Doctor-Patient Trust in the Transition of Rural Society: A study on two villages in central China

本文通过对我国中部地区两个村村民与村医、乡镇卫生院医生之间医患信任状况的调查发现,村民对村医和乡镇卫生院医生采取的分别是“人际信任”和“制度信任”的信任逻辑；而在农村社会从传统向现代转型、农民对医疗专业化预期提高、医疗服务更加专业化和制度化的背景下,未来村民对于村医的信任逻辑将是人际信任与制度信任的叠加。医疗体制与社会环境共同形塑了医生的行为,使村医和乡镇卫生院医生的行为既有共性又有区别。在当前中国社会的大背景下,对照西方的发展趋势,笔者认为,未来需要思考的是如何将传统性因素融合进未来的社会制度中,使其发挥积极作用。

Based on fieldwork in two villages in central China, the authors find that there are two different trust logics in doctor-patient trust in rural society. Villagers' trust to village doctors is personal trust, while their trust to doctors of township hospital is institutional trust. With the transition from traditional society to modern society, as well as the rising of villagers' expectation for health service, the logic of villagers' trust to village doctors would be a combination of personal trust and institutional trust. At the same time, both medical institutions and social environment have shaped doctors* behavior. The implication of this research for the new medical reform is that to improve villagers' trust to village doctors, the professional education of village doctors should be emphasized to enhance their institutional legitimacy, and at the same time,villagers1 personal trust to village doctors should be fully used and strengthened to regulate and monitor village doctors' behavior.

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