Violence against doctors and other medical practitioners in China has been reported as an increasing problem. National Ministry of Health statistics indicate that the number of violent incidents against hospitals and medical staff increased from about 10,000 in 2005 to more than 17,000 in 2010. A survey by the Chinese Hospital Association reported an average of 27.3 assaults per hospital per year in 2012, up from 20.6 assaults per hospital per year in 2006. In 2012, an editorial in The Lancet described the situation as a "crisis" for the practice of medicine in China.
Contents
Causes
Many of the reported attacks on Chinese medical practitioners have been by patients or their family members who were dissatisfied with the care they received. In one widely publicized incident in March 2012, a patient suffering from ankylosing spondylitis and tuberculosis used a knife to attack several doctors in Harbin after the patient was refused a drug treatment that he had requested. One doctor who had not been involved in the patient's case died. In August 2012, the family and friends of a patient who died in surgery in southern Nanchang started a "full-scale melee" that involved more than 100 hospital personnel; the hospital staff armed themselves with sticks and mace for self-protection. In November 2013 several hundred doctors and nurses protested at the No. 1 People's Hospital in Wenling after a patient dissatisfied with his sinus surgery overpowered security personnel and stabbed three doctors.
Violence may stem from patient dissatisfaction with care, costs associated with insurance premiums, unrealistic expectations, and overworked and underpaid hospital staff, as well as the rising cost of health care due to the government's inability to subsidize hospital operations. Lack of a third-party formal dispute resolution system in many hospitals has been suggested as a factor, and the acceptance of bribes or good-faith money in the form of red packets has been implicated. Media coverage, and a lack of health literacy amongst the Chinese population, who may often seek unnecessary high-level care, have also been implicated.
Yi Nao
The phenomenon of Yi Nao (Chinese: 医闹; literally: "healthcare disturbance") has been identified as a contributing factor in violence against medical personnel. Yi Nao is the organized disturbance of hospitals or medical staff, usually to obtain compensation for actual or perceived medical malpractice. Yi Nao is usually perpetrated by organised criminal groups hired by patients or their families, although Yi Nao gangs may also solicit activity. Yi Nao has been increasing in recent years. A 2013 article in the British Medical Journal describes Yi Nao gangs as consisting "largely of unemployed people with a designated leader. They threaten and assault hospital personnel, damage facilities and equipment, and prevent the normal activities of the hospital." Citing a survey published in 2006 of 270 tertiary hospitals, over 73% of the hospitals reported experiencing Yi Nao.
Response
The Chinese Medical Association has issued a statement calling for system-wide reforms to be made. In October 2013 the Ministry of Public Security of the People's Republic of China advised hospitals with over 2,000 beds to hire "at least 100 security guards". However, increased implementation of security guards, metal detectors, and legal threats has been criticised as failing to deal with the underlying causes of the violence.
The International Business Times reported in November 2013 that hospital personnel at Zhongshan Hospital and Huashan Hospital were learning taekwondo from a martial arts instructor after a chief physician of the head of the otolaryngology department of Wenling Hospital was murdered by an angry patient in October 2013.
Violence against doctors has been cited as one reason for a decrease in the popularity of medicine as a profession.