“Do we know the problems? We do, but there are these things called medical ethics and sacrifice that constrain us. If we don’t see the patients who are waiting, how is it going to work? If we can do it. If we can endure it, just endure it,” said Dr. Poowanai Sarkhampee, Hepato-pancreato-biliary Surgeon at Sunpasitthiprasong Hospital in Ubon Ratchathani, who shared his thoughts with Thai PBS World on the harsh working conditions of medical personnel in Thai state hospitals, which has become a hot topic on social media.
In state hospitals, doctors, interns and nurses alike have to endure long hours, sometimes working 24 hours in a row, just to make sure the patients get the medical attention they need. The unhealthy workload has led to the number of new medical personnel dwindling and these problems have existed for a long time.
Demand and supply
While qualified medical professionals are in short supply, the number of patients keeps rising. When the doctor-to-patient ratio becomes disproportional, the workload increases to the point that some people to just leave the profession altogether.
Dr. Poowanai explained the situation from his personal experience during his early years at a 10-bed community hospital, which served up to two hundred outpatients per day. The doctor would have only a few minutes to see each patient. This is on top of doing night shifts and inpatient rounds, among other things.
He said he does not think working these kinds of hours is right, but it is how the system has been so far, with severe understaffing in many hospitals.
It is not a surprise that medical personnel in Thailand are in short supply, given the harsh and unhealthy working conditions, not to mention the compensation packages for doctors at state facilities, which have remained unchanged for decades.
In their first year after graduation, fresh medical interns will be sent to provincial hospitals across the country. Dr. Poowanai said that’s the first time they face the real world, compared to studying in a training hospital, where they have army of experts and professionals providing support.
The harsh working conditions begin there, the first year of internship, and it’s ongoing unless they leave the system. This has led to fewer 2nd and 3rd year interns in rural area, before they can qualify to begin their medical specialty studies. Even then, after specialty graduation, they will loop back into the same working cycle “Because of the doctor shortage,” said Dr. Poowanai.
The surgeon said he has put up with the working conditions this long because being a surgeon was his childhood dream and he has a clear purpose and goal for what he wants to do. He understands, however, that a work-life balance is important, especially with the younger generation. “It is right that you have to be in good health before you can treat others, but a good work-life balance is difficult in our public health system,” he added.
