Society must help doctors to improve their quality of life

What are the main reasons hospital doctors, especially in rural areas, resign from their jobs?

Thailand has been facing this problem for more than 30 years and has not been able to resolve it. Nowadays we have 30,000 doctors across the country but only 3,000 work at 700 rural hospitals. It is not enough to provide healthcare to people, particularly poor people.

But we have to understand the nature of medical professionals. After they graduate from medical school, all doctors have to work at state hospitals in rural areas as a social service to contribute their skills and knowledge and to pay for their education by working in the public sector for three years. Each was subsidised to the tune of Bt1.8 million for six years. This is why they have to recompense the taxpayer and the government. If not, they have to pay Bt400,000 in compensation to the medical school.

But due to the low compensation penalty, which was first imposed in 1973, plus their heavy workload and low salary at public hospitals, most doctors prefer to pay the penalty and work at private hospitals on a higher salary. At private hospitals, they don't have to shoulder the risk of being sued for an unprecedented medical error. They can improve their quality of life by working in a big hospital in an urban area.

Do you think that doctors who quit the public sector before the end of the three-year period are failing to devote themselves to working for the public?

It is not correct to claim they do not have morals. We should look at other factors, such as the way doctors live and work in rural areas, and take a holistic approach to resolve this problem. Society expects doctors to devote themselves to working for the public but at the same time society must give something to them which improves their quality of life. It does not mean doctors have to eat salt instead rice.

What is the way to resolve this problem?

The National Health Office is now drafting a 10-year-plan to promote human resources. The plan comprises five strategies: building and developing a policy to produce manpower, changing the approach to producing manpower so that it responds to the needs of the country, ensuring human resources are adequately distributed across the country, building and managing knowledge to develop manpower in an effective way, and promoting and developing Thai wisdom and the role of the community in looking after the health of local people.

This is the overview plan but the government and society should consider increasing payments to doctors in state hospitals, especially in rural areas, to help them to live with dignity.

Additionally, the Medical Council should issue a licence which permits doctors to work in their hometown for only five or 10 years, depending on the needs of people in that area. I think this measure could push doctors to work in rural areas.

However, we should consider alternative ways to resolve this problem.

How do you encourage doctors to work in state hospitals in rural areas?

Doctors learn from treating patients in state hospitals while they are at medical school. So it is their responsibility and promise to recompense society.