Experts parse challenges to China health reform

BEIJING - Two Chinese experts have parsed challenges to China's health care that include overuse of medical resources and medical disputes, as they called on more input to address such challenges and ensure sound development of the health sector.

Wang Yan and Wang Manyi, both from the Chinese Orthopaedic Association (COA) and delegates to the Seventh COA International Congress that closed Sunday in Beijing, offered some insights on how to tackle such challenges.

In China, government sponsors less than 10 percent of the operating costs of public hospitals, COA statistics showed.

Doctors sometimes prescribe excessively and overuse medical equipment to fill the operating costs, a practice that often lead to medical disputes.

In 2010, a septuagenarian patient died after 11 heart stents were put into his body and blocked his blood vessels.

The excessive use of medical equipment is both a waste and harmful to people's health. To stop such practice, COA President Wang Yan proposed institutional improvement.

In the realms of orthopaedics, the COA had pushed for the establishment of the Chinese Joint Registry and Information System in 2012.

The system enforces entry standards for hospitals, which saw joint replacement surgeries a profitable business and vied for qualifications.

So far, 27 major hospitals have already been registered into the system, Wang said.

Unlike the United States, where medical graduates have to go through tough examinations and residency programs before they become doctors, the majority of Chinese medical students go straight to work after graduation.

Chinese medical graduates go through residency training as hospital employees. The quality of training depends on hospitals.

At the government level, neither standards for residency programs nor a unified certification system for fellowship training exist.

Experts from the COA congress have advocated more training for young doctors. They also believed it necessary to establish national policies on residency training.

Wang Manyi, chair of the trauma society, a sub-specialty society under the COA, called for adding standardized residency training into law on medical practitioners.

Wang said it important to send doctors to prestigious medical institutions, where they might improve clinical skills through reinforced study.

Medical disputes are not uncommon in China, in which doctors often become targets of anger that resulted from misdiagnosis or patients' misunderstanding on treatment programs.

In March, a teenager stabbed a doctor to death and injured three others at a local hospital in northeastern city of Harbin as he misunderstood his treatment prescribed by doctors.

A similar case occurred in September 2011, when a patient stabbed and seriously injured a surgeon at Beijing Tongren Hospital following a medical dispute, in which the patient alleged that the surgeon had committed malpractice during an operation.

Lack of communication between doctors and patients, uneven technical level of medical staff, loopholes in China's health legal system, complex and costly legal procedures, as well as excessive medical treatment are among the leading causes for medical disputes, Wang Yan said at the conference.

In a bid to reduce the number of medical disputes, Wang proposed to use a patient-centered, team approach to increase patients' understanding on procedures and risks and use a third-party mediation mechanism to improve the medical arbitration system.

COA President Wang also advocated promotion of medical liability insurance which is suitable for both doctors and patients and ensuring the doctors' self-protection and rights.