In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are At Risk

A physician at Shenzhen Humanity Hospital washes his hands after performing an operation, May 20, 2011.

Forbes Conrad / Bloomberg / Getty Images

On a recent Monday afternoon, doctors at Beijing Tongren Hospital stopped working. Their hour-long protest aimed to raise awareness about what they say is a rising problem in Chinese hospitals: attacks on medical personnel. "Punish the attacker severely and give dignity back to doctors," read a digital sign set up by the staff, according to state media.

Days earlier, Xu Wen, a 43-year-old otolaryngologist at the hospital, had been brutally attacked by a dissatisfied patient. Wang Baoming, a Beijing calligrapher and throat cancer patient that Xu had operated on in 2006, stabbed Cu 17 times in her arms, head and back, after spending years blogging about the allegedly failed surgery and trying to sue the doctor for medical malpractice. The Ministry of Health, as well as several non-governmental organizations, issued statements condemning the assault. Internet forums and social media websites were quickly inundated with prayers for the injured doctor. "I am beyond angry," wrote an Internet user named "ole2011" on the popular Tianya forum. "The murderer must be punished. Let's pray for Dr. Xu!" (Read about China's growing medical boom.)

China is no stranger to hospital brawls. On September 21, relatives of a deceased patient barged into the Wuhan Union Hospital, injuring more than 10 security guards with metal batons. In June of 2009, some 20 doctors across the country were killed or severely injured by disgruntled family members of patients. According to survey results published by the China Hospital Management Association, medical treatment disputes have risen by an average 23% every year since 2002.

This wave of violence underscores deepening strain in doctor-patient relations. While physical attacks are widely condemned, at least publicly, many patients complain that doctors can be arrogant and irresponsible. "I hope all doctors will reflect on themselves," reads one comment on Sohu, a major Chinese web portal. "Please try to be responsible for your patients and don't be blinded by profits."(See pictures of the making of modern China.)

Doctors counter that they are being vilified without cause. "Doctors are obviously an disadvantaged group in society," says an orthopedist at a prestigious Beijing hospital who speaks on condition of anonymity. "We have spent so much of our youth on a medical degree that yields so little economic reward. And in the end, we become like a public enemy." According to numbers released by the Chinese Medical Doctor Association, close to 96% of doctors in the country are dissatisfied with their salaries, which, on average, are just 19% higher than what the average Chinese worker makes.

Indeed, there are several signs that the health system is stressed. First, there is a wide disparity between industry standards in rural and urban areas. "Right now, you can graduate from a three-year medical program [in the country] and be a doctor, or you can go for a 10-year program and be a doctor," says the orthopedist. "Of course, the better educated ones will try to stay in big cities." As a result, rural patients flock to Beijing and Shanghai, lowering the country's urban doctor-patient ratio of 2.74 doctors per 1,000 people in 2010, according to statistics released by the Chinese Ministry of Health. In rural areas, though, the ratio is 0.95 doctors per 1,000 people. (In France and Germany, the ratio in 2007 was about 3.3.)

Even worse, the attacks have already been shown to severely dampen the morale of doctors. More than 95% of some 6,000 doctors surveyed by the Chinese Medical Doctor Association this year expressed discontent with salary, and as many as 78% said they wouldn't want their children to study medicine. Doctors say violent attacks hurt patients as well as doctors. "I don't know her personally," writes a netizen who identifies himself as a doctor on Sina Weibo, a popular micro-blogging service. "But doctors like Xu typically performs about 20 surgeries a day. Chances are, she will never be able to operate again, which means that every year, thousands of cancer patients could miss the chance to be cured."

Read about China at the age of 60.

Read about what is next for China.

In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are At Risk

A physician at Shenzhen Humanity Hospital washes his hands after performing an operation, May 20, 2011.

Forbes Conrad / Bloomberg / Getty Images

On a recent Monday afternoon, doctors at Beijing Tongren Hospital stopped working. Their hour-long protest aimed to raise awareness about what they say is a rising problem in Chinese hospitals: attacks on medical personnel. "Punish the attacker severely and give dignity back to doctors," read a digital sign set up by the staff, according to state media.

Days earlier, Xu Wen, a 43-year-old otolaryngologist at the hospital, had been brutally attacked by a dissatisfied patient. Wang Baoming, a Beijing calligrapher and throat cancer patient that Xu had operated on in 2006, stabbed Cu 17 times in her arms, head and back, after spending years blogging about the allegedly failed surgery and trying to sue the doctor for medical malpractice. The Ministry of Health, as well as several non-governmental organizations, issued statements condemning the assault. Internet forums and social media websites were quickly inundated with prayers for the injured doctor. "I am beyond angry," wrote an Internet user named "ole2011" on the popular Tianya forum. "The murderer must be punished. Let's pray for Dr. Xu!" (Read about China's growing medical boom.)

China is no stranger to hospital brawls. On September 21, relatives of a deceased patient barged into the Wuhan Union Hospital, injuring more than 10 security guards with metal batons. In June of 2009, some 20 doctors across the country were killed or severely injured by disgruntled family members of patients. According to survey results published by the China Hospital Management Association, medical treatment disputes have risen by an average 23% every year since 2002.

This wave of violence underscores deepening strain in doctor-patient relations. While physical attacks are widely condemned, at least publicly, many patients complain that doctors can be arrogant and irresponsible. "I hope all doctors will reflect on themselves," reads one comment on Sohu, a major Chinese web portal. "Please try to be responsible for your patients and don't be blinded by profits."(See pictures of the making of modern China.)

Doctors counter that they are being vilified without cause. "Doctors are obviously an disadvantaged group in society," says an orthopedist at a prestigious Beijing hospital who speaks on condition of anonymity. "We have spent so much of our youth on a medical degree that yields so little economic reward. And in the end, we become like a public enemy." According to numbers released by the Chinese Medical Doctor Association, close to 96% of doctors in the country are dissatisfied with their salaries, which, on average, are just 19% higher than what the average Chinese worker makes.

Indeed, there are several signs that the health system is stressed. First, there is a wide disparity between industry standards in rural and urban areas. "Right now, you can graduate from a three-year medical program [in the country] and be a doctor, or you can go for a 10-year program and be a doctor," says the orthopedist. "Of course, the better educated ones will try to stay in big cities." As a result, rural patients flock to Beijing and Shanghai, lowering the country's urban doctor-patient ratio of 2.74 doctors per 1,000 people in 2010, according to statistics released by the Chinese Ministry of Health. In rural areas, though, the ratio is 0.95 doctors per 1,000 people. (In France and Germany, the ratio in 2007 was about 3.3.)

Even worse, the attacks have already been shown to severely dampen the morale of doctors. More than 95% of some 6,000 doctors surveyed by the Chinese Medical Doctor Association this year expressed discontent with salary, and as many as 78% said they wouldn't want their children to study medicine. Doctors say violent attacks hurt patients as well as doctors. "I don't know her personally," writes a netizen who identifies himself as a doctor on Sina Weibo, a popular micro-blogging service. "But doctors like Xu typically performs about 20 surgeries a day. Chances are, she will never be able to operate again, which means that every year, thousands of cancer patients could miss the chance to be cured."

Read about China at the age of 60.

Read about what is next for China.

Can a Stronger Chinese Currency Save the U.S. Economy?

Posted by Austin Ramzy Wednesday, October 5, 2011 at 1:50 am

Give Charles Schumer credit for persistence. The New York Senator first introduced legislation that targeted Chinese currency in 2003, and has been a leading congressional advocate of the view that China keeps the value of its currency, the renminbi, artificially low, giving its exporters an unfair advantage when competing against U.S. manufacturers. On Monday a bill co-sponsored by Schumer that would allow for duties on goods from countries found to be currency manipulators won a Senate vote to open debate 79-19. If it passes a full Senate vote later this week it faces tougher odds in the House, where Speaker John Boehner has called the legislation "dangerous." The White House has also so far not said where it stands on the bill.

On Tuesday China's Foreign Ministry, Ministry of Commerce and central bank all slammed the bill, warning that it could set off a trade war and harm the global economy. Schumer responded Tuesday on the Senate floor by suggesting the Chinese position was a bluff, as a trade war would harm China more than the U.S. "They won't cut their nose to spite their face," he said. "They may take a few sanctions in response, but they're not going to create a trade war."  It is much the same argument Schumer put to me while on a visit to China in March 2005. But in the past five-and-a-half years, a few key numbers have changed. Most significant is U.S. unemployment. In March 2005 the unemployment rate was high at 6.1%, but this August it stood at 9.1%. That added economic misery in the U.S. will add to the political pressure to punish China.

But other figures have changed, too. Since March 2005 the renminbi has appreciated by about 30%. China recognizes that it needs to allow the value of its currency to rise to help encourage domestic consumption, manage inflation and move away from a reliance on cheap exports to create economic growth. But even as the renminbi appreciates, the U.S.-China trade gap has grown from $202 billion in 2005 to $273 billion last year. At the same time China's global balance of trade has shifted, and this year it became a net importer. Many countries, particularly those that export the energy and raw materials China needs, are benefiting from its continued expansion.

The difficult economic picture in the U.S., combined with the intensified political atmosphere of a presidential campaign will ensure that Schumer's trade bill gets a much more attention than it would have in years past. At the same time, given the opposition from Boehner and the reluctance of President Obama to endorse the measure, it's likely that it will be shot down once again. But even if the legislation fails, a stronger Chinese currency is inevitable. How much that will help the American economy remains unanswered.

Austin Ramzy is Beijing correspondent for TIME. Find him on Twitter at @austinramzy. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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