Research On The Legal Status Of Medical Personnel Based On Doctor-patient Relationship

ObjectiveIn the context of social transformation, although physician-patient relationship is good generally, but the relations between doctors and patients show a rising trend year by year. How to build a harmonious relations between doctors and patients which has become a hot issue. The existing definition legal status of medical personnel apparently did not match the current status and development. Comparing with the reality changes, the concepts of changes have some lags, which make medical staff in a very awkward position, but also face many problems, so clearing the legal status of medical personnel, clarifying the rights of medical personnel and obligations, determining the responsibility scope of medical staff and responsibilities constitute, all of them as above are important to protect the legitimate rights and interests of medical staff, and promote the rational and harmonious relations between doctors and patients.MethodsThis study adopted qualitative and quantitative methods to analyse all of the data on the base of Literature Analysis, and author assimilated and analyzed some basic theoretical knowledge of the legal status related doctor-patient relationship and medical staff by literature search. We chose typical on-site investigation as quantitative research methods, and then questionnaire surveyd 480 medical personnels in two tertiary hospitals in Wuhan with typical on-site survey methods; and chose 420 out-patients and in-patients with questionnaire in a certain tertiary hospital in Wuhan. All of the questionnaire data were coded and valued assignment, and then used Epidata3.1 and SPSS 13.0 statistical software for statistical analysis; some of them mainly used descriptive analysis and chi-square test. In addition, we collect directly "the province's medical malpractice case investigation summary" between 2005 and 2006 from Health Department of Hubei Province. We discussed with six health administrative officials, six presidents of the tertiary hospitals, four legal experts of the Judiciary Law and three University of Education by unstructured interviews. And then, we collected Three hospital medical staff disputes, clinical directors of medical departments, and legal advisers by focus group discussions; interviewing six presidents of tertiary hospitals, four legal experts of the Judiciary Law and three University of Education, six health administrative officials by unstructured interviews. And then, we collect two Health officials, president of the hospital, the hospital medical staff disputes, clinical director of medical organizations, the legal adviser of the 2, a total of 10 people to the medical professional environment, protect the legal status of medical personnel issues related to countermeasures by focus group Discussion.Results1. The connotation of studies about legal status of medical personnel in doctor-patient relationship.The author limits the boundary of "medical personnel" which includes doctors, nurses, pharmaceutical personnel and other health workers with any kind of license, and not administrative staff and support crew, and confines to study legal status of medical personnel in the doctor-patient relationship. I believe that the doctor-patient relationship in some special cases is administrative law relationship, but in most cases the general doctor-patient relationship is civil legal relationship. In the study of general the legal status of medical personnel in doctor-patient relationship, their legal status should be focused on the status of civil legal relations. Though, during ongoing perfect and complete legal system building, it will be a trend to build a specialized medical relative law to adjust doctor-patient relationship. The study about legal status of medical personnel is to study licensed doctors, nurses, pharmaceutical personnel and other health workers'right and obligation. 2. empirical research's analyzed outcomes(1) cognitional difference between doctors and patients in questionnaire survey:there are obvious diversities among cause cognition about happening of medical tangle, total cognition about dealing with medical tangle and the most worried aspects after the happening of medical tangle. But doctors and patients choose the same ways, most of ways are compromise settlement, to solve medical tangle.(2) systematical analysis about relative law and regulations to adjust doctor-patient relationship:in present, there is no specialized basic law system about adjust doctor-patient tangle, responsibility confirm and criteria for compensation for medical injury in China; The regulations and the impact of existing legal documents related to the rights and obligations of medical personnel regulations are systematically analyzed. Based on the interviews and panel discussions, considered the present practices of legislation and resolving medical disputes, it is believed that the missing of right guarantee of medical personnel still is a serious problem.3. The results of empirical research and analysisThrough analyzing cognitive attitudes of medical staff and patients to medical dispute and the data of medical malpractice of Hubei Province provided by the Health Department, we can see that the self-evaluation of medical staffs own career is low and they hold a common recognition that the current doctor-patient relationship is tensely; most of the medical staff hold that the doctor-patient relationship is a special relationship of health care supply and demand, not the simple supply and demand relationship; the understanding of doctor-patient relationship from medical staff and patients are quite different; when medical dispute occurs, the medical institution and the patients are more inclined to negotiated privately to get the settlement, but not willing to take administrative mediation or judicial proceedings. And the patient usually requires medical institutions to provide financial compensation, and once the demands are not met, patients and their families will often take some damage to the legitimate medical institutions and medical personnel, such as the disrupting the normal order in medical institutions, even beating the medical staff.4. The analysis of influencing factors on the legal status of medical personnel is based on summarization and analysis of quantitative and qualitative data. Influencing factors on the legal status of medical personnel were defined by this process. There are four major aspects, factors of institution of law, social factors,factors of hospital and staff and factors of patients.(1) Factors of institution of law include the lack of unified laws, difficult dilemma of judicial application, lack of law enforcement on the protection of legitimate rights and interests of medical staff.(2) Social factors include the lagging behind of health care system, the lack of sound social health insurance system, lack of insurance system; shortcomings of medical education model, some negative impact on doctor-patient relationship produced by medical high-tech development, society serious crisis of confidence, inappropriate media and public guide.(3)Factors of hospital and staff include quality deficiencies of medical care, the poor attitude of medical staff, medical ethics problems, lack of sound medical treatment and prevention system.(4)Factors of patients include the inadequate understanding of health care risk; the changing of concepts on medical treatment, the rights conciousness increased and bring serious medical trouble to the medical institution.Conclusions and SuggestionsAccording to various factors of the legal status of medical personnel, this article proposes some suggestions that can protect the legal status of medical staff, generally speaking, there are five suggestions, first is to increase the national legal protection, second is to make more effort on the construction of social cooperative system, third is to establish insurance system against medical damages, forth is to strengthen the concepts for self-discipline and keeping rights of medical staff and the fifith is to improve the haromonious relationship between doctors and patients.(1) strengthen the national legal protection, there are three aspects, establishing unified medical practising law by the legislative branch; treating doctors and patients equally and fairly in judicial process; protecting medical staff through law enforcement.(2) make more effort on the construction of social cooperative system, there are seven aspects as followed, enhancing healthcare system reform, accelerating the construction of medical insurance system, improving the diversity of medical dispute resolution mechanism, changing patterns of medical education, rebuilding social trust, mechanism establishing sound administration system for patients' opinions and creating a harmonious relationship for doctors and patients.(3)establish insurance system against medical damage,, which includes establishing both hospital liability insurance and special insurance against medical damages. The hospital liability insurance is for safeguarding the medical staffs, and the special insurance against medical damages is for the patients.(4)strengthen the concepts for self-discipline and keeping rights of medical staff themselves, specifically including the following, to improve construction of medical dispute resolution system; to better the medical personnel's legal consciousness; to strengthen the ethics education on medical staff to improve the inner quality of medical personnel; to ensure strict system of work to strengthen the medical quality management; to establish medical inform system for patients to know their health situation; keep a good communication between doctors and patients.(5)improve the heromonious relationship between doctors and patients, specifically including\medical knowledge promotion for patients; clearify the rights and obligations of patients; patients should try to change their attitudes on doctor-patient relationship.