Friday, 30 May 2014

Dodgy doctors or innocent victims of patient violence?

by Michael Woodhead
In Australia hardly a week goes by without a report in the media of a 'dodgy doctor' - a male medical practitioner who has sexually assaulted a female patient. You don't hear much of this kind of thing from China but coincidentally today there are two reports in which doctors have been accused of inappropriate behavior towards female patients. Are they genuine or are these yet more instances of China's wave of violence against doctors in an overloaded/corrupted system?
In the first case, a doctor in Nanjing was bashed by the drunken husband of a woman who claimed he had acted 'immorally' to lift her clothing to perform a cardiac exam. The doctor had been trying to perform an electrocardiogram test on the women for cardiac function. As anyone who's had an ECG knows, this involves the placing of up to 12 electrodes on the skin of the chest - there's no avoiding contact. The female patient objected to this, called her husband and he hit the male doctor so hard he broke the doctor's nose. The second case is from Gansu, where a woman took exception to a doctor examining her back, despite her seeking help for a suspected fractured coccyx. She accused the doctor of inappropriate manipulation and called her husband - almost identical outcome to the first case - the husband arrived and set about smashing the doctor around the head with a metal stool, leaving him battered and concussed.
 In both cases medical staff say the doctors were behaving appropriately and carrying out the recommended and necessary routine tests on women to investigate their medical problems. If taken at face value, these reports differ from those seen in western countries, where typically a male doctor will perform inappropriate examinations on women in private. It might be that the Chinese medical staff are covering up for their colleague, but personally I doubt it. While I feel sympathy for the women and their sense of being treated inappropriately, it sounds like the system is to blame here rather than lecherous doctors. In western countries like Australia it is now standard operating procedure to have a female chaperone present (or at least available on request) if a male doctor is to perform any kind of sensitive examination of a female patient. Another 'safeguard' with primary care-based systems is that you can see the same personal 'family doctor' or one of a familiar team on each visit, and so trust is built up in the treating doctor. In China's hospital-based system it's often a case of  'wait three hours to see a doctor for three minutes' and the doctors are strangers. The hugely overloaded Chinese healthcare system does not allow women the option of choosing to see a female doctor, and there may not usually be the option of a female chaperone.
As China develops and expectations about healthcare and personal 'human rights' increase, expect more of these kind of complaints and violent reaction to male doctors. And it could become a particular problem in China's western provinces with a high Muslim population. But what of the rights of women who really are being abused by medical staff? With the growing concern about violence against doctors (and the increasing emphasis on punishing those who take matters into their own hands) there is a risk that the bad doctors will get off scot-free.

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