Three modes of power operation: Understanding doctor-patient conflicts in China's hospital therapeutic landscapes

Doctor-patient conflicts in contemporary China are increasing in numbers and severity. This health geographic study shows how hospitals as a type of therapeutic landscape can shape doctor-patient relationships. First, the comprehensive nature of therapeutic landscapes with an emphasis on power operation within symbolic environments is provided as a framework for this study. Second, the results from participant observation and interviews with patients and doctors previously involved in conflicts are reported from Internal Medicine and Surgery Departments, within four hospitals in Anhui Province, Eastern China. The study finds that the spatial and temporal arrangements of spaces, the inside decorations and the different modes of discourses can build or ruin harmonious doctor-patient relations. The research concludes that adaptations to current hospital therapeutic landscapes can improve trust between patients and doctors, resulting in fewer conflicts and better health outcomes in China. •Hospitals are described per spaces, decorations, doctor-patient power relations and discourse between medical encounters.•Spatial and temporal arrangements of these environments shape doctor-patient relationship to enhance or reduce conflicts.•Adaptations to improve hospital therapeutic environments for patients and doctors are provided.