Status, causes and consequences of physicians’ self-perceived professional reputation damage in China: a cross-sectional survey

Abstract

Background Conflict between physicians and patients is an increasingly serious problem, leading to the disrepute attached to Chinese physicians’ social image and position. This study assesses the status of physicians’ self-perceived professional reputation damage and explains it’s the adverse outcomes including withdrawal behavior and workplace well-being. Moreover, potential causes of Chinese physicians’ disrepute have been outlined. Methods Primary data were collected through a cross-sectional online survey of physicians from 10 provinces in China, who were invited to complete an anonymous survey from December 2018 to January 2019. A total of 842 physicians (effective response rate: 92.22%) were recruited as participants. Results About 83% of the participants self-perceived professional reputation damage from the sense of the public opinion concept. Approach half of participants exhibited the idea of turnover intention (47.3%) and one or more symptoms of burnout (46.4%). About 74.9% of the participants experienced a degree of stress. Additionally, three out of five participants reported low-level subjective well-being. More than 70% of the participants disapproved of their offspring becoming a physician. Four factors leading to physicians’ damaged professional reputations are those addressed: conflict transfer, cognitive bias, improper management, and individual deviance. Stigmatised physicians are more likely to practice high-frequent defensive medicine (β = 0.172, P <0.001), intend to leave the profession (β = 0.240, P <0.001), disapprove of their children becoming physicians (β = 0.332, P<0.001) and yield worse levels of workplace well-being, including high levels of perceived stress (β = 0.214, P <0.001), increasing burnout (β = 0.209, P <0.001), and declining sense of well-being (β = − 0.311, P<0.001). Conclusion Chinese physicians were aware of damaged professional reputations from the sense of the public opinion concept, which contributes to increasing withdrawal behaviors and decreasing workplace well-being—a worsening trend threatening the entire health system. This novel evidence argues a proposal that Chinese health policy-makers and hospital administrators should promote the destigmatization of physicians immediately.

High prevalence and risk factors of dropout intention among Chinese medical postgraduates

“…In the present study, half of the medical postgraduates experienced verbal or physical violence, indicating the vulnerability of medical postgraduates, who often work as primary doctors in China; their experience of violence was found to be strongly associated with turnover intention. Apart from violence, the declined professional reputation of doctors was another risk factor for burnout and turnover intention [ 102 ]. Our findings regarding this issue are similar to those of another study reporting that undergraduates are 1.26 times more likely to give up their medical career when they believe that ‘doctor is not an occupation with a high social status and reputation’ [ 36 ].…”

“…China has only 0.14 general practitioners and 0.25 nurses per 1,000 people [ 6 ], and the country’s medical professionals suffer from decreasing public trust, a declining reputation, and adverse media reporting [ 7–9 ]. Violence and negative comments on healthcare providers have increased in China, which have been strongly associated with the decision to leave jobs in the sector [ 8 , 10–12 ]. Moreover, there has been a huge reduction in Chinese medical postgraduates deciding to enter clinical work, with only a small proportion of medical postgraduates (752,233 out of 4,314,791 students, 15.91%) registering as doctors in the past decade [ 13 ].…”

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey

“…A single indicator was a poor measure of organizational psychology. Therefore, three indicators, subjective happiness, stress, and emotional exhaustion, were selected to represent physicians’ whole state of organizational psychology, and those indicators have been used to measure organizational psychology in the Chinese context [ 34 ]. Considering the physician’s workload, subjective happiness and psychological stress were separately measured by a single item.…”

“…The following single-item measure of subjective happiness was used: “In general, do you currently feel happy?” The response was coded on a 5-point Likert scale (1 = “very unhappy” to 5 = “very happy”), with a higher score representing better well-being. This subscale has been extensively used in the Chinese context [ 34 ]. Psychological stress was assessed by the following question: “Stress means a situation in which a person feels tense, restless, nervous, or anxious or is unable to sleep at night because their mind is troubled all the time.…”

“…Therefore, three items in monitoring “job satisfaction,” “defensive medicine behavior,” and “turnover intention” were selected to represent the physicians’ organizational behavior and well-being. These indicators were measured using a single-item question, which had been used in a previous study in the Chinese context [ 34 ]. The following single-item measure of participants’ job satisfaction was used, “Overall, how satisfied are you with your current job?”, which was rated on a 5-point Likert scale, (1 = strongly dissatisfied and 5 = strongly satisfied), with higher scores indicating higher job satisfaction.…”