Medical workforce shortage in Thailand causes serious public health problems
Thailand is facing a serious shortage of medical personnel, including doctors, nurses and radiologists. Deputy Minister of Health Dr. Tavisin Visanuyuotin noted that the lack of staff affects all medical professions.
The public health system has 24,649 doctors, which is 48% of the total number of doctors in the country. They are responsible for providing medical care for approximately 75-80% of the population, and the ratio of doctors to the population is 1:2000, which is a rather high workload for specialists.
The total production capacity for the training of doctors in the public and private sectors is about 3,300 people per year. Of this total, one third is issued by the Ministry of Health. The distribution process includes a consortium committee responsible for making distribution decisions and involves several affiliated organizations.
A study of the Human Resources Reform Plan and Health Care Tasks conducted by the Ministry between 2018 and 2027 found that the system needs approximately 2,000 doctors annually. However, the distribution is only about 1800-1900 doctors. For example, in 2023, 2,759 graduates graduated, but only 1,960 of them were assigned to state medical institutions.
The remaining quota is given to various institutions such as the Ministry of Defense, 6 regional medical institutions and other government agencies. This distribution corresponds to the number of qualified doctors or interns who need to be trained in the 117 designated hospitals set by the Medical Council of Thailand. In 2022, this system was ready to accept only 3128 interns, but only 2150 were distributed, which is 68.7%.
High workload and long working hours of medical staff
In a survey conducted among healthcare facilities between November 15 and 30, 2022, it was found that professionals worked more than 40 hours a week in 65 healthcare hospitals. In particular, 9 hospitals had a workload of more than 64 hours per week, 4 hospitals more than 59 hours, 11 hospitals more than 52 hours, 18 hospitals more than 46 hours and 23 hospitals more than 40 hours a week. To date, 20 hospitals have successfully reduced working hours as part of the plan, implemented over 3, 6, 9 and 12 months.
Over the past 10 years (from 2013 to 2022), over 19,355 physicians have been hired and only 226 physicians have retired in their first year of employment, accounting for 1.2%. This is a relatively low figure due to the need to undergo advanced training before further education. In the second year of work, 1875 doctors retired, which is 9.69%.
In the third year of work, 858 doctors retired, which is 4.4%. Moreover, 1,578 doctors have retired, accounting for 8.1%. Together with the retirement of 150-200 doctors per year, the total number of retired doctors is 655 per year. Further studies have shown that doctors participating in the Collaborative Project to Increase the Number of Rural Doctors (CPIRD) can make up to 80-90% of the system, as they are selected from local residents.
Attention to the health workforce: salary, well-being, career development and work sharing
Dr. Tavisin also emphasized that the concern for personnel in all health professions focuses on four aspects that are systematically implemented:
- Salary: Discussions are underway with the Central Accounting Office to review and request adjustments to various forms of compensation based on workload and economic situation.
- Wellbeing: Includes questions about housing, environmental conditions, safety, and various amenities.
- Career Development: Discussions are underway with the ministry to increase the staffing structure and promote positions.
- Workload Sharing: More physicians still need to be graduating and requesting additional distribution to support the system.
The new staffing structure announced for 2022-2026 aims to reach the goal of 35,000 doctors by 2026. There were also discussions with the ministry regarding personnel management in new formats and various employment opportunities.
Strategies for attracting and retaining the medical workforce
Given the lack of medical personnel in Thailand, the government and health organizations are taking steps to attract and retain qualified medical personnel. One of the main strategies is to provide scholarships and financial incentives for students to attract them to the medical field and increase the number of medical graduates.
In addition, there are training and development programs for staff that help improve their skills and qualifications. These include specialized courses, trainings and conferences, as well as the opportunity to study abroad.
In order to retain medical personnel in the healthcare system, measures are being taken to increase the attractiveness of jobs. This includes improving working conditions, providing additional benefits and incentives, providing good housing and health insurance, and creating opportunities for career growth and professional development.
The impact of the lack of medical personnel on the quality of healthcare
The lack of medical personnel has a significant impact on the quality of medical care provided in Thailand. Overburdened doctors and other healthcare professionals can lead to poor patient care, delays in diagnosis and treatment, and an increased risk of errors.
One of the main consequences of a shortage of staff is an increase in the workload of doctors, which can lead to fatigue, stress and reduced concentration, which can adversely affect the accuracy of diagnoses and the quality of care provided. This may lead to possible negative consequences for the health of patients.
As part of the Health Workforce Improvement Program, efforts are being made to increase the number of medical graduates and to increase allocations for distributing physicians to health facilities.
There are also training programs and seminars aimed at improving the professional skills and competence of medical personnel. In addition, workflow optimization and load balancing strategies are being developed to ensure efficient use of available resources.
In general, addressing Thailand's shortage of health workers and improving the quality of health care requires a comprehensive approach, including improving working conditions and the attractiveness of the profession, expanding training and development opportunities, and optimizing the staff distribution system. Only through the joint efforts of the government, medical organizations and educational institutions can significant results be achieved and high quality healthcare be provided to all Thai citizens.
Author of the article: Ekaterina Antonova
