医学职业精神知行差异的社会文化因素分析——基于北京六家医疗机构的调查研究

Analysis of the Social and Cultural Factors of the Difference between Knowing and Doing in Medical Professionalism:Based on Investigations of Six Medical Institutions in Beijing

通过分析,发现当前影响医务人员对医学职业精神的认知和实践无法统一的社会文化因素有:中国社会转型时期特有的社会信任危机背景导致医患间信任受到了严重挑战;医改制度设计缺陷与激励机制扭曲引发医患利益对立冲突;差序格局下"公私群己的相对性"导致医疗公平难以实现;医务人员与患者对疾病的不同认知和理解。认为目前医务人员虽然对医学职业精神认知程度比较高,但当下医患关系依然紧张的现状仍未得到很好的缓解。

Through the analysis of social and culture factors influencing that medical staff's cognition and practice of medical professionalism can bot be unified, which included that social trust crisis in the period of social transformation led to the serious challenge of the trust between doctors and patients; the defects in the medical reform system design and distortions of incentive mechanism triggered conflicts of interests between doctors and patients;" the relativity of public and private groups" under the pattern of difference sequence led to difficult realization of health equity; and medical staff and patients had different cognitions and understandings to diseases, this paper pointed out that although the medical staffs ' cognition degree of medical professionalism was relatively high, the current tense situation of doctor-patient relationship still had not been very good relief.