A gloomy future for medical students in China

Article in The Lancet by Dr Zeng Jie of the Mental Health Institution of the Second Xiangya Hospital, Central South University, Changsha, Hunan

 

in The Lancet:According to the Chinese Medical Doctor Association, there were 17 243 cases of violent attacks against health-care workers in 2010, in China. On Oct 25, a patient beat a senior doctor (head of the Ear, Nose, and Throat department) to death, adding a new victim on this too-long list.

Hospitals in China are deemed as dangerous working places, and being a medical practitioner has turned into a life-threatening job. The deteriorated relationship between health-care providers and patients not only affects the present generation of professionals, but also the future generation of doctors. National medical colleges warn that the number of medical students is decreasing, and medical students in their last year of MD or PhD programmes are hesitating to continue their career. Only one-sixth of the 600 000 medical licence owners have been registered to a health-care institution in the past 5 years; this means that 500 000 newly qualified young doctors have left medicine without using their medical licence. Many medical students have lost enthusiasm in pursuing their career, and wonder why this once respected profession has changed into a non-promising job.

Misunderstandings and distrust between health-care providers and patients take root in socially, culturally, and economically complex ground.

First, most patients think that doctors and hospitals tend to do over-examination and unecessary treatment. Some treatments can be unaffordable for families. Second, the media can exacerbate tensions between doctors and patients, with sensational but disproportionate media coverage and misleading reports. Third, the rapid economic growth generates high expectations for the care each citizen deserves. Some patients believe that once they have paid the bills, doctors should do everything and guarantee a cure without risks, side-effects, or failures. Worryingly, patients are playing the role of judge to decide who is a good doctor or not. Last but not least, poor communication between doctors and patients in daily medical practice is exacerbating the situation. Some doctors can see 70—80 patients a day, spending only 5 or 6 min with each patient, hence fuelling dissatisfaction among patients and their family.

Once respect and trust between doctors and patients have been broken, it is very unlikely to be repaired in a short time.