Hundreds of protesters from Wenling, Zhejiang Province, gather in the yard of the First People's Hospital of Wenling on Monday, calling for zero tolerance toward violence against medical staff. Photo: IC

On Monday, hundreds of protesters gathered in the courtyard of the First People's Hospital of Wenling, Zhejiang Province. However, they were not disgruntled patients who were protesting, they were doctors.

Clad in white coats and gauze masks, the doctors were mourning their colleague, Wang Yunjie, who had been stabbed to death on October 25. Lian Enqing, a patient at the hospital, had been dissatisfied by a surgery performed by hospital staff, and had vented his rage on Dr Wang, who was the chief physician with the ear-nose-throat department of the hospital, as well as two other doctors who were injured in the attack.

The doctors were not just mourning the death of their colleague, they were also protesting against the dangerous situation faced by medical staff, which has resulted in a series of violent attacks by patients.

Being a doctor may not seem like a hazardous profession, but in China, with increasing tensions between medical staff and patients, the risk of being attacked is very real, and the situation appears to be getting worse.

United but hated

"Doctors nationwide have never shown as much solidarity as they have since the incident in Wenling. All my fellow doctors in my online social networks are keeping a close eye on it. Many cried while watching the news," a doctor surnamed Wu from the Guangzhou-based Sun Yat-sen Memorial Hospital, told the Global Times, noting that doctors have been oppressed for a long time and they need to be able to express themselves.

It's not just doctors who are alarmed, and it's not just the staff in Wenling. Medical staff across the country, including nurses and office workers, expressed their outrage over the attack and appealed for understanding from society while organizing their own activities.

But not all are sympathetic. The violence itself is evidence of seething rage toward medical professionals.

After a trainee doctor at a hospital in Harbin, Heilongjiang Province, was stabbed to death by a patient on March 23, 2012, more than 4,000 of 6,000 people participating in a poll chose the word "happy" to express their feelings after reading the news on the Web portal Tencent.

The Internet is rife with complaints from Net users telling stories of their unpleasant experiences while being treated in hospitals, often by doctors who did their job perfunctorily or made patients undergo unnecessary examinations in order to earn more money. There are also comments indicating that it was necessary to give bribes in order to receive better treatment. As far as these Net users are concerned, the doctors have earned the wrath of the public.

This wrath manifests in violence and examples are everywhere. A doctor from the Second Affiliated Hospital of Guangzhou Medical University was beaten on October 21 by his patient's family members when he refused to let them take away a diseased patient's body - to permit them to do so would have been illegal.

A doctor from the Liaoning Fengtian Chinese Medicine Hospital was stabbed six times by a patient on October 20. The ICU of the Shanghai Shuguang Hospital was smashed by family members of a patient who died despite treatment on October 17. The list goes on and on. A report released by the Chinese Hospital Association in August showed that the average number of violent attacks on medical workers per hospital has reached 27 a year, and the number of incidents of doctors being injured increases each year.

 "The relationship between doctors and patients is incredibly bad. Patients often make threats to sue doctors, swear at them and even beat them. This is often the case in my hospital," a pediatrician surnamed Deng in Beijing told the Global Times, noting that doctors need to be wary of patients to protect themselves, treating every patient as a potential attacker.

Security a solution?

The government has answered the problem by beefing up regulations on hospital security. The National Health and Family Planning Commission issued a regulation on October 12, which mandated that at least 3 percent of the staff at hospitals should be security staff, or that for every 20 beds there should be a guard.

Ma Weihang, deputy director of the Health Bureau of Zhejiang Province, said Tuesday that security measures would be enforced in hospitals, with security check systems, surveillance, alarm bells and security crews to be set up, to ensure the safety of medical workers, patients and their families, the China News Service reported.

Doctors, however, have called these solutions a temporary band-aid.

"I'm afraid that the fights might get fiercer if people are required to do security checks, especially when they are seriously ill patients among masses of people at the hospitals," Deng said, noting that the cost of this security equipment will come out of hospital budgets, meaning that hospitals will need to squeeze even more money out of patients and potentially worsen the relationships with patients.

Wu echoed with Deng, saying that tensions may increase as patients may feel like they are visiting a prison rather than a hospital.

Symptoms of sick system

The current medical system gives rise to the tensions between doctors and patients, said Zheng Xinye, a professor at the School of Economics at the Renmin University of China, noting that the low income of doctors contributes to the problem, and causes poor service and problems like bribery.

In Deng's hospital, the registration fee for patients to see a doctor is usually 3 yuan ($0.5), while fees for doctors with professor titles vary from 6 yuan to 9 yuan. Wu said that a doctor with a doctorate degree may earn a monthly salary of just 5,000 yuan. Doctors often work overtime under extreme pressure, noting that what they are paid doesn't correspond with the effort they put in.

"If doctors cannot earn a reasonable salary from their expertise, they can only solve the problem through extra prescriptions and treatment fees," Wu admitted.

"Doctors are sacrificial lambs and they are coerced into being the 'bad guy,'" Zheng said.

"The brutal case in Wenling and comments online made us even more frustrated. I used to encourage my students to be passionate about medicine, but after this, I don't know how to keep encouraging them to stick to this career," Deng said.