Medical hierarchy in professional ranking and its implications in China


  • Lingling Zhang US Centers for Disease Control and Prevention


Medical hierarchy is a system where health professionals are ranked according to certain criteria. While hierarchy helps identify the seniority and mentorship to which junior practitioners can refer, it can also become a barrier in medical practice and sometimes lead to undesirable perceptions and consequences for both medical professionals and patients. Physicians in Denmark perceived the hierarchical position as a major determinant of influence on technical and ethical decisions.1 German physicians complained about the monarchy-like system in clinical positions that led to a negative working atmosphere and reduced health-related quality of life among young physicians.2 Srivastava3, drawing from the author’s own medical practice in the US, showed that blind adherence to hierarchy defined by medical specialties could lead to disastrous outcomes.


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