Rural Thai Hospitals At A Loss As Doctors Quit Over P4P

[webfact]

Rural hospitals at a loss as doctors quit over P4P
PONGPHON SARNSAMAK
THE NATION



BANGKOK: -- The mass resignation of doctors and specialists in protest over the new pay-for-performance (P4P) scheme is causing chaos in many rural hospitals.

According to the P4P scheme, a doctor's salary and additional allowance are calculated according to the number of patients they see.

Since the Public Health Ministry initiated its plan to implement the P4P scheme on April 1, up to 148 doctors have quit rural hospitals. Some have moved to state hospitals in town, private hospitals or beauty clinics.

Yala's Raman Hospital is one of the many that have put the P4P scheme in place, and appears to be suffering badly from it. So far, one specialist has asked hospital director Dr Rosalee Pattayabut for a transfer, which would leave the hospital with no obstetrician to provide treatment for pregnancy, childbirth and reproductive health.

"I'm wondering if I should let this obstetrician go or ask her to stay. If she moves, local people will have to travel 26 kilometres from Raman to seek obstetric care in town," Rosalee said.

Previously, doctors and medical staff were paid additional allowances based on remoteness and the number of years in their job. This method was meant to retain medical workers in rural and remote areas where doctors are in short supply.

The P4P scheme, on the other hand, is aimed at improving medical workers' efficiency at state hospitals nationwide. Unfortunately, it is making doctors in remote areas unsure about how much work they need to do to be eligible for the same amount of extra wages they were previously being paid.

"It's difficult to find a specialist who is willing to work in a restive area. We were lucky to have an obstetrician to provide care for pregnant women, but now we've lost her," Rosalee said.

The 60-bed Raman Hospital only eight has doctors now to serve 300 to 400 patients per day, over and above having to visit villages to provide primary care and health-promotion services.

Ever since the obstetrician submitted her request, other doctors appeared to be disheartened and have gone on leave.

"I promised to do what I can to protect them," Rosalee said.

He is the only doctor on duty at the hospital for the time being.

Roi-Et's 60-bed Selaphum Hospital is facing a similar problem, as doctors are seeking to quit and move to work in town-based hospitals.

"Some said they wanted to move because they were no longer motivated to work at a rural hospital," Selaphum Hospital director Upathin Runguthaisiri said. The hospital only has seven general physicians and two specialists to treat up to 400 patients daily.

Rural hospitals are the key healthcare unit to screen patients before they are referred to provincial hospitals. Hence retaining medical workers is necessary, and to do that they need to be paid an additional allowance.

The number of rural doctors willing to give up their jobs is on the rise, leaving some hospitals with just two doctors on duty.


-- The Nation 2013-04-05

[Buchholz]

.

Yingluck's administration championing the cause of the rural poor.

Provoke their doctors to leave them.

.

[Bobobirdiebuddy]

What absolute idiocy by Yingluck's government. This was 100% predictable as rural doctors already carry huge work loads and work under very trying conditions. Let's hope the Red Shirts in the countryside see what Thaksin's minions are really up to - using the rural poor to get into office so Phua Thai officials can have access to the cookie jar. Someone is making money on this, somewhere. It's a shame it's not the health care professionals who sacrifice so much for Thailand.

[hellodolly]

Two things predictable

1 Doctors leaving rural hospitals

2 PTs lack of concern for the poor

[jonclark]

What absolute idiocy by Yingluck's government. This was 100% predictable as rural doctors already carry huge work loads and work under very trying conditions. Let's hope the Red Shirts in the countryside see what Thaksin's minions are really up to - using the rural poor to get into office so Phua Thai officials can have access to the cookie jar. Someone is making money on this, somewhere. It's a shame it's not the health care professionals who sacrifice so much for Thailand.

The Red shirts won't worry - They just call the doctors 'elites etc.etc. followed by propaganda, about how doctors are democrat voters and their actions are seeking to undermine the fantastic PTP government.... its all a plot by an invisible hand' and it will be business as usual.

[LuckyLew]

well done Yingluck and friends .... way to look out for what is best for all the citizens of Thailand

[slapout]

The one thing I have noticed with this government is consistency, no matter what the project, intent, nor method, the public comes out on the short end.

[Locationthailand]

Hardly news and totally predictable. Another 'fail' to PTP - mindless morons dancing to the tune of a nefarious conman criminal puppet master.

[Mario2008]

Not many doctors are willing to work in remote rural areas. I have seen a hospital where they only have 2 doctors, they change every year as they don't want to stay. Just doing their tour of duty after having graduated. It means people don't get expert care. If even less doctors want to work in rural areas, the results will be felt all over the country.

Some hospitals are the only care and have a lot of hill tribe and refugees in their area and these hospitals are a first line of defense. Less or substandard care heightens the risk for diseases such as malaria and tuberculosis. Untreated that will spread all over the country.

[Jonathanukthai]

What absolute idiocy by Yingluck's government. This was 100% predictable as rural doctors already carry huge work loads and work under very trying conditions. Let's hope the Red Shirts in the countryside see what Thaksin's minions are really up to - using the rural poor to get into office so Phua Thai officials can have access to the cookie jar. Someone is making money on this, somewhere. It's a shame it's not the health care professionals who sacrifice so much for Thailand.

The Red shirts won't worry - They just call the doctors 'elites etc.etc. followed by propaganda, about how doctors are democrat voters and their actions are seeking to undermine the fantastic PTP government.... its all a plot by an invisible hand' and it will be business as usual.

It is the pore rural red sheets that will suffer the most. If they are happy suffering let them suffer, they can keep on voting red. Silly ignorant people, this is my problem with democracy in uneducated countries, it can be very harmful, i think Political science and economics should me taught from the age of three.

[Asiantravel]

a bit of a difference though arguing about 70,000 baht, compared to £700,000 salaries in England..........!!

“ A Sunday Telegraph investigation found that some doctors were earning a staggering £15,000, a figure that works out as an annual salary of more than £700,000. “

http://www.dailymail.co.uk/news/article-2305272/Trainee-doctors-paid-2-000-A-DAY-NHS-control-agency-payments-scandal.html

[thhMan]

All Thailand's issues can be resolved in the same method...

PVP for all Government Officials.... Problem solved !

[GentlemanJim]

I think Thaksin has been talking too much to the chap next door in Cambodia. Many people on here have already identified Thaksins desire to become President and the use of the 'Red Army' being akin to the initial tactics of the khmer. Now we have the situation where Thaksin can turn the poor against the educated and 'elite'. "This is what the dems and the elite do to the poor", will be all over red radio from morning to night. The poor 'reds' will despise the Doctors, and who will Thaksin set up next?....Teachers? Under Pol Pot who did the masses of uneducated murder first during their 'revolution'.......Doctors and Teachers. The move with the Doctors seems an innocent miscalculation by the Government, but when you put it in with everything else Thaksin is doing in the holistic view, it is all painting a very sinister 'big picture'.

[Mosha]

Not many doctors are willing to work in remote rural areas. I have seen a hospital where they only have 2 doctors, they change every year as they don't want to stay. Just doing their tour of duty after having graduated. It means people don't get expert care. If even less doctors want to work in rural areas, the results will be felt all over the country.

Some hospitals are the only care and have a lot of hill tribe and refugees in their area and these hospitals are a first line of defense. Less or substandard care heightens the risk for diseases such as malaria and tuberculosis. Untreated that will spread all over the country.

The doctors we get are fresh out of training. For anything serious, people go into Ranong.