I, the current situation of doctor-patient relationship and the main causes of the problem
Doctor-patient relationship from a general point of view, is the basic harmony in the existence of local disharmony, harmony is the mainstream, disharmony is a tributary. Doctor-patient relationship is caused by complexity, there is a lack of medical resources, the masses, "difficult to see a doctor", "expensive", the patient has a view; there is a poor quality of medical care, service attitude is not good, the masses are not satisfied; there are also more complex social factors. Both the system, the mechanism of the problem, but also the ideological aspects of the problem, as well as governance and supervision is ineffective and other reasons, the main reasons for the following aspects:
(a) the lack of trust between doctors and patients, is an important cause of conflict between doctors and patients. Lack of trust and understanding between doctors and patients, can not think differently. Part of the medical staff can not put themselves in the shoes of patients, but more consideration for the medical organization and their own interests. And some patients also lack understanding of medical staff, do not understand the complexity of medicine.
(2) insufficient communication between doctors and patients, the increase in medical disputes, is an important factor in the discordant relationship between doctors and patients. Some statistics show that: in the medical disputes that have occurred, due to insufficient doctor-patient communication, the doctor-patient relationship is not harmonious resulting in disputes accounted for about two-thirds of the total.
(C) the lack of humanistic care in the medical process, exacerbating the doctor-patient relationship disharmony. Cure and save lives is one, but some doctors only pay attention to the "neck do not pay attention to people; in some medical institutions, medical activities only emphasize rely on * instruments and equipment, ignoring the doctor and the patient's communication.
(4) patient complaints and safeguard the rights and interests of the channel is not smooth is the direct cause of the impact of the doctor-patient relationship. Although our country has been a few years ago on the implementation of the new "Medical Accident Handling Regulations", but after the occurrence of medical accidents, just accident identification costs up to a few thousand dollars, the cost of patients to defend their rights and interests is too high, to maintain rights and interests through the normal channels, in fact, is still a very difficult thing.
(E) China's current medical security system and related laws and regulations have not kept pace with the market economy, the universal health insurance system is not sound, is the most fundamental reason for the sharp contradiction between doctors and patients. Data show that many countries due to a sound system of universal medical insurance, universal participation in medical insurance, the vast majority of medical costs are borne by the insurance company, will not be paid by individuals with high medical expenses, there are few conflicts between doctors and patients.
Two, how to build a harmonious doctor-patient relationship
For medical institutions, to build a harmonious doctor-patient relationship, first of all, we must look inward, face up to and overcome their own shortcomings, can not complain about the patient's lack of understanding, complaining about the problem can not be solved. We should be good at analyzing our own problems, finding reasons and formulating measures from the service environment, service concept, service attitude, service effect and other aspects. The First Affiliated Hospital of China Medical University is a modern large-scale comprehensive hospital integrating medical treatment, teaching, scientific research and preventive health care, and is also a rescue center for difficult and serious diseases in Northeast China and parts of North China. In recent years, we adhere to the patient-centered, from ideas to planning, from initiatives to implementation, everything from the interests of the patient, and actively change the service mode, improve the quality of service, the patient's satisfaction as the pursuit of the hospital. From the practice of our hospital, to build a harmonious doctor-patient relationship to strengthen medical services in six areas, with the protection of people's health to promote the construction of a harmonious doctor-patient relationship.
One is to humanize service as the center, looking for service innovation. With China's accession to wto and diversified development of medical services, medical service system is facing a revolutionary change. In the more intense competition in the medical market, patients in the medical treatment is not only concerned about the hospital's medical level, and more concerned about the hospital's humanized service. In addition to the hard power of technology and equipment, hospitals cannot ignore the competition of soft power such as governance mode and service level. How to integrate the concept of humanization into the whole process of medical services and hospital management, to change the past "patients to the hospital is to see a disease, the hospital is only to treat the patient's neck of the stereotypes, to establish the medical object is first of all "people", followed by "neck of the modern medical model will be It is an important topic of modern hospital construction and governance, which deserves serious thinking, research and exploration. Hospitals should take measures on how to respect, understand, care for patients, and other aspects of the search for service innovations, through humanized services to continuously improve the public satisfaction of the hospital.
The second is to adhere to the guidelines of social benefits, to create a hospital of integrity. Medical institutions at all levels should adhere to the social benefits as the highest guidelines, adhere to reasonable inspection, reasonable medication, reasonable fees, strictly prohibit a variety of "billing fees"; efforts to reduce the cost of medicine to patients, the establishment of medical expenses sunshine system, seriously do a good job in the charge of consulting work, so that patients and their families at any time to query the cost of the situation, so that the patient can rest assured that the effective measures to eliminate the patient in the process of medical treatment, the patient's health care system is a very important part of the hospital. Measures to eliminate the patient consultation process, registration time is long, payment
time is long, long time to get medicine, short time to see a doctor "three long and one short" phenomenon; strict implementation of the centralized bidding system for medicines, to put an end to the phenomenon of drug dealers in hospitals to bring money to promote the phenomenon of medicines; the implementation of the doctor-patient agreement system, and prohibit the medical staff to accept the "red packets". "Red packets" and accept "food"; social supervisors to monitor the hospital's medical ethics and medical style.
Third, the establishment and improvement of doctor-patient communication system to promote doctor-patient communication. In order to strengthen the doctor-patient communication, medical institutions to the doctor-patient communication from the form, channels, content, requirements, skills, effects, assessment and other aspects of standardized governance, to achieve "a requirement, two skills, three grasp, four attention, five avoid, six ways. A requirement, that is, medical personnel should have integrity, respect for patients or families, with compassion and patience; two skills, that is, listen to the patient's inquiries, more to the patient's condition, treatment effects, medication and examination purposes, care for the patient's life in the process of medical treatment or inconvenience; three grasp, that is, to grasp the patient's condition in a timely manner to the development of changes in the situation of the medical costs and the patient's psychosocial; four pay attention to, that is, pay attention to the communication object of emotion, the affected person, and the patient's social and emotional health, and the patient's social and psychological health. It is to pay attention to the communication object's emotion, education level and the feeling of communication, the communication object's knowledge of the disease and the expectation of communication; five avoidance, that is, avoiding to force the patient to accept instantly, avoiding the use of stimulating language or words, avoiding the use of medical vocabulary that the patient does not understand, avoiding to force to change the patient's point of view and avoiding to suppress the patient's emotion; six ways, that is, the prevention-oriented targeted communication, Six ways, namely, prevention-oriented targeted communication, interchangeable object communication, collective communication, written communication, coordinated consent communication and physical control image metaphor communication. Through the omni-directional, multi-level, multi-perspective subject communication, effectively improve the quality of service, timely resolution of conflicts and disputes between doctors and patients, and enhance the patient's trust in the hospital and the understanding of medical personnel. Hospitals should accept and deal with patients' complaints in a timely manner through the establishment and improvement of doctor-patient communication system and complaint handling system, and regularly collect patients' opinions on hospital services for timely improvement. Medical staff should fully respect and maintain the patient's right to information, the right to choose, to sympathize with the patient's pain, sympathize with the patient's difficulties, respect the patient's ideas, dispel the patient's concerns, and strive to make the patient to obtain physical and mental health.
Fourth is to provide superb, high-quality technical services, so that patients can rest assured. With the continuous development of society and the times, the people's living standards continue to improve, the people's demand for medical services has also increased, coupled with the continuous development of the human disease spectrum, which requires medical personnel not only to have a good service attitude, but also have superb medical technology, we must continue to use the modern science of the new knowledge, new achievements, new methods, new technologies, to fight with a variety of human diseases, and use the new and superb medical skills to relieve the patients. High-tech superb medical skills to relieve the patient's pain. Doctors should have a strong sense of responsibility for patients, really think about the patient, sincerely for the patient service, to relieve the pain of patients as a lifelong pursuit of the highest.