The exodus of 146 rural doctors to protest against the Public Health Ministry' s decision to cut their hardship allowance could increase further, doctors say.
There are currently 3,425 doctors working at rural community hospitals nationwide according to a recent survey by the National Health Security Office.
The survey found that each rural doctor was responsible for taking care of 48 patients a month.
The recent surge in resignations means the remaining doctors will have an increased workload, the survey found.
Some small hospitals would struggle to cope with the loss of only one doctor. The resulting increase in workload for those who stay could become unbearable, leading to still more resignations, observers fear.
Wattana Parisri, director of Somdej Phraupharajthabo Hospital in Nong Khai and a member of the Rural Doctors Society, said one doctor at his hospital resigned after the ministry cut the hardship allowance.
"I think the shortage of even one doctor today will result in several problems at the hospital, especially an increased workload for other rural doctors," Dr Wattana said.
Dr Wattana called on the Public Health Ministry to put the policy on hold. He feared many other rural doctors would leave state hospitals to find work in private health care.
The original hardship allowance was based on each doctor's degree of isolation and working conditions.
But the cabinet last week approved in principle a change allowing the ministry to implement a performance-related pay system. Under the new scheme, rural doctors will have their hardship allowances cut by half, with the rest paid according to their performance.
Dr Wattana said the shortage of specialists in rural areas is worrying. More of them might move to provincial hospitals which have hardship allowances similar to community hospitals but with much lighter workloads.
Recent graduates are required to commit to rural hospitals for three years to pay for government funding for their education.
But new graduates are more likely to resign due to heavy workloads and their desire to find better opportunities in more advanced hospitals, he said.
Vachira Bothpiboon, director of Chum Phuang district hospital in Nakhon Ratchasima, said the allowance cut would worsen workloads for community doctors. "We already have excessive workloads," he said.
Dr Vachira said his hospital also faces a staff shortage after one doctor resigned in January. The hospital now has six doctors treating a population of 65,000.
The remaining doctors are working extended hours to fill the gap. He said 24-hour shifts may have to scheduled to cover the weekends.
The hospital is also missing doctors who are busy with training sessions in other provinces, he added. Some doctors could not take leave to visit sick parents because of the shortage.
Public Health Minister Pradit Sintawanarong has insisted on implementing the new policy. He has said the performance-based scheme would encourage more doctors to stay in rural areas.
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- Writer: Paritta Wangkiat