Dr Napasorn "Puimek" Weerayuttvilai is known as an actress and singer, as well as an intern medical doctor at Rajburi Hospital. Earlier this month, after she shared on social media her decision to resign from the hospital, the issue of a shortage of doctors in Thailand became the talk of the town.
In her post, Dr Napasorn mentioned previous news about many intern doctors in state hospitals quitting their jobs. She wrote that working in a state hospital was extremely tough. Although she was able to cope, it took a lot out of her. It drained her both physically and mentally.
On the day she resigned, she was on duty for an overnight shift and had been on ward round duty since morning. Over 40 patients lying on extra beds were lined up all the way from outside the ward to the elevator. She was on duty by herself and felt exhausted. In the morning, a colleague arrived at 10am and questioned why she had not finished the ward rounds, urging her to work faster. That incident made her decide to quit.
Dr Napasorn wrote that there is no light at the end of the tunnel, only darkness. Both intern and staff doctors have always been overloaded with work and there seems to be no solution to the doctor shortage. Her hospital budget had been cut, making it impossible to hire more staff. Instead, the number of staff has been decreasing every year.
In the end, Dr Napasorn deleted the post. She explained that she did not want other doctors to get in trouble since they had been kind to her. She concluded that there are problems with hospital operational systems and that healthcare professionals are overworked and exhausted.
Most of Dr Napasorn's followers on social media supported her and sent her warm messages. Many healthcare professionals who already quit their jobs at state hospitals also shared their stories.
From many of the comments on social media, not only doctors but also other healthcare professionals suffer from working long hours. Besides being tired due to overworking, many of them were upset that their salaries were delayed for three to six months. State housing for doctors in rural areas is also in a poor condition. A few comments mentioned that the houses they lived in were deteriorating to the extent that snakes could enter. Another post shared a personal experience that her room was old and not functional, with the bed obstructing the entrance as soon as the door was opened.
While many people felt sorry to learn about the poor working conditions of healthcare professionals, others have different opinions. They criticised Dr Napasorn and other interns who quit their jobs for lacking the values and principles necessary for being good doctors. They believe that doctors should dedicate themselves to helping patients rather than be concerned about money -- doctors already have comfortable lives compared to other careers that require hard work.
In Thailand, doctors who graduate from public universities are required to work in state hospitals for three years to pay back their educational expenses. This policy is implemented to compensate for the support that the government provides medical students. If intern doctors want to resign from state hospitals before completing the three-year requirement, they are obligated to pay 400,000 baht as compensation. To retain doctors in state hospitals, some people suggest extending the work period for new graduates.
In response to criticism regarding the shortage of doctors, last Tuesday, Dr Taweesin Visanuyothin, deputy permanent secretary of the Public Health Ministry, held a press conference to address the issue. He admitted that in addition to the shortage of doctors, there is also a shortage of other healthcare professionals. However, Dr Taweesin denied recent news of the resignation of 900 interns from state hospitals. He stated that an average of 455 doctors resigned per year between 2013 to 2022.
Dr Taweesin revealed that within the Public Health Ministry system, there are approximately 50,000 to 60,000 medical doctors. However, only 24,649, or 48%, of the total doctors work with the Public Health Ministry. As a result, these doctors have to handle a population of 45 million people under the national health insurance system. This results in a doctor-to-population ratio of 1:2,000 in Thailand, while the world standard is 3:1,000.
The Public Health Ministry also found that among 117 hospitals, doctors in more than 65 hospitals were overworked. Specifically, doctors in nine hospitals worked longer than 64 hours per week and doctors in four hospitals worked longer than 59 hours per week.
In collaboration with the Ministry of Public Health, the Ministry of Higher Education and Science, Research and Innovation plans to increase the number of graduating doctors to over 3,000 per year from 2018 to 2027. By the end of 2027, there will be an additional 30,000 doctors.
According to Dr Taweesin, a survey on doctors' preferences revealed they prioritised reducing their workload to achieve work-life balance. Compensation is a secondary concern.
The Public Health Ministry will focus on increasing recruitment and request the Office of the Civil Service Commission to increase the number of doctors recruited as permanent staff. Moreover, the Ministry of Public Health may consider accepting medical graduates from private universities and abroad as non-civil servant employees before later accepting them as civil servants.
The shortage of doctors has been a long-standing issue which is not easy to solve. I hope people will have better understanding and patience when encountering long queues at hospitals after they learn that doctors and other healthcare professionals are overloaded. I also hope that despite the fact that the country is in the period of the caretaker government, authorities will take the issue seriously and take action. Solving this issue will improve the quality of life for both doctors and patients.
Suwitcha Chaiyong is a feature writer for the Life section of the Bangkok Post