not the first incidence of violence in Chinese hospitals. In March this year, a patient at Harbin Medical University No. 1 Hospital Affiliated stabbed four doctors with a knife. One of the doctors, an intern in his twenties, died from the wounds. After the incident, hospitals started tightening up security, while doctors and nurses panicked.
Surprisingly, facing the death of a young doctor, not all Chinese netizens felt pity or condemned the stabber. According to a report in China Youth Daily, 65% of readers voting in a poll described themselves as “Happy” when asked about their feelings after reading the news.
What exactly is the “doctor-patient relationship?” Netizens on Weibo offered definitions. @最爱香草奶昔 tweeted, “It is a bit after 12 p.m., the children’s hospital is still crowded. Parents who bring their children over are all very anxious, but no one from the hospital is working. They are back home for lunch and a nap. ‘Come after 2:30 for check-ups and diagnoses!’—This is the ‘doctor-patient relationship’ in China.” @走猫步的天使 said, “A nurse called Yan Ni was beaten to hematuria… this is the current ‘Doctor-Patient Relationship’!”
These tweets evince opposite understandings of the current relationship between doctors and patients. One distrusts the doctors and thinks they are not being responsible. Besides extremely long wait times and the doctors’ cold or indifferent attitudes, many patients complain about under-the-table deals where doctors receive “red envelopes,” essentially bribes for doing their job. The other tries to understand doctors and finds it unreasonable to blame only doctors for the deterioration of relations with patients. It’s not easy on anyone, and not all doctors are villains.
Online, many doctors and medical students worry about the future of their chosen profession, and even their personal safety. @天使Li468 tweeted, “As the relationship between doctors and patients becomes tenser, and as violence in hospitals becomes more severe, it is hard to [fully] understand the pressure that public opinion places on health workers. We need to reflect and ask what really caused the current situation. Only those who’ve studied medicine themselves can understand, and they don’t want their children to take the same path.”
Much like in the U.S., it costs a fortune to be a Chinese medical school student. The pressure is intense, and the amount of work a student does is clearly disproportionate to how much a student gains in future income. As relationships with patients worsen, doctors now must also seriously consider their personal safety as well.
As the daughter of a doctor, I’ve heard many similar complaints. My mother and her colleagues complain that all problems come from management. Many doctors’ explanation for the high price of medicine is similar to that of netizen @古三思‘s:
“Medicine factories need to raise the prices for profit. [Competing with others, ] they have to fight their way into the hospitals. And since the hospitals have no better way to generate income, make the prices even higher. Doctors are only the last part of the chain of benefit. The solution to the problem is medical reforms. Make competition between medicine factories fair. Standardize treatment processes. The government should pay the doctors, so that hospitals don’t have to earn money from high medicine prices to pay their employees.”
In fact, medicine factories have their own representatives who are responsible for the promotion of their medicine in hospitals. For those doctors who have the right to prescribe, each prescription brings them a commission from the company representative. However, these doctors are not the majority in any hospital.
As for the “red envelope” money, one of my mother’s colleagues says that she often has to drive to a city two or three hours away for a diagnosis. If the inviting hospital doesn’t provide “red envelope” money, the money my mother’s own hospital gives her isn’t even enough to purchase gas for the trip.
Even if patients and their families understand that their pain comes more from the system than from health workers, medical reform is difficult. In the U.S., discussion about health insurance reforms started at the beginning of the twentieth century, and it is still a focal point in elections. In Berlin, my friend once had to wait for over three hours to get a doctor to see her sprained foot. In China, there are perhaps more problems as conflicts between doctors and patients mount. But when comparing China with developed countries, remember that her medical reforms only started in 1985. There is still a long way to go.
“医患关系”到底代表了什么？新浪微博网友们从各自的角度给出了不同的定义。@最爱香草奶昔_说:”中午12点多，儿童医院内就医的人们依旧是人声鼎沸，陪护着小儿患者的家长们个个心急如焚，但无论是收费、坐诊还是检查的医务工作者们早已纷纷回家吃饭、午休。 ‘检查、治疗，两点半以后再来！’——这就是中国的医患关系……” @走猫步的天使则称:”沈阳医学院奉天医院急诊室护士燕妮被患者家属殴打至血尿，打人者高喊我老丈人是七路派出所所长，打你也白打，太气愤了。这和我爸是李钢有什么区别？这就是现在的医患关系！”
网络上的在职医生和医学生则对这一职业的前景，甚至自身安危表示了担忧。@天使Li468说: “随着医患关系的紧张医闹的壮大…让医务人员承受的压力与舆论谁能明白…导致这种局面到底是什么造成的值得反思…所以只有学医才能深深体会到所以才不让自己的孩子走自己的路啊…” 而另外几位自称是从事医疗行业的网友也说，尽量不让自己的孩子学医，不仅因为学费高，压力大，工作收入与产出不成比例，也更是因为医患关系让医生们开始严肃考虑自身的性命安危了。