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医患冲突、舆论倾向与医生集体声誉
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TitleThe Doctor-patient Conflicts, the Drift of Opinions, and the Doctor Collective Reputation  
作者蔡东玲 张一林 龚强  
AuthorCai Dongling, Zhang Yilin and Gong Qiang  
作者单位西南财经大学 
OrganizationSouthwestern University of Finance and Economics 
作者Emaildonglingcai@foxmail.com;ylzhang@swufe.edu.cn;qianggong@znufe.edu.cn 
中文关键词医患冲突 集体声誉 防御性医疗 舆论倾向 政府执政力 
Key WordsDoctor-patient Conflict; Collective Reputation; Defensive Medical; the Drift of Opinions; Government Credibility  
内容提要由于医生在提供医疗服务的过程中占有绝对的信息和专业优势,因此一旦发生医疗纠纷事件,媒体等公众舆论在追究当事医生责任时往往带有“有罪推定”的倾向,希望借此保护病人、防范医生的道德风险。本文基于集体声誉的视角审视医患冲突问题,发现有罪推定的舆论倾向极易加剧医患矛盾。由于医疗服务质量的不可观测性和疗效的不确定性,病人信任医生的必要前提是整个医生职业群体拥有优良的集体声誉和社会公信力,但有罪推定的舆论倾向极易损坏医生的集体声誉和社会公信力,在医生集体声誉欠佳的情况下,医患冲突在所难免。更为严重的是,随着医患冲突加剧、有罪推定成为病人和公众舆论的固化思维,医生将不得不依靠“大处方”、“大检查”等防御性医疗措施进行自我保护,由此造成医生的集体声誉和社会公信力进一步下降,医疗市场陷入“医生集体声誉下降——病人防备医生——医生防备病人”的恶性循环。本文的政策含义在于,治理医患冲突的关键是提升政府及监管部门处理医疗纠纷的公信力,只有当医生和病人双方都相信自身的权益能够得到政府及监管部门的公正维护时,医疗市场才能形成病人“敢于”信任医生、医生“敢于”尽职服务病人的“互信均衡”,医疗行业的公益性才能得到充分发挥。 
AbstractAs doctors occupy absolute of information and professional advantage in the process of providing medical services, so in the event of medical conflict, the media and public often blames doctors from the view of “presumption of guilt”, hoping to protect patients and prevent moral hazard of the doctor. This paper focuses on the doctor-patient conflicts from the perspective of collective reputation, and finds that guilty presumption is an important cause of rising doctor-patient conflict. Specifically, this paper shows that due to the uncertainty of medical service, doctors’ good collective reputation is the necessary premise that patient trusts doctor. Under the environment of presumption of guilt, the collective reputation and credibility of the doctors are highly susceptible to “stigmatized” comments, resulting in more and more patients losing faith in the doctor, and therefore, doctor-patient conflict caused by lack of trust is inevitable. More seriously, as the doctor-patient conflicts intensified, and the presumption of guilt is rigid thinking, doctors have to rely on defensive medicine, like excessive check, for self-protection, which further causes the loss of the collective reputation of doctors. Finally, medical market falls into the vicious circle where doctors’ collective reputation drops, and both patients and doctor are ware of each other. The policy implication of the paper is that the key to relieve doctor-patient conflicts is to enhancing the government’s credibility in the process of settling medical disputes. Only when both patients and doctors believe their rights can be maintenance justly, can medical market form win-win equilibrium where patients “dare to” trust doctors, and doctors “are able to” focus on serving patients, and the public welfare in the medical profession can give full play. 
文章编号WP1123 
登载时间2016-10-18 
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