Written by yxtlavi
"Poor service attitude" "Drugs purchased at designated pharmacies"..... According to Inner Mongolia Radio and Television reports, the "red and black list" of doctors is rolling in a loop at the entrance of the Affiliated Hospital of Inner Mongolia Medical University. Doctors who are complained by patients for these reasons will be publicly named in the blacklist, and all patients who come to see them can see it.
Source: Video number of the Affiliated Hospital of Inner Mongolia Medical University
The hospital is a tertiary hospital and the first public hospital to open the "Medical Ethics and Medical Style Bulletin Board". Its president said in a previous meeting, "Whoever pours the hospital's brand will smash whose job, and whoever smears the image of the hospital will lose his post."
Many places have announced the "Doctor Red and Black List"
On May 18, the Affiliated Hospital of Inner Mongolia Medical University held a relevant kick-off meeting, saying that it would rectify the industry style, improve medical services, and increase public satisfaction. Therefore, in addition to the "red and black list", the hospital will also carry out a series of related actions.
Source: Affiliated Hospital of Inner Mongolia Medical University
According to Chinanews.com, at the launch meeting, the hospital will also launch ten special actions such as "how to change the cold attitude", "how to adjust the service process is unreasonable", and "how to shorten the waiting time for medical treatment", and at the same time, it said that it will strictly implement the reward and punishment system and widely accept social supervision, so that negative models have no way to escape. To this end, the hospital has specially hired 10 social supervisors, including patients, journalists, and administrative staff, and 10 social supervisors will supervise the whole process of this special operation.
The problems presented on the "red and black list" this time mainly come from the feedback of patients through various channels. According to Inner Mongolia Business Daily, Liu Haibo, vice president of the hospital, said in an interview that the hospital will promptly investigate these reported problems and seriously deal with relevant personnel after verification.
In fact, the "red and black list" of doctors has been practiced by other hospitals before. For example, Kunming's Dongchuan District People's Hospital released a "red and black list" last year, posted in front of the outpatient building, and the hospital said that it would expose negative examples of procrastination, perfunctory coping, and weak service awareness in work, which served as a warning.
Source: Kunming Dongchuan District People's Hospital WeChat platform
In 2019, the Yiwu Municipal Health Bureau also set up a "red and black list" to publicly publicize the complaints of various hospital departments, such as "the efficiency of complaints from patients in XX places is low, and the queue is not standardized" and so on. According to the summary of health work released by the Yiwu government, in January ~ March 2022, a total of 466 issues of the red and black list were announced, with 1031 red list contents, 507 black list contents, 28 problem clues investigated and handled, and 2 handling personnel.
Among the patient groups, there has also been a spontaneous sorting out of the doctor's "red and black list". Patients will vote according to their own experience, and doctors on the "black list" are often reminded to "never hang up the TA number". Among them, the most common reasons for patients not to recommend are "poor attitude" and "poor medical skills".
The title of a mother and baby forum post
There are multiple reasons behind the complaint
"Our director has also been complained by patients because his medical skills are not good enough, but we all know that he is the most powerful expert."
Chen Hu (pseudonym), an attending physician from a third-class hospital in Guangdong, recalled that a patient was hospitalized for a month due to an open fracture. The director has been actively treating, but the patient's complicated situation and ultimately did not save the leg, and the patient later complained to the director. "Because the treatment cycle is very long, we can understand that patients are not satisfied, but sometimes there is really no way." Chen Hu said a little helplessly.
Whether it is released by the hospital or spontaneously by patients, the source of information on the "red and black list" is patients. However, the same "red and black list" sometimes has contradictions, for example, in the evaluation of the same doctor, there are two evaluations: "excellent medical skills" and "poor medical skills". A doctor may be on the "red list" of one patient, and TA will also be on the "black list" of another patient.
Xu Yucai, former deputy director of the Shanyang County Health Bureau in Shaanxi Province, said that this is because the patient's complaint is not only aimed at the doctor, but is evaluating his overall medical experience, if the patient is not satisfied with the medical process, then the patient may give the doctor this time on the "black list". Therefore, he believes that the use of "red and black lists" to evaluate doctors is not objective. The article "Patient Satisfaction Assessment Problems and Thinking on Governance Paths" also mentioned that the essence of patient satisfaction is the emotional response of patients to medical services, and it is the sum of evaluations in all aspects. [1]
On a website, two different reviews appear in the same doctor's comment section
At the same time, there may be other reasons behind the patient's complaint about the doctor's "attitude to the doctor".
"I choked with patients in the consultation room, and then I was notified and criticized for my 'poor attitude'." Li Lu (pseudonym) from Anhui Province said, "The patient came back to me after leaving the clinic for a long time and told me that I had lost a receipt and asked me if I had left it in the consultation room. Because there were other patients in the room at that time, I asked him to wait, but he was very anxious, and after waiting for a few minutes, he came in and went straight to the things on my table." Li Lu admitted that his throat rang first, and then the patient went to complain about him.
"I know patients are anxious, but I can't let other patients be affected." Li Lu said that he had just finished surgery the night before, and he rushed directly out of the outpatient clinic, he was very tired, and his patience was indeed insufficient. Therefore, in Li Lu's eyes, it may not be appropriate to be on the "black list" simply because of "bad attitude". Li Lu said, "For example, like my situation at that time, I really can't do the attitude required by the hospital after the pivot, and I will definitely help the patient find it in normal times."
Xu Yucai said that patients' complaints to doctors are often not aimed at doctors, but at the entire diagnosis and treatment process, and complaints are only an outlet for patients' emotions.
Experts: Improving the protection of doctors can improve patient satisfaction
The Yiwu Municipal Health Bureau has said that the establishment of the "red and black list" can "force employees to change their work style, establish a new trend of honest medical practice, form a good atmosphere of honesty and self-discipline, love and dedication, take the initiative, catch up with and surpass the study and entrepreneurship, and enhance the sense of gain of the masses in seeking medical treatment".
So, under the supervision of the "red and black list", will doctors expect that change?
A doctor at his hospital who had a red and black list said he became "particularly careful" after being notified. The doctor, who did not want to be named, said that he had previously treated a patient in his 80s who was mildly deaf, and because the patient could not hear clearly, he lay on the patient's ear and explained the condition loudly, and as a result, this scene was seen by the patient's children, because of the "bad attitude", the doctor was on this month's "black list". "Later, when I encounter patients who can't hear clearly, I won't explain the condition to them, and I'll talk about it when my family comes."
According to the article "Patient Satisfaction Evaluation Problems and Thinking on Governance Path", behind patient satisfaction is the public expression of the current medical and health system reform results and the current state of the social medical environment, and is a prism that reflects a series of problems such as the current social medical service system and mechanism, social medical policy, hospital organization and management, social public opinion environment, doctor-patient trust, and patient cognition, which are jointly affected and constrained by a variety of factors. [1]
Therefore, patient satisfaction surveys need to cover multiple subjects and factors, not just medical staff. For example, if the medical process can be optimized and auxiliary facilities can be added, perhaps this doctor will not be blacklisted.
Patient satisfaction covers a variety of influencing factors Source: "Patient Satisfaction Assessment Problems and Thinking on Governance Path"
"For doctors, we should not supervise, but meet their life security and make them feel respected, they will naturally pay attention to their attitude to diagnosis and treatment, and patient satisfaction will increase accordingly." Xu Yucai said that most of the current patients' "dissatisfaction" is actually a problem of institutional mechanisms and hospital operation and management, and solutions to problems should be considered from multiple aspects in order to maintain the benign operation of hospitals. (Curator: YXTLAVI | Executive Producer: Gyouza)
Image source: Video number of the Affiliated Hospital of Inner Mongolia Medical University
Resources:
[1] ZHENG Guoguan, WANG Xiaohe, QIAN Yu, WANG Hui, REN Jiayan, CHEN Jie, TAO Qi. Patient satisfaction evaluation problem and governance pathway[J].China Health Policy Research,2019,12(3):8-16.)
[2] China Discipline Inspection and Supervision News: "The Red and Black List of Doctors Still Needs to Be Viewed Rationally"