Survey finds doctors unhappy and dangerously overworked

By The Nation

 

File photo

 

DOCTORS and nurses at state hospitals in Thailand are chronically overworked, according to the Department of Medical Services, which is tabulating the results of a survey that found about 60 per cent of doctors work more than 80 hours per week and 90 per cent had to take shifts even when ill.
 

Evaluation of the poll results would be completed this week, said department chief Dr Somsak Akkasilp, and solutions proposed next week to Public Health Minister Dr Piyasakol Sakolsatayadorn and the ministry’s permanent secretary, Dr Sukhum Kanchanapimai.

 

Somsak said a team led by Medical Law Office deputy director Dr Methee Wongsirisuwan was assigned late last year to assess the workloads of doctors, nurses, pharmacists, medical technologists and radiology technicians, who all work night shifts.

 

The goal was to gather information on which solutions could be based. 

 

Somsak said solutions would first be implemented to benefit the more than 10,000 medical personnel at 31 hospitals under the ministry. They account for 70 per cent of 18,000 staff overseen by the department. 

 

Initial findings indicate that about 60 per cent of the 1,000 doctors polled work more than 80 hours a week – double the Medical Council’s recommended limit of 40 hours. Somsak said all factors |contributing to the discrepancy would be studied and solutions sought.

 

Working even when ill

 

Dr Methee wrote on Facebook page that the poll uncovered 30 per cent of physicians working more than 100 hours a week. 

 

Another 15 per cent said they |had worked shifts every day of the week and 90 per cent reported taking shifts even when they felt ill because there was no one to replace them or they felt “compelled” to |do so.

 

Seventy per cent of the doctors had worked shifts even when a parent, spouse or child was ailing, leaving them unable to care for their own family members, Methee wrote.

 

More than 50 per cent of doctors were examining more than 100 outpatients a day on top of their hospitalised patients. 

 

Recently revised standards for medical exams require a doctor to spend at least 10 minutes tending to new patients and at least five minutes with repeat patients.

 

More than 55 per cent of the doctors surveyed claimed to be treating nearly 70 emergency cases per day, Methee said. 

 

Ninety per cent said mistakes were possible in treatment because of their work overload and sleep deprivation.

 

Seventy per cent of doctors said their work was affecting their own physical and mental health, resulting in depression, burnout and insomnia, while 65 per cent said they were unhappy working in the medical profession.

 

Source: http://www.nationmultimedia.com/detail/national/30361878

 

-- © Copyright The Nation 2019-01-09

How much of this can be put down to Thaksin's ill-advised 30 baht scheme, which was intended purely as a vote-winner and had nothing to do with reforming or updating the public health system? Correct me if I'm wrong, but I believe that since this scheme was introduced, the number of students seeking the once-highly prized spots in university medical faculties has dropped so badly that some institutions are being forced to lower their entrance standards. Meanwhile, in the provinces, particularly the far-flung ones, hospitals are losing medical staff hand-over-fist and forced to threaten doctors with delicensing if they try to leave. And it's all because medical staff are stretched and stressed as a result of the 30-baht scheme -- the social security scheme has contributed as well, from my observations, but it is the 30-baht scheme that has broken the camel's back. Sit in any outpatient department at any hospital and watch the chaos -- doctors so busy they barely return a wai; patients being turned over like cattle in a market; talk to a pharmacist on the sly and hear them bitch about dishing out sugar tablets.

 

The 30-baht scheme is a total crock and is destroying the health system. It needs to be replaced by a system of community nurses who would act as health advisers and a buffer for doctors. The social security scheme also needs to be revised and expanded to cover more workers. No one should be denied medical treatment, but there are better ways than the 30-baht scheme.

Pack your bags... Go to US.. 

work half a day... golf,  hunt, fish... Become wealthy beyond your wildest dreams... Retire early... Come back Thailand and live like a king... 

Could they, doctors, feel over worked because they run private practices whilst employed at hospitals, arriving on duty late, because of thier commitments elsewhere?

 

As for nurses, my guess is that they, nurses, are expected to work 12 hour, plus, shifts per day with two days off within one month earning below the minimum wage limit and having to pay a bond with no or little sick leave pay, minimal maternity leave as well as pay for thier own nurses uniform, as is the case with most other employees within other sectors of the Thai work market/ places.

Edited January 8, 20197 yr by Sonhia
Mistake

19 minutes ago, Sonhia said:

Could they, doctors, feel over worked because they run private practices whilst employed at hospitals, arriving on duty late, because of thier commitments elsewhere?

 

As for nurses, my guess is that they, nurses, are expected to work 12 hour, plus, shifts per day with two days off within one month earning below the minimum wage limit and having to pay a bond with no or little sick leave pay, minimal maternity leave as well as pay for thier own nurses uniform, as is the case with most other employees within other sectors of the Thai work market/ places.

Yes, it's very common for medical doctors employed at government hospitals to run around and both moonlight part-time at private hospitals, and at the same time open night clinics for extra income. Those employed by private hospitals, where the pay is higher, have better hours, but still often get involved in entrepreneurial ventures like clinics, etc..

 

I think it's a matter of qualifications. Those government hospital doctors whose credentials are less than stellar usually will be working more hours, and opening clinics too, but maybe not be invited to work at private hospitals.

 

I imagine Sheryl on this forum knows much better than I do or anyone else on this forum, so hopefully she chimes in with a more informed view.

Edited January 9, 20197 yr by keemapoot
a

2 hours ago, webfact said:

Ninety per cent said mistakes were possible in treatment because of their work overload and sleep deprivation

There are plenty of deformed plastic surgery faces seen on the streets of bkk to confirm that.

29 minutes ago, RotBenz8888 said:

There are plenty of deformed plastic surgery faces seen on the streets of bkk to confirm that.

And what about the ultra white faces? Were they scared to death by the doctors?

6 hours ago, Dexlowe said:

How much of this can be put down to Thaksin's ill-advised 30 baht scheme, which was intended purely as a vote-winner and had nothing to do with reforming or updating the public health system? Correct me if I'm wrong, but I believe that since this scheme was introduced, the number of students seeking the once-highly prized spots in university medical faculties has dropped so badly that some institutions are being forced to lower their entrance standards. Meanwhile, in the provinces, particularly the far-flung ones, hospitals are losing medical staff hand-over-fist and forced to threaten doctors with delicensing if they try to leave. And it's all because medical staff are stretched and stressed as a result of the 30-baht scheme -- the social security scheme has contributed as well, from my observations, but it is the 30-baht scheme that has broken the camel's back. Sit in any outpatient department at any hospital and watch the chaos -- doctors so busy they barely return a wai; patients being turned over like cattle in a market; talk to a pharmacist on the sly and hear them bitch about dishing out sugar tablets.

 

The 30-baht scheme is a total crock and is destroying the health system. It needs to be replaced by a system of community nurses who would act as health advisers and a buffer for doctors. The social security scheme also needs to be revised and expanded to cover more workers. No one should be denied medical treatment, but there are better ways than the 30-baht scheme.

Are you really serious?

It is all to blame on the existing health care schemes?

Which of course is not beneficiary for the "medical industry annex private healthcare" that is characterised by greed, profit and may I mention it, deaths of the poor, refusal of treatment, no insurance due to age or pre-existing problems, going broke because of not able to pay the bills, etc,etc,etc.

In fact, the growth of private healthcare and the bloody insurance business is slowly killing the state run healthcare to the detriment of the poor and the elderly.

Same all over the world. But they are paid well or get into a practice that is unique. Some nurses in OZ work a theatre shift say on weekends and can earn about $120+ph plus benefits. Other people in the community do the same but are not signaled out as being overworked. Poor Dears.

7 hours ago, Dexlowe said:

How much of this can be put down to Thaksin's ill-advised 30 baht scheme, which was intended purely as a vote-winner and had nothing to do with reforming or updating the public health system? Correct me if I'm wrong, but I believe that since this scheme was introduced, the number of students seeking the once-highly prized spots in university medical faculties has dropped so badly that some institutions are being forced to lower their entrance standards. Meanwhile, in the provinces, particularly the far-flung ones, hospitals are losing medical staff hand-over-fist and forced to threaten doctors with delicensing if they try to leave. And it's all because medical staff are stretched and stressed as a result of the 30-baht scheme -- the social security scheme has contributed as well, from my observations, but it is the 30-baht scheme that has broken the camel's back. Sit in any outpatient department at any hospital and watch the chaos -- doctors so busy they barely return a wai; patients being turned over like cattle in a market; talk to a pharmacist on the sly and hear them bitch about dishing out sugar tablets.

 

The 30-baht scheme is a total crock and is destroying the health system. It needs to be replaced by a system of community nurses who would act as health advisers and a buffer for doctors. The social security scheme also needs to be revised and expanded to cover more workers. No one should be denied medical treatment, but there are better ways than the 30-baht scheme.

So what is the answer?

6 hours ago, keemapoot said:

I think it's a matter of qualifications. Those government hospital doctors whose credentials are less than stellar usually will be working more hours, and opening clinics too, but maybe not be invited to work at private hospitals.

 

 

the contrary is true. typically government hospitals are staffed by graduates of difficult entry prestigious famous government universities, eg; mahidol, chula, etc

20 minutes ago, atyclb said:

 

 

the contrary is true. typically government hospitals are staffed by graduates of difficult entry prestigious famous government universities, eg; mahidol, chula, etc

I'm sure that is true for prestigious teaching hospitals, places like Chula and Siriraj, but for provincial government hospitals I think that is the opposite is it not?

17 minutes ago, atyclb said:

 

 

the contrary is true. typically government hospitals are staffed by graduates of difficult entry prestigious famous government universities, eg; mahidol, chula, etc

Exactly.  Also, the Thai government will pay for some people to get their training abroad and in return, they have to work in a government hospital for a specified amount of time.  This is from an older article so I’m sure the exact figures are not current.  The doctors can even be heavily fined if they do not complete their compulsory government service.

 

“After graduation from public medical school each medical graduate has to work for the public for three years. Public doctors can also practise privately, and many of them do. However, if they do not practise privately, they receive USD250 special allowance per month.”

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC317381/

3 minutes ago, keemapoot said:

I'm sure that is true for prestigious teaching hospitals, places like Chula and Siriraj, but for provincial government hospitals I think that is the opposite is it not?

Nope...they are paid hardship allowances when they have to complete their government service in rural areas.

did the article discern between residents in training and those post residency?

9 hours ago, Dexlowe said:

How much of this can be put down to Thaksin's ill-advised 30 baht scheme, which was intended purely as a vote-winner and had nothing to do with reforming or updating the public health system? Correct me if I'm wrong, but I believe that since this scheme was introduced, the number of students seeking the once-highly prized spots in university medical faculties has dropped so badly that some institutions are being forced to lower their entrance standards. Meanwhile, in the provinces, particularly the far-flung ones, hospitals are losing medical staff hand-over-fist and forced to threaten doctors with delicensing if they try to leave. And it's all because medical staff are stretched and stressed as a result of the 30-baht scheme -- the social security scheme has contributed as well, from my observations, but it is the 30-baht scheme that has broken the camel's back. Sit in any outpatient department at any hospital and watch the chaos -- doctors so busy they barely return a wai; patients being turned over like cattle in a market; talk to a pharmacist on the sly and hear them bitch about dishing out sugar tablets.

 

The 30-baht scheme is a total crock and is destroying the health system. It needs to be replaced by a system of community nurses who would act as health advisers and a buffer for doctors. The social security scheme also needs to be revised and expanded to cover more workers. No one should be denied medical treatment, but there are better ways than the 30-baht scheme.

So it's all Thaksin's fault even though he's been gone for about 13 years and no one since has had the energy or care or the brains to fix a broken system. You seem to forget the junta has been running the show for almost 5 years and could have done something to overhaul public health services. But like everything else they prefer to talk about it rather than do anything. The education system, health and safety, Bangkok's pollution and traffic, road safety are a few more examples of junta incompetence and inaction. 

UK is just as bad, if not worse, it's not just a Thai problem.