What Hong Kong must do to stop the public hospital brain drain: let doctors and nurses feel human again
Recently there has been a lot of discussion about over a dozen cardiologists in public hospitals leaving the system for the private sector. In fact, the exodus of doctors and nurses is not a recent phenomenon, nor is it confined to any single speciality. Many neurologists, gastroenterologists, surgeons, obstetricians and gynaecologists are also leaving the public health care system.
Burnout among health care professionals in the public sector is a global phenomenon. My colleague in psychiatry tells me that, according to a recent survey he conducted, around 50 per cent of health care professionals in Hong Kong are at risk of burnout, and 10 per cent display symptoms of moderate depression. This problem is rooted in issues at both the personal and systemic levels.
The perfectionism of doctors and nurses, the culture of blame in medicine and the dehumanisation of the health care system are some crucial factors. Every year, more patients are attracted to public hospitals, with higher expectations. This magnifies the burden of health care providers to an unprecedented level, not to mention the fact that they are also under public scrutiny through the media.
In my view, the dehumanisation of our health care system is the most demoralising. We are trained to look after people, to care about their physical and psychological well-being. Yet, every day, we are spending most of our time entering data into computers, flipping through pages after pages of laboratory results and radiographs online, and scanning bar codes on patients’ wristbands and documents.
We hardly have the time to look at our patients and give them a warm smile. Today, we have all the “means” – potent drugs, endless diagnostic tests and sophisticated surgical equipment – but have lost the “meaning” of medicine.
I don’t think these issues can be resolved by just adding resources to the health care system, by simply raising the salary of doctors and nurses or by increasing the number of medical, nursing and pharmacy students, to make up for the loss. We have to help them find the “meaning” of their work. We have to restore the trust and rapport between doctors, nurses and their patients, and regain our respect for health care professionals.
Today, we are losing many of our young, sharp-minded and well-experienced professionals in the public sector. Our health care system needs to stop this brain drain. We have to give some “meaning” to their dedication by rebuilding a healthy organisation-physician relationship, in order to maintain the high standard of health care services in Hong Kong that we are so proud of.
Dr Joseph Sung, professor of medicine, Chinese University of Hong Kong