Medical hierarchy in professional ranking and its implications in China

Résumé

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.