In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are at Risk

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A physician at Shenzhen Humanity Hospital washes his hands after performing an operation on May 20, 2011

On a recent Monday afternoon, doctors at Beijing Tongren Hospital stopped working. Their hour-long protest aimed to raise awareness about what they say is a rising problem in Chinese hospitals: attacks on medical personnel. "Punish the attacker severely and give dignity back to doctors," read a digital sign set up by the staff, according to state media.

Days earlier, Xu Wen, a 43-year-old otolaryngologist at the hospital, had been brutally attacked by a dissatisfied patient. Wang Baoming, a Beijing calligrapher and throat-cancer patient whom Xu had operated on in 2006, stabbed the doctor 17 times in her arms, head and back after spending years blogging about the allegedly failed surgery and trying to sue the physician for medical malpractice. The Ministry of Health, as well as several nongovernmental organizations, issued statements condemning the assault. Internet forums and social-media websites were quickly inundated with prayers for the injured doctor. "I am beyond angry," wrote an Internet user named ole2011 on the popular Tianya forum. "The murderer must be punished. Let's pray for Dr. Xu!"

China is no stranger to hospital brawls. On Sept. 21, relatives of a deceased patient barged into the Wuhan Union Hospital, injuring more than 10 security guards with metal batons. In June 2009, some 20 doctors across the country were killed or severely injured by disgruntled family members of patients. According to survey results published by the China Hospital Management Association, medical-treatment disputes have risen by an average 23% every year since 2002.

This wave of violence underscores deepening strain in doctor-patient relations. While physical attacks are widely condemned, at least publicly, many patients complain that doctors can be arrogant and irresponsible. "I hope all doctors will reflect on themselves," reads one comment on Sohu, a major Chinese Web portal. "Please try to be responsible for your patients and don't be blinded by profits."

Doctors counter that they are being vilified without cause. "Doctors are obviously a disadvantaged group in society," says an orthopedist at a prestigious Beijing hospital who speaks on condition of anonymity. "We have spent so much of our youth on a medical degree that yields so little economic reward. And in the end, we become like a public enemy." According to numbers released by the Chinese Medical Doctor Association, close to 96% of doctors in the country are dissatisfied with their salaries, which on average are just 19% higher than what the typical Chinese worker makes.

Indeed, there are several signs that the health system is stressed. First, there is a wide disparity between industry standards in rural and urban areas. "Right now, you can graduate from a three-year medical program [in the countryside] and be a doctor, or you can go for a 10-year program and be a doctor," says the orthopedist. "Of course, the better-educated ones will try to stay in big cities." As a result, rural patients flock to Beijing and Shanghai, lowering the country's urban doctor-patient ratio to 2.74 doctors per 1,000 people in 2010, according to statistics released by the Chinese Ministry of Health. In rural areas, the ratio is 0.95 doctors per 1,000 people. (In comparison, in France and Germany, the ratio in 2007 was about 3.3.)

Even worse, the attacks have already been shown to severely dampen the morale of doctors. More than 95% of some 6,000 doctors surveyed by the Chinese Medical Doctor Association this year expressed discontent with salary, and as many as 78% said they wouldn't want their children to study medicine. Doctors say violent attacks hurt patients as well as doctors. "I don't know her personally," writes a netizen who identifies himself as a doctor on Sina Weibo, a popular microblogging service. "But doctors like Xu typically perform about 20 surgeries a day. Chances are she will never be able to operate again, which means that every year, thousands of cancer patients could miss the chance to be cured."