In recent years, medical and health management departments and medical institutions have actively explored the construction of a harmonious doctor-patient relationship. Many hospitals implement open management, establish communication and supervision mechanisms between doctors and patients, and ensure the smooth flow of medical information, which has achieved certain results. However, the tension between doctors and patients, the lack of mutual trust and the increase of medical disputes are very prominent problems at present. We must fully understand the importance and urgency of building a harmonious doctor-patient relationship.

First, the status quo of the doctor-patient relationship and the main reasons for the existing problems

On the whole, the relationship between doctors and patients is basically harmonious, but partially discordant. Harmony is the mainstream and disharmony is the tributary. The causes of the doctor-patient relationship are complex, the medical resources are insufficient, and it is "difficult" and "expensive" for the people to see a doctor. Patients have opinions; The quality of medical care is not high, the service attitude is not good, and the people are not satisfied; There are more complicated social factors, institutional mechanisms, ideological problems, and poor management and supervision. The main reasons are as follows: First, the lack of trust between doctors and patients is an important reason for the contradiction between doctors and patients. There is a lack of trust and understanding between doctors and patients, and it is impossible to put yourself in others' shoes. Some medical staff can't put themselves in the patient's shoes, but should think more about medical institutions and their own interests. Moreover, some patients also lack understanding of medical staff and medical complexity. Second, the lack of communication between doctors and patients and the increase of medical disputes are important factors for the disharmony between doctors and patients. Statistics show that in the medical disputes that have occurred, due to insufficient communication between doctors and patients, disputes caused by disharmony between doctors and patients account for about two-thirds of the total. Third, the lack of humanistic care in the medical process has aggravated the disharmony between doctors and patients. Treating diseases and saving lives is one, but some doctors only pay attention to "disease" and not people; In some medical institutions, medical activities only emphasize relying on instruments and equipment, ignoring the communication between doctors and patients. Fourth, the direct cause of the doctor-patient relationship is the poor channels for patients' complaints and rights protection. Although China implemented the new Regulations on Handling Medical Accidents as early as a few years ago, after the occurrence of medical accidents, the cost of accident identification alone is as high as several thousand yuan, and the cost of safeguarding patients' rights and interests is too high. In fact, it is still very difficult to safeguard rights and interests through normal channels. Fifth, China's current medical security system and related laws and regulations have not kept pace with the market economy in time, and the national medical insurance system is not perfect, which is the fundamental reason for the sharp contradiction between doctors and patients. According to the data, many countries have a perfect national medical insurance system, and all people participate in medical insurance. Most medical expenses are borne by insurance companies, individuals will not pay high medical expenses, and there are few contradictions between doctors and patients.

Second, suggestions for building a harmonious doctor-patient relationship

First, pay attention to humanized service and seek service innovation. With China's entry into WTO and the diversified development of medical services, the medical service system is facing revolutionary changes. In the more intense medical market competition, patients not only pay attention to the hospital's medical level, but also pay more attention to the hospital's humanized service. In addition to hard power such as technology and equipment, hospitals cannot ignore the competition of soft power such as management mode and service level. How to integrate the concept of humanization into the whole process of medical service and hospital management, change the old concept of "patients come to the hospital to see a doctor, and the hospital only treats people", and establish a modern medical model in which the medical object is "person" and then "disease" will be an important topic in the construction and management of modern hospitals. Hospitals should take measures to respect, understand and care for patients, seek service innovation, and continuously improve people's satisfaction with hospitals through humanized services.

The second is to adhere to the standards of social benefits and build an honest hospital. Medical institutions at all levels should adhere to social benefits as the highest criterion, adhere to reasonable inspection, rational drug use and reasonable charges, and prohibit all kinds of "billing fees"; Efforts should be made to reduce patients' medical expenses, establish a sunshine system for medical expenses, and conscientiously do a good job in consulting and charging, so that patients and their families can check the expenses at any time and reassure patients; Take effective measures to eliminate the phenomenon of long registration time, long payment time, long time to get medicine and short time to see a doctor; Strictly implement the centralized bidding system for drugs, and put an end to the phenomenon that drug dealers bring money to sell drugs in hospitals; The doctor-patient agreement system is implemented, and it is strictly forbidden for medical personnel to accept "red envelopes" and "meals"; Hire social supervisors to supervise hospital medical ethics.

Third, establish and improve the doctor-patient communication system to promote doctor-patient communication. In order to strengthen the communication between doctors and patients, medical institutions should standardize the communication between doctors and patients from the aspects of form, channel, content, requirements, skills, effect and assessment, and medical staff should have integrity, respect for patients or their families, compassion and patience; Listen to the patient's inquiry, introduce the patient's condition, treatment effect, medication and examination purpose, and care about the patient's life or inconvenience during medical treatment; Timely grasp the development and changes of patients' condition, medical expenses and social psychology of patients; Pay attention to the emotion, education level and feelings of the communication object, the cognition of the disease and the expectation of the communication object; Avoid forcing patients to accept it immediately, avoid using irritating language or words, avoid using medical professional vocabulary that patients don't understand, avoid forcing patients to change their views, and avoid suppressing patients' emotions; Prevention-oriented targeted communication, object exchange communication, collective communication, written communication, coordinated communication and physical comparison and image metaphor communication. Through all-round, multi-level and multi-angle communication, the service quality can be effectively improved, the contradictions and disputes between doctors and patients can be resolved in time, and the trust of patients in the hospital and the understanding of medical staff can be enhanced. Hospitals should establish and improve the doctor-patient communication system and complaint handling system, accept and handle patients' complaints in a timely manner, regularly collect patients' opinions on hospital services, and make timely improvements. Medical staff should fully respect and safeguard patients' right to know and choose, sympathize with patients' pain, sympathize with patients' difficulties, respect patients' ideas, dispel patients' concerns, and strive to make patients get physical and mental health.

The fourth is to provide exquisite and high-quality technical services to reassure patients. Doctors should have a strong sense of responsibility for patients, truly consider patients, sincerely serve patients, and take relieving patients' suffering as their highest pursuit in life.

Fifth, strict hospital quality management to ensure medical safety. Medicine is a science that has not been fully recognized by human beings, and there are still some fields that need to be explored by human beings. Some diseases can't be completely cured at present, or are not sure about 100%, but diseases are the top priority for patients. Therefore, while providing high-tech services for patients, we should also strive to ensure the safety of medical services, minimize errors and accidents, and provide safe and secure medical services.

The sixth is to establish a medical notification system to enhance mutual understanding and trust between doctors and patients. Carry out medical service information publicity and adhere to the hospitalization expense list system. Vigorously promote the new model of "patient-centered" medical service. Let patients "know five things" about the charging standard of diagnosis and treatment, drug price, their own condition, what kind of examination items to do and their attending doctors; "Five Knows" about diagnosis and treatment process, diagnosis and treatment experts, procedures to be done during operation, diagnosis and treatment items, price and service commitment; Then there is the "five reassurances" about examination, diagnosis and treatment, medication, fees and services.