Research On Doctor-Patient Trust In China During The Transformation Period

In the reform of the medical system,the hospital’s management mode has gradually become market-oriented,and its business objectives have mainly shifted from public welfare services to for-profit services,which has brought about many new problems in doctor-patient relationship.Trust is one of the key factors in the harmonious coexistence of doctors and patients.Based on the theory of trust,this paper uses the questionnaire survey and case interview research methods to investigate the status of doctor-patient relationship and its influencing factors during the transition period,in order to improve the relationship between doctors and patients and promote the development of medical sociology.The trust relationship between doctors and patients has both the characteristics of general trust and particularity.The roles of both doctors and patients are irreversible,their status is seriously unequal,and the initiative and advantages are on the part of the medical practitioner.Previous studies have paid more attention to the patient’s trust in the doctor,neglecting the role of the doctor in the trust relationship between doctors and patients;treating the doctor and the patient as two indivisible wholes,ignoring the respective doctors and patients.Internal differences.This article used Stata,Amos to analysis the data with description,correlation analysis,multiple linear regression analysis,structural equation models and supplemented by the method of interviews,to investigate the trust relationship between doctors and patients and its influencing factors.And these are the conclusions:First,there is significant difference in the physician trust among hospitals with different level.At aspect of the technology,the trust of patients toward doctors and nurses irn the first-level hospitals is lower than that of patients in the secondary and tertiary hospitals.On the aspect of personality quality,the patients’trust in doctors and nurses in the first-class hospitals is higher than that in the secondary and tertiary hospitals.The formation of doctor-patient trust in the first-grade hospital are mainly based on the interaction of doctors and patients,however,in the third-grade hospital,the trust is mainly based on hospital resources and technical advantages.The logic of trust forming is different among hospitals of different grades.Therefore,to improve the doctor-patient relationship,the medical resources should be appropriately assigned to the rural and the first-grade hospitals.Compared with outpatient patients,hospitalization patients have higher degree of trust in doctors,which indicates the importance of doctor-patient interaction.Trust has cognitive basis,when individuals are contacts with others more frequently and in-depth,and then be familiar with each other,they will be more understanding each other which will give the evidence to make a judgement.After all,trust is often produced in the interaction.Game theory also found that increasing the frequency of interaction between the two parties would increase trust and increase the likelihood of cooperation.Therefore,the increase of interaction between doctors and patients is conducive to enhancing the trust of doctors and patients.As the development of modern technology doctors become indifferent treatment tools easily,regarding patients as the carrier of the disease.The research thinks that medical personnel should pay more attention to this phenomenon,when communicates with patients taking care of the patient’s emotions.The patient’s moral expectation for the doctor is more than the technical expectation.Compared with the technology of the doctor and hospital equipment,the morality and attitude of the doctor have a greater influence on the trust of the doctor.Doctors’ attitude,willing to answer the question,skilled degrees will affect patients’trust in the doctors.What’s more,the willing to answer questions influence greater on doctors’trust than the technology.People have a high expectation to doctors’,morality,when patients fronting negative information and environment would have negative emotions toward to doctors.The result of the mood is not just because of the behavior itself,but also is mainly produced from the damaged confidence in the field.Therefore,the medical staff should strictly abide by professional ethics and improve comprehensive quality without damaging the image of doctors when improving professional skills.In the process of establishing structural equation model to analysis doctors’trust,the study finds that social trust and policy perception are very important factors that affect the doctors’ trust.And in different level hospitals,the influence of social trust and policy perception are greater than that of medical technology,medical morality and hospital environment,which indicates that the improvement of the doctor-patient relationship not only needs medical workers to improve their own quality,hospitals need to enhance management culture,the government departments also need to improve the institutional environment,improve residents’ medical fairness,enhance the trust between people.What’s more,the median needs to guide public opinion objectively,not to misguide the patients.About patient’s behaviors,the patient’s unreasonable request and the trust of the doctor can significantly affect the doctors’trust in patients.The less unreasonable demands of the doctors,the more trusting in patients.In these interviews,doctors have mentioned that the patient’s unreasonable demands will have an impact on their patience and attitude.When doctors perceived more trust,they will trust patients more.Without doubt,the sense of trust is the most key factors that affect doctor-patient trust,and this shows that trust is mutual.Therefore,the improvement of doctor-patient relationship needs not only to improve the service attitude of medical staff,but also to improve patients’ moral cultivation and understanding basic medical knowledge.The transformation of social structure promotes the transformation of Chinese society from traditional society to modern society.The transition from planned economy to market economy has also promoted the market-oriented reform of medical institutions.In the process of medical reform,medical institutions neglected its public welfare and service,and turned to pursue economic interests,which weakened the purpose of serving the people and undermined the fairness and justice of medical services.At the same time,the role of doctors and patients has been alienated.Medical staff use their knowledge power to ask patients for remuneration,and patients provide economic benefits to medical staff through non-institutional means.The role of doctors and patients is misplaced,and the behavior of doctors and nurses does not accord with the patients’moral and technical expectations toward doctors and nurses.The pursuit of economic interests has led to medical care and patients becoming accustomed to solving medical disputes through "medical trouble".Institutional trust in the medical industry was lacked.The process of urbanization has promoted the economic development of urban areas,increased the income of residents,greatly improved the level of medical and health technology in urban areas,but medical treatment is mainly machine-based,interpersonal relationship is indifferent,and people rely more on the establishment of trust system.When institutional trust is lacking,it is difficult to establish doctor-patient trust.At the same time,urbanization process makes medical facilities,medical talents and other resources flooding into cities,which not only results in the overcrowding of tertiary hospitals in cities,but also causes great pressure on medical staff.It also leads to the medical technology level and basic service facilities in rural areas are far inferior to those in urban areas,which makes it difficult to retain medical talents.However,the traditional relationship trust in rural society still exists in agriculture society.In rural areas,interpersonal trust based on consanguinity and geography still exists,which is helpful to the establishment of doctor-patient trust relationship in rural areas.