Chinese Physicians: “Under the Knife”

Across the globe, there are few professions held in such high regard by society as that of a physician. Everyone seems to agree on the fact that these individuals are pursuing a valuable and altruistic career – everyone, that is, except for China.

China is currently suffering from a shortage of physicians. The most recent data finds that countries within the Organization for Economic Co-operation and Development (OECD) have 3.2 physicians per 1000 population. China currently has 1.6 physicians per 1000, and there is little evidence that this statistic will improve anytime soon. There are a plethora of obvious reasons as to this shortage of physicians – poor pay, long working hours, and minimal future prospects. While each of these reasons deserve their own analysis, I’d like to take a stab at examining the phenomenon of “Yi Nao”, or medical disturbance, and how it is also contributing to the less than adequate supply of physicians in China.

Yi Nao is the organized disturbance of a hospital or its medical staff, usually in order to obtain compensation for perceived malpractice. A 2012 study found that violence against medical personnel rose 23% each year from 2002-2012 with hospitals now reporting approximately 27 assaults annually per hospital. Some of these violent acts have even been fatal. For example, upset about his untreatable spinal condition, 17 year old Li Mengnan wandered into the First Affiliated Hospital of Harbin Medical Association and brutally stabbed Wang Hao in March 2012. Wang Hao wasn’t even the attending doctor for the assailant – he was simply the first person in a white coat that Li saw. In 2011, a man from Beijing stabbed his oncologist seventeen times due to his perceived lackluster throat cancer treatment. Also, in a two week period of February 2014, disgruntled patients paralyzed a nurse in Nanjing, cut the throat of a physician in Hebei, and beat another doctor in Heilongjiang to death with a lead pipe.

There is also another sect of Yi Nao that is growing, and it is more professional in nature. Criminal groups or even underground gangs will be hired by patients or their families to exact revenge on health professionals. Their services will range from protests outside the hospital to outright murder of the attending physician. In 2013, the Ministry of Public Security advised hospitals with over 2000 beds to have at least 100 security guards. This has done little to decrease the tension between patients and medical staff. In fact, it is appearing to have the opposite effect as just one month after the Ministry’s advice, a patient overpowered security at one hospital and stabbed three doctors.

New laws are being enacted by the government to try to protect doctors and other medical personnel. Nevertheless, China is seeing a mass exodus of physicians to other fields, such as the pharmaceutical industry, and even to other countries. One children’s hospital in Shanghai says it has lost over a third of its pediatricians in the past 2 years and is struggling to meet the market’s demands. Beefing up hospital security seems like a lackluster method to combat Yi Nao, and I wouldn’t expect to see much change in the doctor/patient relationship until more drastic measures are taken. Furthermore, until the government can address the other major issues such as poor pay and long hours, the supply of physicians in China will continue to dwindle.

Ryan J Hildebrand
MBA/MHA Candidate 2017