Table 3.

Quotations supporting manifestations of patient–physician mistrust

Theme	Quotes
Non-resolution with residual patient resentment towards hospitals	(1) “There are several reasons for this [resentment]. One is that in China taking the legal route is too complex. Second, a patient considers fairness. He worries about whether or not health institutions cover up for each other. Third, there are certainly some people instigating it, including medical mobs at our hospital. Every time it's the same several people and some are professional medical mobs. In China, a lawsuit is really inconvenient. It might be able to resolve the problem, but the patient can't necessarily wait that long. Finally, if the patient goes and stirs up trouble and sees that the government again comes out and helps him resolve the problem, he will feel that choosing this route is best, as a result it encourages this practice.”—Physician (2) “At the beginning he said that he wanted our associate dean to come out and apologize to him. We gave the patient an explanation, but he continued to make a fuss. The patient later made requests that made us not know whether to laugh or cry. He said, ‘All I want is to have your director to kneel down and apologize in public. That is all I want, nothing else.’ Then one of our colleagues from the medical affairs department became angry and said, ‘If you say this then there's nothing we can do. We can't go on discussing.”—Administrator (3) “The physicians, nurses, no one was able to mediate between the upset patient and the hospital. These people said they wanted to see the director. They also organized a medical mob and held banners at the hospital. They said the hospital treated human life as worthless. They made it so the doctor was not able to continue seeing other patients because of the dispute. The patient's whole village came.”—Physician
Violent resolution of a medical dispute	(1) “But I don't know why they still have not taken the normal channel. Later when the family members forced the hospital to pay the money, at once he (the patient) climbed to the fourth floor and jumped.”—Nurse
Non-violent resolution through informal mechanisms	(1) “[The patient affairs department] might go communicate with the patient and give the patient a platform for communication because many patients today feel that doctors are too remote. I file a complaint about you but you don't fear complaints. Actually patient affairs has this kind of function. If doctors and nurses do not treat a patient well, this complaint is valuable. Then our hospital would definitely give a warning to the relevant staff, the relevant doctors and nurses, or even take disciplinary action or make a dismissal. This can definitely happen.”—Physician (2) “In our institution's [hospital with a new primary care model] guidelines we strictly prohibit physicians from accepting red packets and money from pharmaceutical representatives. And our appointment system schedule has to a certain extent helped mitigate conflicts.”—Physician (3) “Here [hospital with a new primary care model] it's organizational reform. We are putting more emphasis on patient satisfaction, encouraging a patient service mentality, aligning more with international standards, so we are demanding more and more from ourselves.”—Physician