Dire Need For Doctors In Rural Thai Areas

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SPECIAL REPORT

Dire need for doctors in rural areas

By Wannapa Khaopa

The Nation

Study finds most medical graduates come from cities, prefer to stay there

Yes, working in remote areas with few facilities and a heavy workload is tough, but it's not that bad to work there, one doctor says. People simply need to adjust their lifestyle and point of view towards rural areas.

Dr Puttaraksa Deesin is the director of Tha Khanto Hospital in Tha Khanto, a small district in Kalasin, in the Northeast. He knows well how hard - and how happily - one can work in a rural area.

Most physicians, however, prefer to work in urban areas, where there are big public and private hospitals. This trend has resulted in a severe shortage of physicians in rural areas.

Puttaraksa is different. He quit a private hospital many years ago to work at a provincial hospital and moved later to the district hospital. He was well rewarded for work at the private hospital, where his income was three times that in his current one.

"If you are single and like tranquil and natural areas, you can live and work happily in a district like me. There is no convenience store, no ATM, no entertainment venues and few food shops here, but I adjusted my views and lifestyle," he said. "I now work here happily, and so would you.

"Having only two doctors here - including me - we work very hard, taking turn to take care of patients, but our relationship with the patients is much different from those working in urban areas. Rural people are nice. We are quite intimate. I don't have any problems about legal charges against me," he said.

However, Puttaraksa said most medical students were from families in urban areas, so it was difficult to push them to work in rural areas.

Nonglak Pagaiya, manager of the Human Resources for Health Research and Development Office (HRDO), confirmed that most newly graduated physicians opted to live in urban areas, and this was one of the main reasons for the lack of physicians in rural areas.

Nonglak cited a survey of 574 newly graduated physicians last year that showed up to 77 per cent lived in urban areas, while only 21 per cent said their home towns were in remote areas. (The other 2 per cent did not identify their home towns.)

"Most [doctors] are urban people. So it is really hard to have them work in rural areas," she said.

Puttaraksa said working in a district hospital, especially one in a small district with few facilities, could discourage physicians.

This is why Nonglak wants the government to continue the One District One Doctor (ODOD) project, plus the Collaborative Project to Increase Production of Rural Doctors (CPIRD). These focus on identifying good students in rural areas and giving them the chance to study medicine, in a bid to increase the number of physicians in rural hospitals.

Records from 2003-2007 show fewer physicians trained through the CPIRD had left the Public Health Ministry than those not recruited under the project.

Dr Thinakorn Noree, an HRDO researcher, said training available to physicians prepared to spend their own money to learn to be specialists also caused doctors to quit jobs with the ministry within a few years.

"Medical schools should not allow them to be trained if they have not worked for public hospitals for three years in return" after the country spends about Bt1.8 million teaching each of them, he said.

Nonglak said the HRDO backed a proposal to increase the fine imposed on physicians who quit the Health Ministry within a few years from just Bt400,000 - an amount set back in 1973 - to Bt1.8 million.

The HRDO plans to put these proposals to the National Commission on Human Resources for Health on May 26, to make it easier to retain doctors in rural areas.

-- The Nation 2011-05-03

[sirchai]

"If you are single and like tranquil and natural areas, you can live and work happily in a district like me. There is no convenience store, no ATM, no entertainment venues and few food shops here, but I adjusted my views and lifestyle," he said. "I now work here happily, and so would you.

Most doctors are not single. What about paying them a higher salary?

Here in the lower northeast you shouldn't have an accident in the evening or on weekends. There's mostly no doctor available.

I had a motorcycle accident here and broke my leg. The fact that they don't want to lose face, made my time after the operation to a two year lasting long nightmare.

He could have signed a document to send me to the neighbor province, where they're more familiar with difficult fractures.

You might have a Dermatologist after an accident with inner bleeding............:jap:

Edited May 3, 2011 by sirchai

[jimbeam1]

Thailand is in dire need of good Doctors, full stop.

jb1

[ScubaBuddha]

Thailand is in dire need of good Doctors, full stop.

jb1

Yes. It was just a couple years ago when they were saying that there were not enough doctors to staff the government hospitals here in Phuket. And media reports about not enough nurses is constant.

[rreddin]

Thailand is in dire need of good Doctors, full stop.

jb1

Yes. It was just a couple years ago when they were saying that there were not enough doctors to staff the government hospitals here in Phuket. And media reports about not enough nurses is constant.

My daughter is a newly qualified doctor in the UK. She must work in a government hospital for a period of time (I think it is a couple years) before she can choose to work either in the private sector, continue working in government hospitals or go into general practice. There is a system in place that allows medical school graduates to express a preference of where they would like to work, but which also ensures that the whole country is adequately provided with doctors. That means some people do not get to work in their preferred location. A similar system might be helpful here.

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Bt10 billion on 16,500 new medical staff

The government will spend more than Bt10 billion on training at least 16,500 medical workers within 10 years, expecting them to work in remote areas to provide medical services to local people.

The plan is expected to mean people in remote areas nationwide will no longer have to travel far from home to receive medical treatment at hospitals in cities.

The Cabinet Wednesday gave the green light to the Public Health Ministry to go ahead with the plan, which will send 16,500 new physicians, nurses and dentists to 9,750 hospitals across the country.

-- The Nation 2011-05-04

[Bagwan]

So each hospital will get 1.7 new staff members. They may be, or not, physicians, dentists or nurses. Yeah, that 'll solve the problem.

[Bagwan]

So each hospital will get 1.7 new staff members. They may be, or not, physicians, dentists or nurses. Yeah, that 'll solve the problem.

[lannarebirth]

My best friend here in Thailand is a Thai doctor. He's got a really good gig for himself and earns 400-500k/ mo working for a foreign based company. According to him, from conversations we had months ago, the reason Thai doctors will not go to rural areas is that there are no schools for their children to go to. They would certainly not send their kids to the "local" school. Some might wish for "better" Thai schools or International schools like my frind paid for for 13 years. Anyhow, improve the education system locally and you'll get better doctors.

[MaiChai]

K. Puttaraksa has a very different outlook on life to most middle class Thais, who just want to get rich. Also the system here means that if you are poor and train as a doctor, chances are you have some quite large debts incurred as a student that need to be paid off when you start working. Thailand doesn't have much of a welfare system, so the reality is that health care professions can charge more in urban areas than in rural areas, simply because urban people have more disposable income. Thus in Thailand it always comes down to money. Pretty much for everything.