MMA suggests shift system for doctors in public healthcare
KUCHING: The Malaysian Medical Association (MMA) has proposed that the government implement a shift system for doctors in public healthcare similar to the European Working Time Directive (EWTD).
Its president Dr Azizan Abdul Aziz said such system would be able to prevent burnout and further brain drain among doctors.
“The EWTD requires the working week to be an average of 48 hours while doctors in Australia generally work between 35 and 38 hours a week.
“Doctors in Malaysia’s public healthcare system doing active on-calls in departments such as medicine, surgery, obstetrics and gynaecology, orthopaedics, paediatrics and anaesthesiology work an average of between 60 and 84 hours per week depending on manpower resources.
“To mitigate burnout and further brain drain, the MMA is proposing that the government adopt a shift system for all doctors doing active on-calls in public healthcare via three shifts per day while introducing a flexi-allowance for medical officers (MOs), specialists and sub-specialists,” she said in a statement.
She added that MMA had proposed this to the Ministry of Health during a meeting recently.
Dr Azizan pointed out that under the country’s public healthcare system, housemen work on a shift system until they complete their training.
“MOs and specialists in the six departments I mentioned work on an on-call system where those put on active on-call duty work their normal working hours from 8am to 5pm and then begin their on-call hours from 5pm to 8am the next day.
“This is then followed by normal working hours from 8am to 5pm which is a total of 33 hours straight,” she said.
She noted that on a regular basis and due to the heavy workload, MOs and specialists work beyond their on-call hours.
“Certain departments permit post on-call time off in the afternoons at the discretion of the head of the unit,” she said.
Dr Azizan stressed that such shift system must not go on as burnout among healthcare workers increased the risk of medical errors.
”We cannot expect doctors to perform at their best and deliver the best outcomes when they are clocking in these unreasonable hours.
“At the rate we are going, if the status quo remains, more public healthcare doctors will leave to either private healthcare or to pursue opportunities abroad.”
Dr Azizan said long working hours can also increase the risk of heart disease, stroke and death.
“According to the World Health Organisation’s (WHO) first global analysis of the loss of life and health associated with working long hours released in 2021, between 2000 and 2016, the number of deaths from heart disease due to working long hours increased by 42 per cent, and from stroke by 19 per cent.
“The study concluded that working 55 or more hours per week is associated with an estimated 35 per cent higher risk of a stroke and a 17 per cent higher risk of dying from ischemic heart disease, compared to working 35 to 40 hours a week,” she said.
She also said that the number of doctors leaving public healthcare should not be taken lightly as over 70 per cent of the population depended on public healthcare for their health needs.
“It was reported that from 2017 to 2022, contract MO resignations rose by a staggering 1,131 per cent. It was also reported that 890 specialists resigned from government service between 2018 and 2022.
“The harrowing reality of the Malaysian brain drain is further corroborated with the recent release of a study by the Department of Statistics Malaysia. If left unchecked, our public healthcare would be facing impending collapse,” she remarked.