Question 2: How to improve the doctor-patient relationship? The doctor-patient relationship is actually a kind of interest relationship. Establishing a perfect medical insurance reimbursement system and investing a lot of money in medical treatment not only meets the needs of patients to spend less money on medical treatment, but also regulates the behavior of clinicians. In the doctor-patient relationship, patients and doctors are contradictory, so they need to play the role of mediation. * * *, the indifference and acquiescence to one-sided media reports is the initiator of the increasingly prominent contradiction between doctors and patients.
Question 3: How to improve the doctor-patient relationship from the perspective of professional ethics, promote the harmony between doctors and patients, and build a harmonious doctor-patient relationship requires the joint efforts of the whole society. Hospitals should adhere to the patient-centered concept to serve the people and strive to ensure that the people can enjoy safe, cheap, convenient and effective medical services; At the same time, safeguard the legitimate rights and interests of doctors and reasonable income, and create a good practice environment and service environment for doctors. It is necessary to strengthen legal awareness, guard against medical risks, strengthen the awareness of proof, earnestly strengthen the education of medical ethics, take all precautions from the source, relieve patients' awareness of hospital prevention, and build a harmonious doctor-patient relationship with quality services, so as to fundamentally guarantee the harmony between doctors and patients and social stability.
Question 4: How to strengthen and improve the doctor-patient relationship? Doctors and patients depend on each other, doctors live for patients, medicine develops because of diseases, and patients need medical treatment to get rid of diseases and restore health. Doctors and patients should become the most harmonious interpersonal relationship in society. Teacher Gao specializes in Medical Etiquette, which can effectively teach you to ease the relationship between doctors and patients.
First of all, doctors realize the importance of communication. Doctors should respect medicine, trust the law, explore the truth of handling medical tort with wisdom, establish a new concept of modern medical service based on honesty and rules, strengthen legal education and research, and practice medicine honestly and legally.
Second, be good at communication. Doctors have professional knowledge, which is easily understood by patients as "prevaricating patients with professional knowledge" in communication. Therefore, doctors should be good at using ways, methods and life experiences that patients can understand, so that patients can fully understand their own condition and treatment plan and actively cooperate.
Finally, doctors should pay attention to the standardization of medical documents. Medical records and other medical documents are not only records of medical activities, but also the only and most important basis when disputes between doctors and patients occur. Doctors must overcome the consciousness of attaching importance to medical treatment and ignoring the writing and preservation of medical documents, and promote the standardization of medical activities by improving the writing quality of medical documents.
Question 5: How to promote the healthy development of doctor-patient relationship? With the progress of science and technology and the development of socialist market economy, great changes have taken place in people's values, moral concepts and interpersonal relationships, and the doctor-patient relationship reflected in medical activities has also shown a new development trend.
First, the development trend of doctor-patient relationship
Since the 1990s, the obvious changes in the doctor-patient relationship are closely related to the progress of science and technology, the renewal of ideas, and the enhancement of people's sense of autonomy and participation, which generally includes four aspects.
(1) The trend of "humanization" in the doctor-patient relationship: Since the 1990s, medical high-tech technology has been widely used in clinical diagnosis and treatment, which has greatly changed the way of diagnosis and treatment and nursing, especially in large hospitals, where automation, informationization and remote control are widely used. Doctors obtain data of patients' physiological and biochemical indexes through high-tech service facilities such as machines, instruments and equipment, which has the characteristics of high sensitivity, accuracy and rapidity. This trend of replacing people with machines weakens the ideological exchange between doctors and patients, increases the dependence of doctors on high-tech facilities, and ignores the influence of patients' social and psychological factors on diseases.
(2) The trend of "economization" in doctor-patient communication: Due to the large population in China, the existing health resources still cannot meet the growing medical and health needs of the broad masses of the people, and there are problems such as "difficulty in seeing a doctor, hospitalization and operation". In the case of contradiction between supply and demand, loose policies have also been implemented, such as allowing hospitals to run in various forms, trying out roll call surgery, amateur paid services, etc., which have alleviated the "three difficulties" and satisfied the masses. However, in some places, medical services tend to be commercialized, and the relationship between doctors and patients tends to be economical. The principle of equivalent exchange of commodity economy has penetrated into the relationship between doctors and patients, and even unhealthy trends such as power and money trading have emerged.
(3) The "diversified" trend of doctor-patient requirements: Under the conditions of reform and opening up and the development of socialist market economy, the diversified tendency of people's values is also reflected in the doctor-patient relationship. Doctors require patients to actively cooperate with diagnosis and treatment, and the doctor-patient relationship should be "guidance-cooperation type" or "* * * participation type", so as to avoid uncooperative or conflicting type as far as possible; Patients' requirements for medical care are also different in levels and grades, showing a diversified trend. Some patients pursue high-quality services and require high-grade wards or even non-medical services; Some patients only need basic medical care; Some patients can't even achieve the most basic medical care. (D) The trend of "legalization" of the adjustment mode of doctor-patient relationship: the adjustment mode of doctor-patient relationship mainly depends on morality. But when the ethics of doctor-patient relationship rises to legalization, the medical order will be more perfect. Nowadays, the consciousness of autonomy and participation of both doctors and patients is enhanced, and the concept of safeguarding their own rights and consciously performing their duties is increasingly strong, which provides an ideological basis for health legislation. In addition, the clinical application of high-tech has caused a series of social and ethical problems, which need to be solved urgently by health legislation, such as using high-tech for gender identification; Family moral and social problems caused by artificial insemination and in vitro insemination; The source of donors and the fairness of health resource allocation in organ transplantation are directly related to the relationship between doctors and patients. It is not enough to rely only on moral norms, but must be regulated by legal system, which is imperative. Second, the factors affecting the doctor-patient relationship
(A) the concept of doctor-patient medicine: today's biomedical model has turned to bio-psychological-social medical model, people's health concept,
The concept of medicine has changed greatly. However, some medical staff still adhere to the traditional biomedical model and fail to see or pay attention to the influence of psychological factors such as emotion and ideology and social factors on diagnosis and treatment. Coupled with the application of high technology, the "humanization" trend of doctor-patient relationship has prompted some medical staff to have a purely technical view, while the broad masses of people and patients require medical staff to perform their duties according to the new medical model, which will inevitably lead to a big gap between the expectations of doctors and patients and affect the doctor-patient relationship.
(2) Moral cultivation of doctors and patients: Moral cultivation is two-way, doctors should talk about medical ethics, and patients should also talk about medical ethics. In real life, a few medical staff lack medical ethics, lack the spirit of serving patients wholeheartedly, and are irresponsible for their work, which is manifested in: shirking responsibility for patients with unknown or complicated conditions and delaying diagnosis and treatment; Afraid of taking the responsibility of emergency patients or difficult patients, shirking; Being blunt towards patients and ignoring patients' right to seek medical treatment is a minority, but it directly damages angels in white's image and affects the relationship between doctors and patients. A few patients don't speak medical ethics, don't abide by hospital rules and regulations, don't respect the personality and dignity of medical staff, and even accuse, abuse or even beat medical staff with a little dissatisfaction ..... >>
Question 6: How to treat the doctor-patient relationship correctly? Building a harmonious doctor-patient relationship based on doctor-patient communication is the basic content of modern medical model. The low level of doctor-patient communication will inevitably affect the doctor-patient relationship, resulting in tension between doctors and patients and disputes between doctors and patients. The relationship between doctors and patients is the focus of China's medical and health system and even the whole society. How to treat and deal with the current doctor-patient relationship has become one of the key points in the construction of hospital culture and medical ethics. The relationship between doctors and patients is the foundation of hospital's survival and development. Therefore, if hospitals want to be invincible in the increasingly fierce medical competition, they must take the needs of patients as the center and establish a doctor-patient relationship of mutual treatment, understanding, trust and support. Only in this way can we realize the sustainable development of hospitals and maintain social stability and unity. This paper discusses the present situation and existing problems of doctor-patient relationship, and puts forward the idea of building a harmonious doctor-patient relationship. Nowadays, medical treatment has gone into a big misunderstanding, and it rarely really cures patients. This requires a * * * knowledge: 1. Subjectively (1) China advocates equal humanitarianism and Bethune spirit, and there are indeed many such models in the health front. They are honest and clean, and serve patients wholeheartedly. However, with the comprehensive establishment and in-depth development of the market economy, people's awareness of commodities has increased and their material level has improved. A small number of medical staff regard practicing medicine as a means to seek personal gain, which hurts patients and leads to great opinions from patients. Some people spend a lot of money on medical treatment, which leads to psychological imbalance and conflicts with medical staff. Secondly, because normal income can't meet the material needs of doctors objectively, a few doctors use the opportunity of treating diseases to engage in unhealthy practices in the industry: "kickbacks" and "red envelopes", which harm the interests of patients. Third, some medical staff are not high enough in professional ethics, and they are cold and hard, pushing and shoving patients, which makes patients dissatisfied, and conflicts and disputes inevitably occur. This is because some medical staff have feudal ethics: you are asking me when you come to see a doctor, and you have to listen to me. This unsympathetic thinking will not lead to tension between doctors and patients. Fourth, some doctors prefer illness to love others. They only care about patients who are useful for their own scientific research and projects, but ignore other patients. This is undoubtedly a blow to sensitive patients, and disputes will certainly occur. (2) In terms of management, there are also some reasons why the management of hospitals is not strong enough: (1) The system is not perfect, and there is no complete set of management and supervision institutions, so that a few medical staff can take advantage of it. Management confusion makes medical activities lose their norms and the overall medical quality of hospitals is poor. Therefore, at present, our hospital has purposefully and timely carried out measures such as "patient-centered", "strengthening internal quality, shaping external image" and "benevolence and convenience", which have achieved certain results and are beneficial to improving the current unsatisfactory doctor-patient relationship. (2) The management ideas of some hospitals are biased. Due to the fierce competition in the medical market objectively. Hospitals pay more attention to two aspects of economic benefits. Especially after the independent accounting of the departmental economy, the department is responsible for its own profits and losses and can only conduct economic accounting. To some extent, there is a bad atmosphere of one-sided pursuit of economic benefits, which has a negative impact on patients' psychology. I believe that hospitals in socialist countries will soon become "medical exchanges" and gradually become stale! Second, the contradiction between doctors and patients is the responsibility of patients, but patients are sometimes the main instigators of conflicts. The main manifestations are as follows: (1) Some patients have high expectations for medical treatment, thinking that a minor illness should be cured, while others are hearsay and dissatisfied with how this disease was treated like this. There was a fight in the hospital. Some ill-bred family members abused the doctor. (2) Distrust: Some patients want senior doctors to treat them. If they are not satisfied, there will be some complications, which will be considered as caused by young doctors and disputes will occur. (3) Some diseases will have adverse psychological effects, such as cancer and chronic diseases. If they are not cured for a long time, patients will be dissatisfied and desperate, and they will be angry with medical staff. (1) It is necessary to improve the professional ethics and technical level of medical staff, improve their service attitude, and treat patients with sympathy and comfort. Especially in today's bio-psychological-social model, the requirements for doctors are higher. We should not only cure the patient's illness, but also understand and guide the patient's psychological state, meet the patient's reasonable requirements, make the patient feel happy when he is hospitalized, and cooperate with the doctor for treatment. We find "caring with heart" very convincing. When you ignore the patient's pain, think about what you want the doctor to do to you if you are sick. In addition, with the rapid development of medical technology, medical staff should have the enterprising spirit of "making further progress" and strive to master advanced medical technology to serve patients. In appearance, movement, language and medical work ...
Question 7: How to strengthen communication between doctors and patients, reduce contradictions between doctors and patients, improve communication skills between doctors and patients, reduce contradictions between doctors and patients, and create a harmonious medical environment.
A survey by the World Health Organization found that when a patient complained about his illness, the average time he was interrupted by a doctor was 18 seconds. When patients want to express their views on treatment, doctors have prescribed prescriptions at the first time ... Senior experts from Hefei One Plus One Hospital said that more than 90% of doctor-patient disputes stem from improper communication between doctors and patients, so every medical staff should master the skills of communicating with patients and strengthen humanistic attention to patients' social and psychological needs. Research shows that patients and the public are most dissatisfied with doctors, often because of their poor communication skills, not their professional skills. According to reports, some doctors often proceed from their own point of view when conducting diagnosis and treatment, and rarely consider the patient's thoughts; Even rely too much on some high-tech instruments in diagnosis and treatment, and are unwilling to spend time communicating with patients.
Medical staff should not only communicate with patients, but also master communication skills. The communication between doctors and patients is professional, and doctors should play a leading role. It is wrong to complain about patients' poor expression ability. Doctors must be sincere and approachable, and have the desire and motivation to help patients relieve pain and promote rehabilitation. It is no exaggeration to say that communication skills are indispensable for doctors. The following speech focuses on communication skills:
1. Listening: This is the most important and basic skill, but unfortunately, it is often overlooked by busy doctors. Doctors must listen to patients' complaints with patience, concentration and concern as much as possible, and respond, such as changing expressions and eyes, nodding to say "hmm", or simply inserting "I heard clearly" and so on. Patients with toothache, in particular, often worry about the pain caused by doctors' treatment, especially fear and doubt about the sound of dental drills and dental instruments. Doctors need to patiently explain that dental treatment in regular hospitals has changed from "painless treatment" to "comfortable treatment" to eliminate unnecessary fears. Of course, the patient's narrative should not go too far from the topic, and the doctor can politely remind the patient to get back to the topic. In a word, listening is the most important step to develop a good doctor-patient relationship. Mistakes in diagnosis are often caused by doctors' insufficient listening.
2. Acceptance: Believers are doctors, and patients should trust and accept doctors. Patients or their families who don't trust doctors and are treated by doctors are most likely to have disputes. Doctors should also accept patients unconditionally, without any rejection, disgust, disgust and impatience.
3. Affirmation: This refers to affirming the authenticity of the patient's feelings, and shall not be arbitrarily denied. For example, patients complain that "my teeth here are always jumping." Doctors must first affirm the authenticity of patients' jumping sensation and understand patients' discomfort and worry. We should not take a negative attitude towards the patient's thoughts, even if they are obviously morbid, let alone argue with the patient.
4. Encouragement: Appropriate appreciation and encouragement can narrow the distance between doctors and patients.
5. Choice: As the saying goes, all roads lead to Rome. Doctors may have many kinds of treatment schemes and tell patients their advantages and disadvantages. Patients can make different choices according to their own ideas, time schedule, economic situation and so on. Doctors fully respect patients' choice on the basis of treatment effect. Of course, doctors can't accommodate unreasonable or unrealistic demands made by patients, because doctors can't accurately predict the "future".
In order to make the communication between doctors and patients smoother and obtain more comprehensive information, doctors should mainly do the following work: (1) improve their own quality and increase the knowledge and popularity of communication; (2) It varies from person to person, which increases the flexibility and intimacy of communication; (3) Listen carefully and encourage patients to actively provide information; (4) Seeking truth from facts to ensure the authenticity of communication information. (5) Establish a good medical ethics, consciously * * * unhealthy trends that are detrimental to the image of medical institutions, respect the rights and interests of patients, start from ourselves, improve the language art of communicating with patients, and create a harmonious doctor-patient relationship.
Medical institutions should also be strictly self-disciplined. First of all, they should lead a good team, carefully sort out the medical disputes in their units in recent years, learn from them, improve measures and methods, take various forms to strengthen the education of employees' laws and regulations and professional ethics, truly implement the "patient-centered" activities, further improve the quality of medical care and improve the service attitude. The second is to strengthen the exchange and training of medical workers and hold more lectures and seminars. Third, * * * relevant functional departments should provide guarantee and support for the hospital to create a good practice environment, and all medical units should take the initiative to communicate with relevant departments to gain social understanding and support. Fourth, increase investment in health care and advanced equipment, especially ...
Question 8: How to improve the doctor-patient relationship is something that both sides need to coordinate.
Question 9: How to improve the tense doctor-patient relationship? The tense doctor-patient relationship can't rely solely on persuasion, but must rely on the law, because some people are really unreasonable and make trouble. If the patient is not satisfied, it can be solved according to law, and there is no need to make trouble.
Question 10: What do you think should be done to improve the main reasons for the tension between doctors and patients?
On the whole, China has made remarkable progress in health reform and development. China used less than 3% of the world's health resources to maintain the health of nearly15 people in the world. The average life expectancy has reached 76 years, and remarkable achievements have been made in medical and health undertakings. This achievement embodies the hard work and selfless dedication of nearly 10 million medical staff. Objectively speaking, the mainstream of doctor-patient relationship in China is good, and most patients and their families are positive, understanding and supportive of the work of medical workers. Over the past 60 years since the founding of New China, a large number of outstanding medical workers have emerged in China, including Hua Yiwei, Wang Zhongcheng, Wang, Wu, etc. Their touching stories show the mental outlook of contemporary medical workers and are loved and praised by the masses. However, at present, the contradiction between doctors and patients in China is prominent, especially the frequent occurrence of malignant injuries to doctors, which has sounded the alarm for us and reflected the reality of the tense relationship between doctors and patients to some extent. According to the statistics of the National Health and Family Planning Commission, in 20 13 years, there were about 70,000 disputes between doctors and patients in medical and health institutions nationwide. The absolute number of disputes between doctors and patients has indeed increased because the current ratio of medical visits to hospitalizations in China has doubled 10 years ago. In addition, with the advent of the era of online media, any sudden social events will be quickly spread and fermented, attracting countless onlookers and even malicious speculation. Medical disputes and other events are more likely to attract social attention, and even become a hot news spot for individuals to take the opportunity to speculate.
However, the contradiction between doctors and patients or the dispute between doctors and patients is a very complicated problem, and any emotional cognition and treatment will not help solve the problem. We need to make a rational and in-depth analysis, explore the reasons from the aspects of both doctors and patients, the characteristics of medical activities, the current situation of medical and health system and social environment, clarify the essence of the doctor-patient relationship, and explore a long-term mechanism to build a harmonious doctor-patient relationship.
Doctors take saving lives as their bounden duty, and "medicine" and "suffering" are by no means antagonistic, but consistent. The doctor-patient relationship, like comrades in the same trench, should be one of the most intimate relationships in the world. The essence of doctor-patient relationship is the same body of health interests. Only when both doctors and patients unite as one and "share the same enemy" can we finally overcome the disease. Of course, due to the limitation of medical technology and the shortage of high-quality medical resources, some discordant notes will inevitably appear in the doctor-patient relationship. Generally speaking, there are five main reasons for the tension between doctors and patients.
There is insufficient understanding of the characteristics of medical services, and the phenomenon of "unreasonable medical care" is still widespread. Medical service has its own characteristics and laws. Due to the limitations of medicine itself, it is not necessary to spend money to cure the disease. Medical service is not a real commodity transaction, and it is impossible to achieve equivalent exchange. Family members often find it more difficult to accept the outcome of both money and people when their loved ones are seriously ill and spend a lot of money, especially when they think that there is a fault in the diagnosis and treatment activities, they are more likely to have a fierce reaction and form contradictions and disputes between doctors and patients. At the same time, the first diagnosis and referral functions of primary medical institutions in China have not been fully brought into play, which has aggravated the contradiction between the ability to provide medical services and the growing health needs of the people. As a result, using experts from large hospitals to solve common diseases consumes scarce high-quality medical resources, increases the burden of diagnosis and treatment of difficult and severe patients, and becomes the fuse of doctor-patient disputes.
There is insufficient understanding of the development law of health undertakings, and the medical and health system is not perfect. The medical and health system is related to people's health, involving medical security, medical and health services, drug production and supply security and supervision. Therefore, it is a long-term and complicated task and a worldwide problem to explore the inherent law of health development and constantly reform and improve the medical and health system. After decades of efforts, especially in the five years since the implementation of the new round of medical reform, China has woven the world's largest basic medical security network covering 654.38+300 million people, and the level of security has also been greatly improved. However, the financing level and reimbursement level of basic medical insurance are still low, the insurance system for serious and serious diseases and the medical assistance system are still not perfect, and the problem of poverty caused by illness has not been fundamentally solved. People are seriously ill, but their personal burden is still very heavy, and the problem of expensive medical treatment has not been fundamentally solved. At the same time, the mechanism of supplementing doctors with medicine has not been fundamentally broken, the salary system, performance appraisal and employment system of medical staff that meet the characteristics of the industry have not been established, the professional and refined management system still needs to be improved, and the medical safety quality and service attitude that cause contradictions and disputes between doctors and patients still need to be further improved.
Insufficient understanding of medical limitations, communication between doctors and patients is still not smooth. Although modern medical technology has made great progress.