近日，东莞市卫生局透露，去年前9个月全市医患纠纷一共发生163宗，而东莞的医疗机构每年用于解决“医闹”的费用平均超过1000万元。从目前来看，“医闹”问题依然是医院运营的心头之痛。严峻的形势下，如何真正化解“医闹”，值得关注探讨。

recently,Dongguan city health bureau said,Last year in the first nine months in the city a total of 163 cases of medical disputes,Dongguan by medical institutions to solve every year"argy-bargy"The cost of an average of more than 10 million yuan.From the current view,"argy-bargy"Problem is still the hospital operation the pain of heart.The severe situation,How to solve"argy-bargy",This concern.

　　“医闹”问题由来已久。尽管东莞为此曾出台过各项措施，甚至允许医院配钢叉催泪弹等对付“医闹”，然而并未得到根本遏制。医患双方协调失败后，患方往往不愿去卫生行政机关调解，而法院诉讼则成本高、时间长。加之利益的诱惑与感情的宣泄，患方剑走偏锋“医闹”，已经成了惯常态势。如何解决，亟须从制度安排上考虑出路。

"argy-bargy"Problem has been.Although the dongguan ever issued measures for it,Even allow hospital with steel fork tear gas, etc"argy-bargy",But have not been at all.Doctor-patient coordination failure after both sides,Health administrative organs have party often don't want to go to mediation,While the court litigation cost is high/A long time.In addition to the temptation of interests with the feelings of anger,With FangJian hail"argy-bargy",Has become a usual situation.How to solve,It is from the consideration on the system arrangement.

　　东莞市卫生部门有关负责人称，当前，东莞拟设医患纠纷调解中心，但这一想法究竟以何种模式运作，尚无定论。业界人士认为，该中心必须独立于医疗机构和卫生行政部门之外，其最终目的在于建立和谐医患关系。

Dongguan city department of health officials say,The current,Dongguan in doctor-patient dispute mediation center,But what exactly does this idea in what mode,Is uncertain.Industry insiders believe that,The center must be independent of medical institutions and the public health administrative department,The ultimate goal is to build a harmonious doctor-patient relationship.

　　2009年至2011年全市发生医患纠纷755宗

From 2009 to 2011 in 755 cases of medical disputes in the city

　　作为国内最大的民营医院之一，东莞东华医院的负责人对“医闹”印象深刻。

As one of the largest private hospitals,The person in charge of the dongguan tung wah hospital"argy-bargy"A deep impression.

　　去年2月，在经过医院、警方长达9个多小时的协调沟通后，死者黄某的家属仍然拒绝将死者尸体搬出东华医院唯一的一间介入手术室。约20名家属用板凳等物体堵住手术室门口，声称“不谈好赔偿，就不搬尸体”。

Last February,In the hospital/After the police more than nine hours of coordination communication,Families of the deceased huang still refused to the dead bodies of donghua hospital only a step in the operating room.About 20 families with objects such as bench blocked the door of the operating room,Claim that"Don't talk about good compensation,Don't move the body".

　　黄某是从其他医院转院来的。当时经过诊断，院方提出进行急诊冠脉介入诊疗是首选抢救方案，家属及患者本人均签字同意手术治疗。然而手术进行了约1个小时，患者就突然出现了心跳停止，经抢救无效后死亡。在听到黄某的死讯后，患者家属情绪激动，认为医院“诱导”患者施行手术负有一定责任。

Huang from other hospitals turn courtyard.At that time after diagnosis,The hospital is proposed for emergency coronary artery interventional diagnosis and treatment is the first choice for rescue plan,Patients with family members and the per capita signature agree to surgical treatment.However the operation for about an hour,Suddenly appeared a cardiac arrest patients,After the rescue invalid death.After hearing huang's death,Patients' families excited mood,That hospital"induction"Surgery in patients with certain responsibility.

　　东华医院的相关负责人回忆，患者死亡后，家属开始在手术室门口大闹起来。“死者妻子、儿子对诊治医生拉扯、踢打，同时拒绝将死者尸体移送至太平间。这让医院着急起来。这间手术室是东华医院唯一的一间介入手术室，如果家属迟迟不肯将尸体搬离，一旦来了其他的急诊病人需要进行手术治疗，该怎么办？”

Relevant person in charge of the tung wah hospital,After the death of patients with,Families started to make noise at the door in the operating room."The dead wife/Son to make a diagnosis and give treatment the doctor pull/kicking,At the same time refused to transfer the corpses to the morgue.It makes hospital in a hurry.This is the only one in donghua hospital operating room in the operating room,If family member bodies will move slowly,Once to the other emergency need for surgery,What should I do?"

　　随后，警方来到现场介入调查。当天凌晨，市卫生局医政科有关负责人也到达现场，就家属方面提出的问题给予了初步解答，并且明确提出，不能将遗体移送作为纠纷处理的前置条件，然而家属仍然拒绝。

then,The police came to the scene investigating.On the same day in the morning,Municipal health bureau YiZhengKe officials also arrived at the scene,And families in the questions given preliminary answer,And put forward,Body cannot be transferred to as precondition of disputes,However, families still refused.

　　“当时家属要求院方天亮前必须就患方提出的60万元赔偿要求给予答复，如果家属满意才能移送尸体，这让在场人员都觉得无法忍受。”东华医院的一名副院长称，“根据国家医疗事故处理的有关规定，一旦患者在医疗机构死亡，尸体应当立即移送至太平间，尸体存放时间一般不得超过2周。这是国家明文规定的，家属以拒绝搬运尸体要挟医院的做法是违法的。”

"Families requirements at the hospital before morning must reply with 600000 yuan for compensation requirement put forward by the party,If family members happy can be transferred to the bodies,This lets present personnel feel unbearable."Tung wah hospital of a vice President said,"According to the relevant provisions of the state medical accident treatment,Once the patients died in medical institutions,Bodies shall immediately transfer to the morgue,Body storage time is generally not more than 2 weeks.It is expressly provided by the state,Families to refuse to carry body to coerce the hospital it is against the law."

　　最终，由于反复沟通无效，凌晨4时，在警方的强力干预下，医院将死者遗体移送至太平间。院方表示，如果家属对医院诊疗有异议，可以申请医疗事故鉴定，通过合法途径解决。

In the end,Due to repeated communication is invalid,At 4 in the morning,In under the strong intervention of the police,Hospital will be the dead body transferred to to the morgue.The hospital says,If there is any discrepancy in family members to the hospital diagnosis and treatment,Can apply for medical accident appraisal,Through the legal way to solve.

　　类似这类由医患纠纷引起的“医闹”，东莞每年都会发生不少。据东莞市卫生局统计，2009年至2011年，全市发生的医患纠纷共755宗，而去年前9个月，医患纠纷已有163宗。一旦出现医患纠纷，部分患方大吵大闹，甚至会在医院门口摆灵堂，纠集一帮人堵医院的大门，破坏医疗设备、扰乱医疗秩序等，此等“医闹”，已经构成东莞卫生界的一大难题。

Similar this kind of caused by the medical disputes"argy-bargy",Dongguan many happens every year.According to the following health statistics,From 2009 to 2011,A total of 755 cases of medical disputes occurred in the city,The first nine months of last year,Doctor-patient dispute has 163.Once appear, doctor-patient dispute,Make a fuss of party,Even set up at the gate of the hospital,Violently was a blocking of the hospital gate,Destruction of medical equipment/Disturb the order of medical treatment, etc,such"argy-bargy",Have a dongguan WeiShengJie a big problem.

　　东莞市卫生部门有关负责人介绍，现在医疗纠纷处理方式主要有三条合法途径，分别是医患双方自行协商、卫生行政机关调解和人民法院诉讼，“很多医患双方协商解决，往往因医院和患者双方缺乏信任，很难形成一致意见，反而容易将矛盾进一步激化。此外，由于医院和卫生行政部门的隶属关系，因此患者家属也不愿意去卫生行政机关调解。第三种途径受阻，则是因为法院诉讼存在着诉讼成本高、时间长的缺陷”。

Dongguan city department of health concerns chief introduction,Dealing with medical disputes mainly now has three legal way,Are patient negotiation between two parties/Health administrative mediation and the people's court proceedings,"Many patient both sides talks things over solve,Often because of hospital and patients lack of trust between the two parties,It is difficult to form a consensus,But easy to further intensify contradictions.In addition,Due to the hospital and the subordinate relations of the administrative department of public health,So patients families also don't want to go to health administrative mediation.The third way,Because there is a high cost of lawsuit court litigation/Longer defects".

　　因此，医患纠纷在无法得到合理、有效解决的情况下，往往会演化为“医闹”。在2009年至2011年出现的755宗医患纠纷中，发生“医闹”事件的就有118宗，这对东莞各级医院，甚至民众正常就医，都造成不小的冲击。市卫生局局长蔡一平就透露，“东莞的医院用在解决‘医闹’上的钱，平均每年就超过1000万元，这还是保守估计。”

so,Doctor-patient dispute cannot be obtained in reasonable/Effectively solve the case,Often lead to"argy-bargy".Appeared in 2009 and 2011 of 755 cases of medical disputes,happened"argy-bargy"There were 118 of the event,The dongguan hospitals at all levels,Even people normal medical treatment,Has caused a lot of impact.Municipal health bureau chief CaiYiPing is revealed,"Dongguan hospital in solution‘argy-bargy’The money,Each year an average of more than 10 million yuan,This is a conservative estimate."

　　提高水平遵守规程是解决“医闹”的根本

Improve the level of abide by the rules is solved"argy-bargy"The root of the

　　事实上，东莞对于对付“医闹”，从政策措施到平时管理，也是煞费苦心。

As a matter of fact,Dongguan to deal with"argy-bargy",From the policies and measures to management at ordinary times,Also take great pains.

　　去年初，东莞市政府出台规定，医院保卫室可配钢叉、催泪剂等攻击性装备对付“医闹”。该措施经媒体报道后，在网络上引起了热议。其中以反对声居多。多数人认为医患纠纷都是患者弱势，没必要把医院建成“堡垒”。这也将东莞卫生部门逼到一个尴尬的境地。

Early last year,Dongguan government regulations,Hospital security room can match steel fork/Aggressive and equipment, such as tear agent to deal with"argy-bargy".The measure after media reports,On the Internet caused a hot debate.In which are probably in the majority.Most people think that medical disputes are vulnerable patients,There is no need to build the hospital"fort".This will also be dongguan health department into an embarrassing situation.

　　面对反对声音，市卫生局有关负责人曾回应，“出台这个文件基于一个背景，‘8.16’长安医院事件，一名男子先后将该院两名医生砍伤。因此有必要对医院的正常秩序采取一些措施。这样一来可以保护其他患者来医院就诊的安全，其次也可以给医生一个安全工作环境。”该负责人认为，对于医院配备攻击性的装备，也是无可厚非。“因为医院本身也是公共场所，所以安保配备与工厂、商场的要求是一样的。配备这些装备并不是为了对付患者，而是为了对付不法分子。”

In the face of opposition,Municipal health bureau officials have responded,"Based on a background on this file,‘8.16’Changan hospital events,A man to the hospital two doctors cut.Therefore it is necessary for the normal order of the hospital to take some measures.In this way can protect the safety of the other patients to hospital,Second can also give the doctor a safe working environment."The person in charge of that,Equipped with aggressive equipment for hospital,Is understandable."Because the hospital itself is a public place,So security equipment and factory/Market demand is the same.Is not equipped with these equipment in order to deal with patients,But in order to deal with criminals."

　　对此，直至今日，东华医院院长李镜波也持支持态度，“这是没有办法的办法”。他说，目前东莞的“医闹”事件，多有不良人员或是社会势力参与，目的是向医院索取较大数额赔偿来牟利。“如果没有第三方势力，医疗纠纷经过协调多数是可以解决的”。

this,Until today,Tung wah hospital dean LiJingBo also support attitude,"There is no way to solution".He said,At present the dongguan"argy-bargy"events,There are many bad people or social forces to participate in,Purpose is to the hospital for large amount of compensation for profit."If there is no third party forces,Most medical disputes through coordination can be solve".

　　这也意味着，医患双方协调并非无从谈起，只要在公平、对等的情况下进行沟通，医患矛盾就能得到缓解或疏通，“医闹”自然也就化为无形。尽管医院及患者对此都是“心知肚明”，但要解决问题，则需制度推力。

This means that,Dissatisfaction of coordination is not mentioned,As long as in the fair/Under the condition of equivalence,Doctor-patient conflicts can ease or dredge,"argy-bargy"Nature also becomes invisible.Despite the hospitals and patients is about it"know",But in order to solve the problem,To be the thrust system.

　　东莞市长安医院也是“医闹”多发之地。该院急诊科廖主任就表示，制度建立并非一朝一夕。站在更务实的角度，还要从医护人员自身做起，根本在于提高医务人员的素质：一个是业务水平的提高，二是服务态度的改善，第三个是遵守医疗操作规程。“在医患关系紧张的当下，相当于把医护人员逼到了一个临界点，对其工作能力与从业态度都是一种考验。”

Changan hospital, too"argy-bargy"The land of multiple.The hospital emergency department director liao said,System establishment is not happen overnight.Stand in the Angle of the more practical,Will start from the staff itself,Ultimate is to improve the quality of the medical staff:One is the level of business,The second is the improvement of the service attitude,The third is to abide by the medical operation procedures."The doctor-patient relationship tense now,Equivalent to the medical staff force to a critical point,The ability to work and working attitude is a test."

　　“当然，医护人员做好自身的同时，制度安排仍然关键。”东华医院的有关负责人认为，对于一家大型民营医院，“医闹”的发生对于医院的声誉、医疗秩序乃至经营都会带来很大副作用，可以说是“伤不起”。有些事情医院明明没有错，但一旦医闹发生了，很多患者便会以为医院的诊疗有问题，下次也不敢到医院看病了，这种心理影响比医闹更严重。

"Of course,,Medical staff to do their own at the same time,System is still the key."Tung wah hospital the relevant person in charge of that,For a large private hospital,"argy-bargy"The occurrence of the hospital's reputation/Medical order and management will bring a great side effects,Can be said to be"Can't afford to injury".Some things clearly not wrong hospital,But once the argy-bargy happened,Many people will think the hospital is a problem with the diagnosis and treatment,Next time, also dare not to go to the hospital to see a doctor,The psychological effects than argy-bargy is more serious.

　　该负责人认为，医患关系矛盾的解决，还是基于在医改的大背景下，从制度入手寻找解决途径。“很多时候，医院要想主动、平等地实现与患者对话并不容易，这需要制度的保障才能实现。

The person in charge of that,The solution of the problem the doctor-patient relationship,Is based on the background of the reform,Find solutions from the system."Most of the time,Hospital to initiative/Equally it is not easy to promote dialogue with the patient,This requires the system of security can be achieved.

　　拟设医患调解中心模式选择待定

In doctor-patient mediation center mode selection undetermined

　　其实，对于“医闹”，曾经的一名“医闹”组织者在接受采访时也是懊恼不已。此人的一名亲戚去年9月在东莞市妇幼保健院看病时猝死，该患者纠集了老乡、朋友等上百人，将医院围得水泄不通，拉横幅、设灵堂，要求医院给说法。医院当时也与死者家属经过了多次的沟通，具体结果也要等待第三方的医疗事故责任鉴定出来后才能见分晓。由于患方始终不理解，结果在“医闹”当天，医院选择报警，数十名警察出动后将组织、参与“医闹”的人全数抓走。

In fact,for"argy-bargy",Once a"argy-bargy"Organizers in an interview is also the chagrin.This person a relatives last September in dongguan doctor maternity and children when sudden death,This patient was violently/Friend, hundreds of people,The hospital around the water,Pull banners/Set up,For hospitals to claim.Hospital at that time, and the dead family members after many times of communication,Practical results will be waiting for the third party liability appraisal for medical accidents after coming out to know.Because of always don't understand,Results in the"argy-bargy"On the day,Hospital choose alarm,After dozens of police on duty will organize/To participate in"argy-bargy"People all detained.

　　“被警方抓走后，警方的负责人也跟我进行了多次沟通，让我觉得自己还是太冲动了。写了保证书才放出来。问题虽然是需要解决，但‘医闹’这种行为确实是不对的。”如今面对记者，该组织者眼神里尽是懊悔。

"Be caught by the police,The person in charge of the police also has carried on many times the communication with me,Make me feel is too impulse.Write a guarantee to put out.Although it is need to solve the problem,but‘argy-bargy’This kind of behavior is wrong."Now facing journalists,The organizers eyes full of regret.

　　因此，“医闹”对于医患双方，都是负影响，有害而无利。基于目前的现状，有没有一种相对公平的方式，既能保证患者利益，也能维护医院权利？正是卫生部门努力思考与全力推动的问题。

so,"argy-bargy"To the patient,Are all negative influence,Harmful and do not have the.Based on the current situation,Is there a relatively fair,Can not only guarantee the interests of patients,Also can maintain the hospital?Is the department of health to think and to promote the problem.

　　业界人士认为，如何化解医闹，就是要克服“缺乏公信力”和“程序冗长”两大毛病，而在当前的法律体系下，采取“第三方调解”的模式，或许能够为“医闹”破局。

Industry insiders believe that,How to resolve argy-bargy,Is to overcome"Lack of credibility"and"Program a long"Two major problems,But under the current legal system,take"The third party mediation"The mode of,May be able to"argy-bargy"The bureau.

　　“第三方调解并不能减少医疗纠纷，只能减少医疗纠纷后患者的非正常维权行为。医调委的专家，主要来源于司法、卫生、保险等部门，经费由财政拨款，在调解过程中，由于医调委的独立第三方身份，医院和患者都能接受其调解，而且制定出赔偿金额，医院支付时也可以有合法依据。”东莞一家公立医院的负责人称。

"The third party mediation does not reduce medical disputes,Can reduce the medical disputes of patients abnormal rights behavior.D the committee of experts,Mainly comes from justice/health/Insurance and other departments,Funds by the financial allocation,In the process of mediation,Due to the medical committee of independent third party identity,Hospitals and patients can accept the mediation,And work out the amount of compensation,Hospital payment when also can have legal basis."Dongguan person in charge of a public hospital.

　　有鉴于此，东莞目前正在展开行动。东莞市卫生局副局长叶向阳表示，该局经过前期调查和分析制订了两种模式，“一种是由政府购买服务的形式，成立一个医患纠纷调解中心。这个中心具有独立法人资格，由市财政出资金，司法部门给予业务指导，让它独立在政府机制之外；第二种模式就是完全的市场化，通过商业保险等形式去操作。相关报告我们已经提交了市政府。”至于最后选择哪种模式，还需待定。

In view of the,Dongguan is currently act.Dongguan city health bureau, deputy director of the YeXiangYang said,The bureau after the investigation and analysis for the two models,"One kind is purchased by the government in the form of services,Set up a medical dispute mediation center.The center has an independent legal personality,By the municipal financial funds,The justice department to give professional guidance,Make it independent outside government mechanism;The second model is the market completely,Through the commercial insurance and other forms to operate.We have submitted to the municipal government related report."As for the last choose what kind of model,Still need to be determined.

　　东莞市同济光华医院的负责人称，“如果有第三方的医患纠纷调处中心，会减轻一些我们的压力，希望这个机构尽快成立。以此为基础，作为第三方调解的配套机制，还呼吁建立健全医疗风险社会承担机制，从而将医院从医患纠纷中解脱出来。”

Dongguan tongji hospital spokeswoman brilliance,"If there is a third party of doctor-patient dispute mediation center,Will relieve some of our pressure,Hope that the agency was set up as soon as possible.Based on the,As a third party mediation mechanism of form a complete set,Also called for establish and perfect the medical risk social mechanism,To hospital freed from medical disputes."

　　目前医疗业界与主管部门比较一致的意见，是拟成立的医患纠纷调解中心必须独立于医疗机构和卫生行政部门之外。“我们不希望这个调解机构设在卫生局下面，否则就没有意义了。”卫生部门的一位工作人员坦言，“经历了这么多年医闹，大家都避之唯恐不及，希望这种制度的出现能够为医闹划上一个句号”。

The medical industry compared with the competent department of the consensus of opinion,Is the establishment of medical dispute mediation center must be independent of medical institutions and the public health administrative department."We don't want this mediation organization in under the health bureau,Otherwise it's meaningless."The health department said one of the workers,"After so many years away,Everyone from the like,Hope that the emergence of such a system can be argy-bargy draw a full stop".