Motivating public hospital doctors

On August 23, when working with the Supervisory Delegation of the Provincial National Assembly Delegation, the leaders of Nghe An General Hospital proposed that the province and the Central Government have a special mechanism so that the hospital can soon become a special class.

Specifically, Mr. Nguyen Van Huong - Director of Nghe An General Friendship Hospital proposed: "In the process of building the North Central Region Hospital, to complete the organizational structure and better meet the needs of medical examination and treatment of the people. Nghe An General Friendship Hospital would like to receive the consent of Nghe An Provincial People's Committee and departments, branches and sectors to allow the hospital to establish a Nuclear Medicine Oncology Department. At the same time, the province and the Department of Health need to create the best conditions for the unit when it becomes a Group I autonomous unit. Support the hospital in the work of health insurance settlement, have a special mechanism to build a Hospital worthy of a regional hospital and soon become a special-class Hospital".

Previously, on March 25, 2021, Nghe An General Friendship Hospital was recognized by the Minister of Health and assigned the task of being the final line of technical expertise in medical examination and treatment in the North Central region in Decision No. 1670/QD-BYT. Along with that, Nghe An General Friendship Hospital is a satellite unit of many central hospitals. And it can be affirmed that this is still the best specialized medical examination and treatment facility in Nghe An today.

So what is a special class hospital? What conditions must be met?

A special-class hospital, simply and generally understood, must meet “hard” criteria such as: Having a long tradition, meeting the criteria on the scale of hospital beds, the number of departments, rooms, and centers; a team of highly qualified doctors, nurses, and medical staff with specialized skills; being a medical facility that implements well, masters high technical requirements in medicine. To date, the country has 6 medical facilities recognized as special-class hospitals, including: Bach Mai Hospital, Viet Duc Hospital, Cho Ray Hospital, Hue Central Hospital, Military Hospital 108, and Thai Nguyen Central Hospital.

The desire to become a special-class hospital of the leaders of the Provincial General Friendship Hospital is correct, standard, and in line with the trend. But before that becomes a reality, it is necessary to pay special attention to the team of doctors, nurses, and medical staff. Why do we say this? Because for a long time, not only in Nghe An but also in the whole country, there has been an increasing number of doctors, medical staff with good skills, expertise, and experienced medical staff transferring from the public sector to private medical facilities.

At the 7th Session of the 18th Nghe An Provincial People's Council, term 2021-2026, Mr. Duong Dinh Chinh - Director of the Provincial Department of Health expressed his concern when he said that from 2021 to now, Nghe An has had 119 medical staff resigning, of which nearly half are doctors. The first reason is due to the treatment regime. The Director of the Provincial Department of Health also said that Decree 56 of the Government on special regimes for medical staff after 10 years of implementation is no longer suitable. Meanwhile, the price of medical services at public medical facilities does not meet the requirements of practice. Therefore, the policies and treatment regimes of public hospitals for doctors and medical staff are too low. The example given by the head of the Nghe An Health sector is that a newly graduated doctor working at a provincial public hospital earns only 5-7 million VND/month. Meanwhile, private hospitals pay from 15-20 million VND/month. For resident doctors, right after graduation, public hospitals pay from 15-20 million VND/month, while private hospitals pay from 70-100 million VND/month.

We always give doctors beautiful words such as: medical ethics, good doctor, good mother. Yes! Regardless of the era, stage of development, those moral values ​​do not change, and are honored by the whole society. However, there is also a folk saying that is summarized as a category of philosophy, that: "Only with food can one uphold morality". Society cannot demand that a doctor always uphold medical ethics, work wholeheartedly, make constant contributions, and be creative if they are not paid appropriately. To become a doctor, the first prerequisite is that the person must be a good student, have a good starting point in specialized subjects, and must undergo 7 years of university training, then spend a few years studying specialties, majors, or residency. It takes a doctor 10 years of training to practice his profession. And it seems that this is what makes many doctors after graduation both want to demonstrate their abilities and want to have an income opportunity to make up for the hard time before. But public hospitals do not easily help them satisfy both of those needs. Especially with the salary and income regime. Not long ago, a young doctor working at a state medical facility shared with the author that at the hospital, the doctors' night shift pay "is only calculated in tens, not hundreds". The salary and other income of doctors compared to the general level in the hospital seem high, but in fact compared to society it is nothing.

“But why are doctors so rich?” – many people ask. It’s because they work both inside and outside. They open private clinics or participate in the activities of private hospitals and clinics after finishing their work at the office. Many doctors even devote more energy to private medical facilities than to the place where they officially work. That’s a fact!

An ophthalmologist recently said that after 10 years working for the number one provincial hospital, he transferred to a private hospital in Ha Tinh. The reason? All for income. Working outside, he receives about 50 million VND per month, and in his free time, he also increases his income from his personal clinic. Meanwhile, as this doctor said: In our state hospital, there is no "room to perform", sometimes colleagues compete with each other for minor surgeries and procedures. A few envelopes from patients can easily give rise to bad habits.

Nghe An is considered the central province of the North Central region. The province has also been identified by the Central Government to focus on investment, construction, and planning to become the medical center of the region. In fact, if not counting the number of public hospitals and medical facilities, Nghe An currently has 16 private hospitals. In addition, there are many clinics, examination and treatment facilities established by doctors. This is indeed a very good thing for the people. Patients have many opportunities to choose medical facilities that suit their conditions for examination and treatment. However, most patients, especially poor patients, really want to be treated and examined at public hospitals because they are covered by health insurance. However, people are also worried about a paradox, which is that medical services at state hospitals are currently of low quality, while there are still many rumors surrounding prescriptions, prescriptions, envelopes, and red envelopes. In addition, patients are also concerned that doctors are not motivated enough to give them the best care.


Image is for illustration purposes only. Source: Document