[Direct answer]Overmedicalization can be legally protected against: According to Article 1227 of the Civil Code of the People's Republic of China, medical institutions and their medical staff shall not violate the treatment norms to carry out unnecessary examinations. The fees charged in violation of the rules can be requested to be returned, and if the patient is harmed, he/she can also claim compensation for medical damage according to Article 1228. The legal remedies include copying and sealing the medical records, filing a complaint with the health department and the medical insurance department, applying for a medical damage appraisal, negotiating mediation and litigation. The statute of limitations for personal injury compensation is three years. For more details, please refer to the relevant provisions.Legal services for personal injury and medical disputesAndBeijing Henglu Law Firm.

I. Problem Background and Typical Scenarios

The common cold is scheduled for continuous infusion for a week, patients are required to undergo a full set of high-cost examinations before minor surgeries, and they are "bundled" with multiple physiotherapy treatments unrelated to their diagnosis during hospitalization. Many patients only discover these questionable practices after reviewing their expense lists. Typical cases include: repeated examinations beyond the needs of the condition; recommending expensive imported drugs when basic medications are available; performing surgeries without indications or expanding the scope of surgery without authorization; arranging treatment programs unrelated to the diagnosis under the guise of hospitalization. Patients' confusion focuses on three points: it's difficult to independently judge what constitutes reasonable medical treatment; medical records and expense details are controlled by the hospital; there are many complaint channels, but they don't know where to start. They also worry that "if they fail to protect their rights, they might offend doctors and affect their subsequent treatment".

II. Key points of contention

  • The criteria for identifying excessive medical treatment: It should be based on the medical level and treatment standards at that time, and combined with the requirements of the obligation of medical treatment in Article 1221 of the Civil Code of the People's Republic of China to judge. There is a certain degree of discretion in medicine, and there is a gap between the patient's subjective feelings and professional judgments. It usually needs to be clarified by medical damage appraisal.
  • Obtaining and preserving medical records: According to Article 1225, patients have the right to access and copy medical record information; if the medical records are concealed, refused to be provided, or falsified, tampered with, or illegally destroyed, patients may claim that the medical institution is presumed to be at fault in accordance with Article 1222.
  • The distinction between fee refund and damages compensation: If the overcharging does not cause any harm, the patient can claim a refund of the difference and report the matter to the medical insurance department; if the overtreatment results in personal injury, the patient can claim compensation according to the liability for medical damage, and the two procedures can be carried out in parallel.

III. Professional analysis by Henglue Lawyers

The core evidence for protecting rights is medical records and expense lists. First, in accordance with Article 1226 of the Civil Code of the People's Republic of China, immediately copy all medical records, including outpatient and emergency medical records, hospitalization notes, medical orders, examination and inspection reports, surgical and anesthesia records, nursing records, and expense details, and require the hospital to stamp and confirm them. If you are worried that the medical records might be altered, apply for the sealing of the medical records in accordance with the "Regulations on the Prevention and Handling of Medical Disputes" (implemented on October 1, 2018), and the sealed documents shall be jointly sealed by both the medical and patient parties. If the medical records are concealed, refused to be provided, or falsified, tampered with, or illegally destroyed, Article 1222 of the Civil Code can directly presume that the medical institution is at fault. This is the most powerful legal leverage for patients in medical disputes, often able to reverse the burden of proof.

In terms of qualification and claims, whether it constitutes excessive medical treatment usually needs to be clarified through a medical damage appraisal, where the appraisal institution evaluates the necessity and rationality of various examinations, treatments, and medications against medical treatment standards. If it is only identified as overcharging, the hospital may be required to refund the difference; if it involves the expenditure of medical insurance funds, it may be reported to the medical security department, and the regulatory authorities shall investigate and handle it in accordance with the "Regulations on the Supervision and Management of the Use of Medical Security Funds" (effective May 1, 2021). If personal injury is caused by excessive medical treatment, the medical institution shall bear the liability for compensation in accordance with Article 121-8 of the Civil Code; if no agreement can be reached, the case may be mediated by the People's Mediation Committee for Medical Disputes or sued in court. Complaints, mediation, and litigation are not conflicting, but the pace should be coordinated with each other to avoid missing key actions while negotiating a settlement.

IV. Practical suggestions and legal basis

At the legal basis level: Article 1227 of the Civil Code of the People's Republic of China (effective from January 1, 2021) prohibits conducting unnecessary examinations in violation of medical treatment norms; Article 1228 stipulates the fault liability for medical harm; Article 1229 requires medical personnel to fulfill their treatment obligations corresponding to the prevailing medical standards at the time; Article 1231 stipulates the presumption of fault circumstances; Article 1235 stipulates the patient's right to review and copy medical records; Article 1229 stipulates the medical personnel's obligation to provide explanations before surgery, special examinations, and special treatments. The "Regulations on the Prevention and Handling of Medical Disputes" (effective from October 1, 2018) stipulates solutions such as consultation, people's mediation, administrative mediation, and litigation. At the practical advice level: Keep payment receipts and expense lists during the visit; copy and seal the medical records as soon as possible after discharge; complaints can first be submitted to the hospital's medical-patient relations office, and then reported to the local health commission in succession; for those involving medical insurance, report to the medical security bureau; it is necessary to evaluate and appraise the case before claiming compensation, and the appraisal opinion generally determines the direction of the case.

5. Henglu Law Firm's Advice

The success or failure of excessive medical rights protection depends 70% on evidence and 30% on procedures: it's better to seal the medical records as soon as possible, check the expense list against the medical orders item by item, and manage the pace of complaints, mediation, and litigation in coordination with the three-year statute of limitations. It's not recommended to adopt extreme methods of pressure, which not only have no legal effect but also may lead to public security responsibilities, thereby weakening the bargaining chips; the rational approach is to solidify the evidence and let the appraisal opinions and administrative investigations speak for themselves. You can start byBeijing Henglue Law FirmEvaluate the probative value of medical records and cost-related materials, or understandLegal services for personal injury and medical disputesThen, choose the order of proceeding with negotiation, mediation, or litigation.

Q1: How can I initially determine if what I'm experiencing is excessive medical treatment?

The self-check can be conducted from three aspects: First, check the correspondence between the necessity of the diagnosis and the actual situation. If things like ordering a full-body CT scan for a common cold or repeatedly taking X-rays without any external injuries clearly exceed the scope of routine medical treatment, it's questionable. Second, check the cost structure. If the proportion of high-value self-paid items is abnormal, or if the cost list doesn't match the doctor's instructions, keep a record of it. Third, check the informed consent process. If the doctor recommends high-value items or surgeries without explaining the alternative options and risks, pay attention to the obligation to provide explanations as stipulated in Article 1,219 of the Civil Code of the People's Republic of China. The conclusions of the self-check cannot replace professional assessments. The final judgment should be based on the medical malpractice appraisal, but sorting out the doubts itself can serve as clues for complaints and appraisals.

Q2: What should I do if the hospital doesn't allow me to copy my medical records?

It is a statutory right to copy medical records. According to Article 122 of the Civil Code of the People's Republic of China, if a patient requests to review or copy medical records, the medical institution shall provide them in a timely manner. According to the Regulations on the Prevention and Handling of Medical Disputes, the scope of copying includes outpatient and emergency medical records, hospitalization notes, medical orders, examination and inspection reports, surgical and anesthesia records, and expense details. If the hospital refuses or delays the request, the patient can file a complaint with the local health commission, which will order the hospital to make corrections. When copying the records, the patient should request the hospital to stamp its official seal on the copies to ensure they are consistent with the originals. Completing the copying and sealing of the records before the dispute escalates is the best way to prevent the medical records from being tampered with.

Q3: Can I get a refund for the extra money spent on excessive medical treatment? Can I also claim compensation separately?

There are two aspects to this. The excess charges for examinations, treatments, and medications constitute expenditures lacking a contractual basis, and the hospital can be required to refund the difference. If personal injury is caused by unnecessary medical treatment, the medical institution can be required to compensate for losses such as medical expenses, loss of income, nursing care fees, and disability compensation in accordance with Article 121 of the Civil Code of the People's Republic of China. The refund of expenses and compensation for damages do not conflict with each other. They can be claimed together in the same case, or the issue of expenses can be first handled through the health administrative department and medical insurance department, while the compensation for damages can be negotiated, mediated, or litigated separately. The two processes can proceed independently of each other, without any interference.

Q4: Which departments are the most effective to file a complaint with?

Choose the appropriate channels according to the purpose: For complaints about medical treatment and medical records, submit them to the hospital's Office of Medical-Patient Relations and the local health and health commission, which have the right to investigate and handle matters related to medical institutions and personnel; For complaints about illegal charges and medical insurance funds, report them to the Medical Security Bureau. According to the "Regulations on the Supervision and Management of the Use of Medical Security Funds", if it is confirmed that excessive medical treatment has caused fund losses, the hospital will face penalties such as refunding funds and fines; For compensation disputes, you can apply for free mediation by the People's Mediation Committee for Medical Disputes, or directly file a lawsuit in court. When submitting a complaint, provide it in writing and request a receipt. The department's handling conclusion can be used as evidence in subsequent litigation.

Q5: How is a medical malpractice assessment conducted? Who bears the cost of it?

The medical damage appraisal is conducted by qualified appraisal institutions. Both the doctor and the patient can negotiate to select an institution, and if no agreement can be reached, the court will appoint one in the litigation process. The appraisal is based on sealed medical records and other materials. If the appraiser deems it necessary, he/she shall appear in court to answer questions. The appraisal fees are generally prepaid by the applicant, and the court will ultimately determine the sharing of the fees according to the liability ratio. If the appraisal finds that the hospital engaged in excessive medical treatment and caused damage, the hospital will generally bear a corresponding share of the appraisal fees. The appraisal opinion is the main basis for the court to determine fault, causality, and the degree of causation. Before applying for an appraisal, it is recommended that lawyers evaluate the medical records and materials and determine the matters to be entrusted, so as to avoid deviations in the direction of the appraisal.

If you are currently facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the relevant evidence, to avoid missing the statutory time limit.Personal injury legal services·Beijing Henglu Law Firm