Liang Zhanming, Xu Min, Liu Guowei, Zhou Yongli, Howard Peter F
The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China.
La Trobe University, Bundoora, Vic, Australia.
BMC Med Educ. 2020 Dec 10;20(1):501. doi: 10.1186/s12909-020-02339-3.
An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession.
A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China.
In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients' views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment.
Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended.
医疗纠纷数量的增加以及针对医生的暴力行为表明中国公立医院的社会对医疗行业缺乏信任。实证证据证实，一个原因是医生缺乏职业认同感。医疗专业人员需要保持高标准的能力和道德责任，并展现出尊重、同情、正直、对需求的响应能力以及对良好道德实践的承诺等品质，以维持职业特权。这些原则和恰当的职业行为是医疗行业职业认同感的基础。
采用定量研究方法，向中国山东省济南市两家医院（三级和二级）的医生和患者发放纸质问卷。
两家医院外科和内科的614名医生以及1184名出院患者参与了调查，回复率为90%。该研究证实，在确定诊断程序和治疗方案以及做出伦理决策时，医生在尊重患者意见和偏好方面展现专业素养存在差异。尽管90%的患者表示尊重医生，但近20%的医生不同意他们得到患者的高度尊重。约12%的医生为了获利给患者开不必要的诊断程序，超过20%的患者表示为了获得更好的治疗给医生送礼。
尽管约80%的医生展现了从业者所需专业素养的某些方面，但医疗人员之间的不一致可能会加剧医患关系紧张。需要对医学课程和实习项目重点进行审查，以帮助医学毕业生形成所需的职业认同感，从而提高患者满意度和改善临床结果。为了有效，建议采用更系统的方法。
