Research On The Doctor-patient Relationship Under The Environment Of Network

BackgroundIt is appeared that’The network of networks’ in the early1980s, and to the early1990s, the trend to development of the network technique came to rapidly. Subsequently, the network began to impact the development of the world economy, politics, culture and society profundity, and promote the change of the social production, living and information spreading, also bring about great revolution to all walks of life. Internet has mould a new social life space as digital, information-based and networked, thus changed every aspect of social life quickly, and changed the behavioral pattern, ways of thinking and self-identity of human also the community patterns, thus triggered the significant transformation of social construction and the significant changing of social relations. The medical industry was influenced in the tide of network development inevitably. In the past decade, the number of people that using the network to search the online medical health information rose, the survey data from U.S. PEW Research Center in2000showed that55%of adult netizen searched for health-related information online, to2012this proportion had exceeded to72%, and the proportion is80%in2013. Not only people can enjoy plentiful medical health information resources with the innovation and development of network technology, but also the network model of many areas of medical industry as medicine circulation, marketing promotion, network medical treatment and doctor-patient communication has gradually been recognized and accepted, the impact of network development for the medical industry has penetrated into every cell in the industry. The network environment makes the activities related to medical healthcare a series of change, and gradually begin to affect the thought and behavioral style of patients and doctors, also the social relations set up by doctors and patients in the treatment process change as well.At present, the situation of the doctor-patient relationship is not optimistic. Medical dispute is risen, medical trouble occurs frequently, violent incidents that assaulting doctor are exposed constantly, doctor-patient conflicts become the focus of people’s lives, doctors and patients gradually become to opposites. the Reasons for the tension between doctors and patients were studied have been studied by many scholars, there are many reasons of doctor-patient conflict, and the asymmetrical doctor-patient information, the different doctor-patient cognition, the exorbitant expect of patients and the checked doctor-patient communication are reasons that everyone aware. Some overseas studies have shown that the development of Internet and network technologies produced a significant advantage in improving the doctor-patient conflicts. Also there are domestic studies in this aspect, but mostly are dispersedly discussion in simplex perspective, the systematic and more comprehensive survey of research on the impact of the network environment to doctor-patient is relatively scarce.In this context, it is attempted to using questionnaire survey between patient groups and physician groups in this paper, and it is analyze how the impact of the doctor-patient relationship affected by the network environment:the two main part between doctor-patient relationship--doctors and patients are influenced respectively; what about their behavior respective; and the new changes of doctor-patient relationship which result in these variation; so what measures should we adopt to alleviate the doctor-patient conflicts, build a harmonious doctor-patient relationship and other issues on account of these new changes. PurposeTo understand the basic situation of the utilization within patients and doctors in our country and the respective influences of network on both doctors and patients can be; then through analyzing the survey results, the new changes and new problems of both doctors and patients and the doctor-patient relationship under the network environment, and then by analyzing these new changes and problems in-depth, to explore the new features and new trend of doctor-patient relationship under network environment, at last, aiming at new features and new trend, by combining with policy environment, adapting developmental requirement, a series of intervention means and solutions that promoting the doctor-patient relationship possess the characteristic of powerful pertinence, preferable pragmatically and operability can be discussed.TechniquesOn the basis of many preliminary reading, the studies of the Internet, network technology and physician-patient relationships domestic and overseas were carded, a preliminary questionnaire was designed by learning previous studies, combining with the specific circumstances of the health care industry in our country, also taking into account the purpose of the project. Then, the questionnaire has been amended several times using the brainstorming, focus group discussions and expert consultation method, and the quality of questionnaire was assessed by pre-survey, so the final questionnaire was determined. After organizing and training of investigators, formal investigations were investigated.In view of the different levels of hospital development and social situation within different economic development provinces, three hospitals located in Jiangsu, Guangdong and Anhui Province were chosen in this study:(1) by using occasional sampling, patient questionnaires were given out in every hospital outpatient service, considering the patients’ actual medical conditions and network usage, patient questionnaires’ target were set at the age of18and above, and the age level in the actual investigation was controlled by investigator.(2) the questionnaires were randomly given out according to40%of the total staff in each department in every hospital clinical departments, in order to ensure the findings are relatively representative, we ensured that about30%of the total number of respondents were associate professors in each survey department When there is doubt as to the questionnaire survey, the investigators should give explanations in time and assistant the respondents to accomplish survey by reading the questionnaire.2010questionnaires were given out,951valid questionnaires were recovered of which990patient questionnaires and888valid questionnaires were recovered of which1020doctor questionnaires. Then the questionnaires were neatened, a database of patients and doctors was establish in EpiData3.1, after entering data, it is statistically analyzed using SPSS22.0.Results1. Aspects of patients(1)The utilization of patients on network medical health information①There are only12.6%respondents who search information through Internet when their body is in good condition, most of them are women and patients with chronic disease, and92%respondents express that they would search basic related medical information through internet when their body is uncomfortable.②In the channel that patients get medic and health information, people who get medic and health through Internet have the maximum amount with the ratio up to75.2%.③83.9%respondents believe that the medical and health information obtained from Internet has a positive impact on their communicate with doctors, which48.6%respondents expressed they get medic and health information through Internet in the process of diagnosis.④For the credibility of the network information,58.1%respondents believe that a small part is credible,2.4%respondents believe that it is incredible, while only32.5%respondents consider they can identify most of the network inveracious information themselves.(2) The influence of online medical model on patients61.5%respondents expressed that they had consulted a doctor online,62.2%respondents expressed they had experience in online appointment registration,75.2% respondents believed that the evaluation of other users would affect their choice of doctor next, and26.6%respondents considered that network has theirs have a decisive effect to choose a hospital.(3) The situation that using the Internet for venting emotional25.9%respondents expressed they would vent their dissatisfaction with the medical staff online,62.9%respondents confirmed that they would take an objective view with be with other user1dissatisfied comments, and24.1%said they would propagandize the positive doctor-patient events online.(4) The influence of media on patients under the network environment64.3%respondents showed that they had questioned the authenticity of negative reports on hospitals and doctors.76.6%respondents confirmed that the negative reports would pull down their own impression of the entire medical industry and doctor groups.2Aspects of doctors(1) The habitual situation that doctors surf the InternetIt is the comprehensive portal website that the doctor group surf most;68.6%doctors expressed that the information getting from Internet related to expertise;70.6%doctors showed that the new information related to their profession from Internet had changed their diagnosis and treatment scheme to the patients; while only a third of doctors showed they would try to remind and inform other users in when they see inveracious medical and health information on Internet.(2) Network interaction situation55.4%doctors expressed that they had experience communicating with patients on Internet, and physicians, male doctors, doctors with Ph.D. degree and higher education and chief physicians are the high propensity crowd who communicate with patients through Internet.81.7%doctors believed that it provided a new platform for the exchange of doctors and patients,64.0%persons confirmed that it increased the communication time with doctors and patients. The main form of interaction in the network,82.9%persons chose online inquiry.(3) The reactivity in actual treatment 69.3%doctors expressed that they had met patients who searching disease-related information over Internet, and54.6%doctors expressed that they would pay more attention to these patients,53.7%doctors expressed that these patients would spend more clinic time,95.6%doctors convinced that they would explain carefully and correct the error when the patients get erroneous information from network.(4) The influence of the media on doctors under network environment94.6%doctors expressed that many negative news on media do not confirm to the fact, these news damaged the image of the medical staff;90.5%persons thought it would worsen the current doctor-patient relationship;85.8%of people think it would reduce the work suppress and lower the medical staffs working enthusiasm. But in the face of media’s negative reports that inflicted to other hospitals and doctors, only31.9%doctors said they would concern about the progress of events actively,68.1%doctors felt helpless and powerless.59.1%doctors expressed they would diffuse and propagandize the positive events around them through Internet.ConclusionsNew changes have been produced of the doctor-patient behavior under network environment:Network has became an important information source for both doctors and patients; The network environment strengthens the doctor-patient communication, the platforms and channels of doctor-patient communication have increased, the satisfaction of patients has improved; both the mode of medical treatment of the patient and the work style of doctor had new changes; the new model of medical service is rising, the online inquiry is appearing, the online follow-up is developing gradually; the network has become a new Promotional channel for both doctors and patients. At the same time, the doctor-patient relationship also exists a series of new questions under the network environment:the acquisition and utilization about Internet health information of patients is not enough; the reaction that the doctors deal with patients is not enough; the medical health information in internet is mixing; the false healthcare information is spreading; the malicious dissemination in internet is existing; media reported unjust and biased obviously.In response to these new changes and new problems, the study started from five levels which is patients, doctors, hospitals, social and government and proposed countermeasures and suggestions about building a harmonious doctor-patient relationship under the network environment:improving the ability to access to and use of health information network, perfecting the patients’online medical model; training the medical personnel to surf on internet reasonably, adapting to the doctor-patient interaction networks as soon as possible, dealing with patients under network environment with a positive response; increase the intensity of internet use in hospital, using the Internet to build the brand of hospitals. Media must stand objective and report rationally and creating the guidance of public opinion correctly; the internet companies need to innovative development model and protect the interests of patients; the government should strengthen the top-level design and network monitoring, and emphasis on the network supervision.