Rural hospitals face doctor shortage

Losing half the extra pay for heavy workloads at remote rural hospitals, doctors likely to move back to lighter workloads in city provincial hospitals.

An 80-bed local community hospital in the far-south.

Click button to listen to Doctor Shortage download

About healthcare

Local hospitals face doctor shortage

4 Apr 2013
Paritta Wangkiat

A small community hospital in a remote rural area.

Resignations by rural physicians protesting a cut in their hardship allowance will see the workload of remaining personal increase to the extent that they too might eventually quit their rural hospitals, the Rural Doctor Society warned on Thursday.

Community hospitals face being hit the hardest because doctors will be tempted to transfer to provincial hospitals where they sacrifice the minimal hardship allowance for an easier workload, according to Wattana Parisri, director of Somdej Phraupharajthabo Hospital and a member of the society.

Research by the National Health Security Office last year revealed there were 3,425 rural doctors stationed at community hospitals and 8,737 stationed at provincial hospitals.

The survey showed doctors in community hospitals averaged 48 patients each month while doctors in provincial hospitals took care of 26 patients monthly.

Mr Wattana emphasised that being short of just one doctor at the moment had yet to cause major problems for community hospitals, but the longer the government's policy to cut the hardship allowance is enforced, the more doctors will abandon the rural health system.

When they graduate, doctors are required to fulfil some years of commitment to rural hospitals to pay for their government education funding, he said.

Mr Wattana said new graduates, however, were just as likely to leave because of the workload and the desire to get better opportunities in more advanced hospitals.

A total of 146 doctors resigned in February and March. The Rural Doctor Society claimed that they were motivated to quit because of the Ministry of Public Health’s new policy on hardship allowances.

The original hardship allowance was based on each doctor's degree of isolation and working conditions. But since Monday, it has been replaced with a performance-related pay system.

Under the scheme many doctors will have their hardship allowances cut by half, with the rest paid according to their performance.

(Source: Bangkok Post, About healthcare, Local hospitals face doctor shortage, 4 Apr 2013, Paritta Wangkiat, link) 

 
Doctor Shortage Vocabulary

shortage - when there is not enough of something การขาดแคลน
a doctor shortage
local hospitals face doctor shortage

rural - in the countryside (farms, forests), not the city  ในชนบท, บ้านนอก
physicians - Same as "doctor"
rural physicians

hospitals in Thailand - (See Wikipedia & List)

local community hospitals - hospitals in a small town or village without less than 150 beds providing primary care only (See Wikipedia)
provincial hospitals - hospitals in the capital or main city of a province

primary care - the first level of healthcare where the sick person sees a doctor or nurse, then if they need to see a specialist they are sent to a secondary care provider (See Wikipedia)

resignations - when someone quits their job
resignations by rural physicians

hardship - when life is difficult and unpleasant (usually due to a lack of money)
allowance - an amount of money that someone receives in order to pay for the things that they need เงินสนับสนุน, เบี้ยเลี้ยง
hardship allowance

a cut in their hardship allowance
protesting a cut in their hardship allowance

remaining - still there, still exist (have not left)
personal - people working for a company or organization
remaining personal - the workers still working for the organization (have not quit and left yet)

workload - the amount of work that a worker must do each day ปริมาณงานที่คนหรือเครื่องจักรทำได้ระยะเวลาหนึ่ง
the workload of remaining personal

the workload of remaining personal may increase to the extent that they too might eventually quit their rural hospitals

extent - size ขนาด
to the extent that ... - creating such a big effect that ......

eventually - at the end of a period of time or at the end of a process ในที่สุด
they too might eventually quit their rural hospitals

Resignations by rural physicians protesting a cut in their hardship allowance will see the workload of remaining personal increase to the extent that they too might eventually quit their rural hospitals, the Rural Doctor Society warned on Thursday.

transfer - to move someone or something from one place, vehicle, person or group to another ย้าย
transfer to provincial hospitals

tempted - to feel like you want to do something
tempted to transfer - to feel like you want to move to a different hospital
tempted to transfer to provincial hospitals

minimal - the smallest possible amount น้อยที่สุด, น้อยมาก
minimal hardship allowance

workload - the amount of work you have to do in your job
easier workload

sacrifice - important or valuable things given up, so that you or other people can have or do something else ความเสียสละเพื่อส่วนรวม give up something you want เสียสละ
sacrifice the minimal hardship allowance for an easier workload

at provincial hospitals doctors sacrifice the minimal hardship allowance for an easier workload

Community hospitals face being hit the hardest because doctors will be tempted to transfer to provincial hospitals where they sacrifice the minimal hardship allowance for an easier workload, according to Wattana Parisri, director of Somdej Phraupharajthabo Hospital and a member of the society.

revealed - made known or showed somthing that was surprising or that was previously secret เปิดเผย
research revealed

community - local people, all the people who live in a local area or place ชุมชน
community hospitals

stationed - to be assigned to a place to work (in the army or government service)
rural doctors stationed at community hospitals

Research by the National Health Security Office last year revealed there were 3,425 rural doctors stationed at community hospitals and 8,737 stationed at provincial hospitals.

survey - gathering information about what people think about different subjects (public opinion) by asking large numbers of people questions and counting their answers, and then using statistics, graphs, and tables to present results (See Wikipedia) การสำรวจความเห็น

The survey showed doctors in community hospitals averaged 48 patients each month while doctors in provincial hospitals took care of 26 patients monthly.

being short of ... - not having enough of ...., having a shortage of...
being short of doctors

being short of many doctors
being short of just one doctor

moment - a very short period of time; a particular time or occasionชั่วขณะ, โอกาสสำคัญ
at the moment - now, right now

policy - a plan of action to guide decisions and achieve outcomes นโยบาย (See Wikipedia)
the government's policy

abandon - to leave a place permanently, especially because it is difficult or dangerous to stay there ละทิ้ง
doctors will abandon the rural health system

Mr Wattana emphasised that being short of just one doctor at the moment had yet to cause major problems for community hospitals, but the longer the government's policy to cut the hardship allowance is enforced, the more doctors will abandon the rural health system.

commitment - a promise to do something in the future ข้อสัญญา  requirement; something that you must do ข้อผูกมัด,  ความรับผิดชอบ
fulfil a commitment - do what you promised to do

funding - money given for a particular purpose การให้เงินสนับสนุน
education funding - money given to someone for education
a doctor's government education funding

When they graduate, doctors are required to fulfil some years of commitment to rural hospitals to pay for their government education funding, he said.

opportunities - a situation where it is possible to do something that you want to do

Mr Wattana said new graduates, however, were just as likely to leave because of the workload and the desire to get better opportunities in more advanced hospitals.

motivated - done for a particular reason มีแรงจูงใจ ถูกโน้มน้าวใจ
motivated to quit

A total of 146 doctors resigned in February and March. The Rural Doctor Society claimed that they were motivated to quit because of the Ministry of Public Health’s new policy on hardship allowances .

working conditions - the work situation

isolation - the state of being separated form other people (living in a place far away from cities and people)
degree of isolation - how far away from cities and where people live
a doctor's degree of isolation 

performance - how well or badly something works (or whether an investment provides a reasonable return)
a performance-related pay system.

The original hardship allowance was based on each doctor's degree of isolation and working conditions. But since Monday, it has been replaced with a performance-related pay system.

scheme - a plan that is developed by a government or large organisation in order to provide a particular service for people แผนการ โครงการ

Under the scheme many doctors will have their hardship allowances cut by half, with the rest paid according to their performance.