Frustration in China with the health care system has resulted in violence. There were 20,000 acts of violence at Chinese hospitals in 2013, mostly aimed at doctors viewed as uncaring or corrupt. Attacks on doctors became so common in the 2010s that a special name took root to describe them — “yi nao,” or “medical disturbance.” “Health ministry data indicates that violent attacks on doctors and other health care workers in the form of beatings, threats, kidnappings, verbal abuse and murder reached 17,243 cases in 2010.

About 85 percent of doctors who responded to a survey in 2020 said that they had experienced violence in their workplace. Only 29 percent of them said that their employers had enhanced security policies afterward. Reuters reported in 2012: Beijing is struggling to deal with an increasingly violent flashpoint of social unrest in its healthcare system as bids to cut costs is failing to ease tensions among millions of people who cannot afford basic treatment. Violent attacks directed at hospital doctors and other healthcare workers in the form of beatings, threats, kidnappings, verbal abuse and even killings soared in recent years to 17,243 cases in 2010, alarming central policymakers who regard China's overhaul of its lumbering public healthcare system a top national priority. [Source: Tan Ee Lyn and Hui Li, Reuters, September 16, 2012]

“Critics say China's efforts to cut treatment costs in public hospitals and defuse tensions do not go far enough and show little sign of reversing the violence of angry sufferers. "The government is very worried about violence against doctors, especially when a few doctors and healthcare workers were attacked earlier this year. Some hospitals now have guards guarding them," said a health official in southern Guangdong province, speaking on condition of anonymity because of the sensitivity of the issue. "It's a top priority to stop these things from happening," said the source, who works in hospital administration.

Incidents of Hospital Violence in China

In 2019 a doctor in a Beijing emergency ward was reportedly stabbed to death by a patient’s son. In February 2014, a doctor in northern Heilongjiang province was beaten to death by an angry patient, while another was stabbed in October 2013. Also in 2014, a 45-year-old man unhappy with the results of his circumcision and its cost stabbed a doctor to death in the eastern province of Jiangsu, Xinhua said.

In October 2013, a knife-wielding patient, who was being treated in the emergency department, stabbed the three doctors at Wenling City No. 1 People's Hospital. Dr. Wang Yunjie died while the other two were wounded, Wenling police said. Afterwards several hundred hospital workers in white coats and surgical masks staged a rare protest, holding up signs that said "uphold justice" and "guarantee medical staffers' safety." [Source: Gillian Wong, Associated Press October 28, 2013]

In June 2011, a young doctor In Nanchang, a provincial capital 300 miles southwest of Shanghai, reportedly suffered a serious head injury in June 2011 after the family of a deceased patient led a protest that turned violent. In 2010 a doctor and nurse were stabbed to death in the eastern province of Shandong by the son of a man who had died 13 years earlier of liver cancer, while a pediatrician was badly injured jumping from a fifth-floor window to escape relatives of a baby who had died.

Siu-wee Lee wrote in the New York Times: In March 2018, a doctor was killed by his patient’s husband. In November 2016, a man attacked a doctor after an argument over his daughter’s treatment. The month before, a father stabbed a pediatrician 15 times after his daughter died shortly after her birth. The doctor did not survive. Dr. Zhao Lizhong, an emergency room doctor in Beijing, was sitting at a computer and writing a patient’s diagnosis when Lu Fu’ke plunged a knife into his neck in April 2012. Around him, patients screamed. Hours earlier, Mr. Lu had stabbed Dr. Xing Zhimin, who had treated him for rhinitis, in the Peking University People’s Hospital and fled. Police officers arrested him in his hometown, Zhuozhou in the northern province of Hebei, later that month. Mr. Lu was sentenced to 13 years in jail. “We know that this kind of thing can happen at any time,” Dr. Zhao said. The root of the violence is all the same: a mistrust of the medical system.

“Mr. Mao, the spokesman for the health ministry, said that while the figures for attacks on medical personnel looked alarming, they needed to be put in context. Chinese patients sought medical help eight billion times in 2016, a number that is equivalent to the world’s population, according to Mr. Mao. There were roughly 50,000 medical-related disputes in that period, a tiny fraction of the total number of health visits. “Therefore, our judgment is the doctor-patient relationship in reality isn’t tense,” Mr. Mao said. [Source: Siu-wee Lee, New York Times, September 30, 2018]

People Who Attack Doctors in China

In March 2012, after being repeatedly refused treatment, Li Mengnan stabbed the first doctor he saw. Christopher Beam wrote in The New Yorker: There was still snow on the ground on the daythat Li Mengnan, a seventeen-year-old boy, hobbled into the First Affiliated Hospital of Harbin Medical University for the last time. He came from a remote town in Inner Mongolia, a ten-hour train ride away, and this was his sixth trip to the hospital in two years. During that time, his illness, an excruciating inflammation of the spine called ankylosing spondylitis, had got progressively worse. Earlier that day, the doctors at the hospital had sent him across town to a clinic for an X-ray, only to tell him, when he came back, that he should have brought the clinic’s notes with him. When he returned with this paperwork, they told him that they couldn’t treat his spinal problem after all, because he had a history of tuberculosis. Li would have to go back to Inner Mongolia untreated. [Source: Christopher Beam, The New Yorker ]

In January 2014, a court in wealthy Zhejian province in eastern China sentenced to death a man, Lian Enqing, who went on a rampage in a hospital and killed a doctor, because he was unhappy with the results of an operation on his nose, state media said. Reuters reported: “Lian, 33, had gone looking in October 2013 for the doctor who treated him at the ear, nose and throat department in Wenling city. Unable to find him, he produced a knife and stabbed to death the head of the department, according to Xinhua. Lian stabbed two other doctors before he was restrained by security guards. Lian's sister, Lian Qiao, told the court that he had suffered respiratory problems and discomfort after the surgery in March 2013, Xinhua said. "While the hospital confirmed that the surgery was successful, Lian felt he was being cheated by the doctors," the report quoted his sister as saying. Her brother, she said, suffered from "persistent delusional disorder". The court, Xinhua said, found he was "conscious of his crime and had the capacity for criminal responsibility".[Source: Reuters, January 27, 2014]

Hospital Protests in China

Barbara Demick wrote in the Los Angeles Times, Often victims of malpractice or negligence have little recourse “but to protest or petition “an archaic process that involves going to Beijing to file grievances with higher authorities. There have also been numerous nonviolent demonstrations at hospitals, where families “or their representatives “dress themselves in the traditional Chinese mourning color of white and scatter fake paper money, an offering to the deceased in the afterlife.

In one week in August alone, “two major hospital protests were reported in addition to the one in Nanchang. The family of a 29-year-old man who died of stomach cancer in the eastern city of Nanjing picketed the hospital, claiming he hadn't been properly diagnosed and that they were threatened when they questioned his treatment. In a public hospital in Guangdong, in the south, women staged a sit-in, wailing, screaming and refusing to leave, according to news reports.

The month before a man who claimed to be a professional protester in Nanchang gave a newspaper interview in which he said that the local government usually chose to pay to quiet the protesters, "for the sake of social stability." "I always tell my clients, if you start a big disturbance, you'll get a bigger compensation package. If you start a smaller disturbance, you'll get a smaller package. And if you don't do anything, you'll get nothing," the man, identified as 42-year-old Xiao Ming, was quoted as saying.

The Chinese government is getting tougher on hospital protesters. In August 2010, a court in the northeastern city of Qingdao handed down what was reported to be the first prison sentence in such a case, sending a man to jail for 18 months for staging a riot at a hospital after the death of his father in January.

Thugs and Hospital Violence in China

Barbara Demick wrote in the Los Angeles Times, “Medical personnel advocates complain that the more violent incidents are staged by hired thugs, paid by families of the deceased in hopes of winning compensation from the hospitals. Sometimes the protesters are from the same village or are semi-professionals in causing trouble. The Chinese have even coined a word for the paid protesters: yinao, meaning "medical disturbance." [Source: Barbara Demick, Los Angeles Times, August 25, 2011]

"It has become a very sophisticated system for chasing profits. Whenever somebody dies in a hospital, the yinao will get in touch with the family and offer their services in exchange for 30 percent to 40 percent," said Liu Di, who is setting up a social network for medical professionals. Liu said the practice arose in the last few years as hospitals became more commercialized. "You see this mostly in second- or third-tier cities where the legal system is less developed."

Zhang Yuanxin, an Urumqi-based plaintiffs' lawyer, said it was difficult to sue for medical malpractice, even in the most egregious cases, and that tempted people to take matters into their own hands. "This is the direct result of the lack of rule of law and the lack of a well-established social welfare system," Zhang said. "Conflicts like these are inevitable and there will be many more if people can't solve their problems through the law."

Hospital in Nanchang Fends off Angry Mob

Reporting from Beijing, Barbara Demick wrote in the Los Angeles Times, “Friends and relatives of a patient who died on the operating table marched on Nanchang Hospital No. 1 brandishing pitchforks and clubs. About 100 staff members, among them young doctors, prepared for the onslaught by arming themselves with long sticks and cans of mace, while the security guards donned police vests and helmets. What followed was a pitched battle in the lobby atrium with horrified patients gawking from the floors above. Although nobody was seriously injured, the incident brought attention to a wave of violence in Chinese public hospitals. [Source: Barbara Demick, Los Angeles Times, August 25, 2011]

In the incident in Nanchang, hospital staff members learned that a mob of about 100 people was heading their way with crude weapons and took it upon themselves to mount a defense. Photographs and video posted on a local website showed men in white coats, apparently doctors, and T-shirted security guards brandishing what looked like oversize baseball bats.

"A lot of the young doctors and hospital security guards couldn't stand it anymore and decided to pick up sticks and defend themselves," a doctor from another Nanchang hospital, who gave his name as Lao Tang, wrote on his social networking site. "My fellow comrades, we fully support you! Well done!"

Protection for Doctors at Chinese Hospitals

Siu-wee Lee wrote in the New York Times: “Many hospitals are taking measures to protect their workers. In the southern city of Guangzhou, the Zhongshan Hospital has hired taekwondo experts to teach doctors self-defense techniques. Hospitals in the eastern city of Jinan are paying private security companies for protection. Last year, the government pledged to station an adequate number of police officers in emergency departments, where most doctor-patient violence occurs. [Source: Siu-wee Lee, New York Times, September 30, 2018]

China’s new healthcare and health promotion law that was passed in December 2019 and went into effect in June 2020 criminalizes threatening or endangering the safety of medical staff. Nanning in Guangxi Province became the first city in China to require local hospitals to install security checkpoints under new regulations issued in 2019 — around the same time the doctor in a Beijing emergency ward was stabbed to death. Sup China reported: On January 8, the Second People’s Hospital of Nanning became the first medical institution in the city to introduce security checkpoints under the new regulations. That day, the hospital had 38 security officers on duty who found several visitors carrying knives. [Source: Sup China, January 13, 2020]

In 2014, the city of Beijing said it was going to protect doctors from growing levels of violence from angry patients with volunteer "guardian angels". Reuters reported: “The campaign recruited students, medical workers and other patients to act as middlemen between doctors and those in their care to defuse disagreements and smooth over tensions, the official Xinhua news agency reported. "Patients will understand doctors better after talking with our volunteers," Feng Guosheng, head of the Beijing Municipal Administration of Hospitals told Xinhua, adding services would include "hospital guidance" and "psychological intervention". [Source: Reuters, April 9, 2014]

“China's government stepped up security at hospitals earlier this year, posting police at some centres and increasing surveillance after a rise in attacks. The Beijing campaign recruited over 1,500 volunteers to serve a one-year term across 21 hospitals in the capital, Xinhua reported, citing another city official Wei Jiang. Authorities have previously said they will increase punishment of those who cause disruption in medical institutions and the health ministry in February cracked down on "red envelope" bribes for quicker and better treatment, often a cause of tension as it raises the price patients have to pay for care.

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Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Yomiuri Shimbun, The Guardian, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated September 2022

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