Thailand's Young Rural Doctors - Al Jazeera

[Craig krup]

Quite interesting documentary.

http://www.aljazeera.com/programmes/the-people-health/2015/12/health-thailand-remote-lifesavers-151209095649963.html

[gerryBScot]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

[Craig krup]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

The thing that shocked me was just how cheap it was for them to buy themselves out of the rural service - less than $12,000 (IIRC).

In the UK GPs - primary care physicians - get paid £125,000. If you expressed that in baht (over 6.5 million), and told a Thai doctor this was the pay, I doubt they'd believe you.

[expatbrit]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

The thing that shocked me was just how cheap it was for them to buy themselves out of the rural service - less than $12,000 (IIRC).

In the UK GPs - primary care physicians - get paid £125,000. If you expressed that in baht (over 6.5 million), and told a Thai doctor this was the pay, I doubt they'd believe you.

Compare and contrast the training/education of UK GP's with that required of a Thai rural doctor !

(A minimum of 10 years training/education in the UK ! )

I hate to think about where that "fairy tale" £125,000 pay story comes from ! The very different reality can be found in the link

http://bma.org.uk/support-at-work/pay-fees-allowances/pay-scales/general-practitioners-pay

[Craig krup]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

The thing that shocked me was just how cheap it was for them to buy themselves out of the rural service - less than $12,000 (IIRC).

In the UK GPs - primary care physicians - get paid £125,000. If you expressed that in baht (over 6.5 million), and told a Thai doctor this was the pay, I doubt they'd believe you.

Compare and contrast the training/education of UK GP's with that required of a Thai rural doctor !

(A minimum of 10 years training/education in the UK ! )

I hate to think about where that "fairy tale" £125,000 pay story comes from ! The very different reality can be found in the link

http://bma.org.uk/support-at-work/pay-fees-allowances/pay-scales/general-practitioners-pay

1) I'm afraid you've confused average GPs with salaried GPs. There are very few salaried GPs, just as there are very few salaried dentists. GPs are clearing six figures - it isn't turnover we're talking about - and they're the most highly paid doctors in Europe. Distrust BMA (ie trade union) figures.

http://www.theguardian.com/money/blog/2011/may/28/gps-underpaid

2) Not all GPs in the UK are trained in the UK.

3) Besides, many people will tell you that the standards of kids trained in problem based learning systems - the norm in UK universities now - are nothing to write home about.

[aussiandrew]

Thank you for the link what a wonderful story to watch I nearly teared up a couple of time. Well done to all involved we could all learn from this story.

[Craig krup]

Thank you for the link what a wonderful story to watch I nearly teared up a couple of time. Well done to all involved we could all learn from this story.

Some of them are pretty amazing. Talk's cheap, but when you could earn three times what you're earning, with less aggravation, it says something if you troop on. The government's pretty cute as well. "If we make you do it for three years a big slice of you (75%, I think) will become so embedded in the community, and so sympathetic to the locals, that you won't actually quit when you could".

Edited December 11, 2015 by Craig krup

[cumgranosalum]

For those who speak in glowing terms of the healthcare system in Thailand, this is a great insight into the standards of training etc...

[cumgranosalum]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

The thing that shocked me was just how cheap it was for them to buy themselves out of the rural service - less than $12,000 (IIRC).

In the UK GPs - primary care physicians - get paid £125,000. If you expressed that in baht (over 6.5 million), and told a Thai doctor this was the pay, I doubt they'd believe you.

Compare and contrast the training/education of UK GP's with that required of a Thai rural doctor !

(A minimum of 10 years training/education in the UK ! )

I hate to think about where that "fairy tale" £125,000 pay story comes from ! The very different reality can be found in the link

http://bma.org.uk/support-at-work/pay-fees-allowances/pay-scales/general-practitioners-pay

1) I'm afraid you've confused average GPs with salaried GPs. There are very few salaried GPs, just as there are very few salaried dentists. GPs are clearing six figures - it isn't turnover we're talking about - and they're the most highly paid doctors in Europe. Distrust BMA (ie trade union) figures.

http://www.theguardian.com/money/blog/2011/may/28/gps-underpaid

2) Not all GPs in the UK are trained in the UK.

3) Besides, many people will tell you that the standards of kids trained in problem based learning systems - the norm in UK universities now - are nothing to write home about.

UK is more open than most to foreign doctors...that's why so many from Germany and EU are keen to finish their training there. Also if you want to practice you have to take various examinations etc to bring you into line with UK standards.

All doctors work for the NHS at some point. In Thailand after a short period, they can go off on their own...usually into the more lucrative and easy areas like cosmetic surgery.

[cumgranosalum]

...as the show points out, the "front line in Thailand is largely paramedics and nurses and then doctors who have to make phone calls in order to continue the treatment

[georgemandm]

It was great thanks I love it and to see some good things in thailand

[Bigstef]

Thanks for sharing that documentary, we can see there good peoples in LOS

[Bob12345]

Nice documentary, well worth watching!

Let me state that i have experienced this from up close as my wife has done her time upcountry after graduation and a lot of aspects she (and we) experienced during this time are brought forth nicely (totally uneducated patients, living in a village without even a supermarket, etc).

Some comments based on the posts above and things not mentioned in the documentary:

A ) while I believe it is a good system that young doctors pay back for their education by serving the community you should ask yourself why this is necessary. Why are these rural hospitals not able to attract qualified staff full-time? If you sign up for a more remote area you get a monthly bonus of 10-20K over working in a bigger city, but it seems that is not enough to attract enough doctors. This method seems like a temporary solution to overcome a more structural problem, but I am unable to figure out what the more permanent solution is that should be underway by now (they started this program 40 years ago?).

B ) as someone else also mentioned, the payment to "pay-off" your community service time is relatively small (about 400K). The difference in salary between being a government employee and working for a private hospital means you can earn this back within a year. Two comments on that:

1. It seems rather unfair as 400K is nothing for an urban middle class family while poorer families can never pay this themselves. It is like you could pay-off military service legally which only benefits the richer families.

2. Why is there such a huge pay gap between government doctors and private hospital doctors? Work in a private hospital is much less stressful, easier, more comfortable, you get more holidays, etc and on top of that, you easily earn 50% more than what government employees earn. The trend is by the way that the gap increases; in the past the family of government doctors' were entitled to more and better healthcare for free, but not anymore. It should be a worrying trend as private hospitals can now easily "steal away" the better doctors Thailand has to offer. Of course i know the answer why the gap is so large, but I am trying to make a point that this gap should become smaller to serve the general population better.

C ) I doubt the retention rates at government hospitals are much better with this program. Loads of my wife's friends are still working for government hospitals but the most often heard motivation for that is that they want to work close to their family home (in the same province as where their parent live) or want to give back to the local community. In either case they would have applied for a government hospital already.

Edited December 12, 2015 by Bob12345

[sawadee1947]

Craig thanks for this link. I've just had a shufti and what is so striking from the first few minutes is here is a genuine report about something in Thailand which is working really well and for which Thailand should be applauded. Good news like this has been in short supply in this country in recent years.

The thing that shocked me was just how cheap it was for them to buy themselves out of the rural service - less than $12,000 (IIRC).

In the UK GPs - primary care physicians - get paid £125,000. If you expressed that in baht (over 6.5 million), and told a Thai doctor this was the pay, I doubt they'd believe you.

Compare and contrast the training/education of UK GP's with that required of a Thai rural doctor !

(A minimum of 10 years training/education in the UK ! )

I hate to think about where that "fairy tale" £125,000 pay story comes from ! The very different reality can be found in the link

http://bma.org.uk/support-at-work/pay-fees-allowances/pay-scales/general-practitioners-pay

(A minimum of 10 years training/education in the UK ! )

How that?????

[thailanddogerator]

What is their salary when working to refund their studies ?

[Bob12345]

What is their salary when working to refund their studies ?

It depends on several factors:

- the more remotely you work the more money you get (further away from Bangkok or from another big city)

- if it is an area with special risks (bonus if you work in one of the three most Southern provinces)

- monthly bonus if you do not open your own clinic

- the number of hours you work (which depends on how much you want to work and how many doctors the hospital has)

- the shifts you do (afternoon shift pays much better as the doctor receives a doctor's fee of about 100 baht per patient; morning shift is when the 30-baht patients come)

- the diseases the patients have (that sounds funny, but when you handle an emergency case you get more more money then when you prescribe someone some couching tablets)

But in total a doctor working in a small city doing a normal number of shifts (normal for a doctor, so over 60 hours per week) earns about 100K per month.

[tebee]

My step-son is about to start his rural doctors term in May. Yes we had the cash to buy him out, but we think it is not only a small price to pay in return for his training, but excellent experience that will help him on his way.

I think we are going to have to buy him out after one year though - he already has a European residence card which he will lose if he works outside the EU for too long.

He's probably going to return with me to the UK were we will get him a job with the good old NHS.

A GP in the UK will have done at least 10 years training - 5 years at medical school , 2 foundation years as a junior doctor, then 3 years speciality training . But it's hard stressful work there if you are in one of the big practices and earning towards the top end of salary band. My GP in rural France on the other hand, did 11 years training, but only has to see about 25 patients per day for 4 1/2 days a week but only earns about £38,000 per year.

[Bob12345]

My step-son is about to start his rural doctors term in May. Yes we had the cash to buy him out, but we think it is not only a small price to pay in return for his training, but excellent experience that will help him on his way.

The first year is in a bigger hospital which can bring a lot of experience as interesting cases can be referred there. The smaller the hospitals become in the 2nd and 3rd year the less interesting the cases and the less he will learn. In smaller hospitals you either prescribe some tablets or refer the patient to a hospital with specialists or expensive equipment, neither is interesting to do.

(thats my view at least, some doctors might prefer the more boring illnesses)