Open Letter to National Health Commission of China about How to Lower the Risk of Overwork Death among Chinese doctors | Teen Ink

Open Letter to National Health Commission of China about How to Lower the Risk of Overwork Death among Chinese doctors

May 20, 2022
By Anonymous

Dear sir or madam,

    How do you do? I am a college student from Zhejiang University and University of Illinois at Urbana-Champaign Institute, who dreams everyone on this world could live and work healthily. With the fast-developing world economy and the increasing work pressure, the phenomenon of overwork death, which means dying from long working hours exposure, occurs in many countries and is on a tendency of increasing. Especially in China, the overwork death among doctors has become a critical serious problem. However, because a medicine major student always needs about over 10 years to become a professional doctor and China has an extremely huge 1.4 billion population, which lead to the shortage of doctors and the overflow of patients, the serious problem of doctors’ overwork death appeared and there are still not evident positive changes to it. Therefore, I believe, setting up a medical qualification test, giving qualified medical students more chances as interns, will help to create a more appropriate and healthier working climate for Chinese doctors, keeping them away from dying of long working hours exposure.

    The working climate for Chinese doctors is getting worse. In China, the most severely afflicted area by overwork death is among those doctors. In a statistical analysis published on International Journal of Cardiology, it shows that from January 2007 and December 2018, the number of doctors’ overwork death in China was 110 cases. And a more shocking statistics is that the mean ages of men and women were around 42 years old and 35 years old, respectively (Gao and Xu). Those young doctors are facing the risk of death just because they work for too long! I believe you would feel heartbreak about it, just like I do.

    Knowing such a sad fact, I was wondering---what causes such a tragedy mostly? After researching, according to a study published on Public Health, it is mainly attributed to the lack of medical resources, especially manpower resources. It is known that the Chinese population accounts for 22% of the world's total population, but there are only 1.2 physicians/1000 population in China, compared with 2.8/1000 population in developed countries (Shan et al. 99). To solve the overwork problem, some hospitals have tried to limit the longest working hours for doctors, but there still exists the shortage of doctors and the expansive needs of patients, that measure didn’t work well.

    To solve the problem thoroughly, we need to find the root cause for doctors’ shortage. In China, becoming a medical student is almost the only way to become a professional doctor. So, does the shortage of doctors mean there are not enough medical students in China? The answer is NO. Weimin Wang, a professor at the Health Science Center, Peking University, conducted research about the scale of Chinese medical education, finding that China has the world’s largest medical education system. According to his study, “in 2018, China had 420 undergraduate institutions with medical education (excluding military institutions), matriculating 286,219 medical undergraduates, 81,128 masters and 14,044 doctors in 2018–2019” (Wang). If we assume all those medical students can be qualified as doctors, because there are 1.4 billion population in China, then it will add about 0.27 doctors for every 1000 population. Although this is just an assumption that cannot come true at once, by comparing with the current situation---1.2 physicians/1000 population, 0.27 will be a big leap and it shows the adequacy potential of reserve force for doctors.

    However, the truth is, although there are large enough medical students, many of them still have a long way to become independent doctors, because the requirement to be a doctor is very strict in China. Basically, according to a study conducted by specialists from Zhejiang University and Peking University, etc., becoming formal doctors usually needs 5 years of medical education and 3 years of standardized resident training; another 6 years is needed if pursuing to obtain a doctoral degree. (Liang et al.). Such a long and boring time of studying in school without too much practicing in hospitals can assure those medical students have adequate knowledge but may make many of them give up being doctors. This would lead to the result that the increase of doctors cannot catch the increase of patients. Some universities have set up a bridge between their medical students and hospitals for practicing, but the requirements are always limited to certain grades and some top students.

    Therefore, I suggest that you could consider setting up a medical qualification test to giving those qualified students more chances as interns. But some people may worry about the safety of the patients and doubt whether those interns are qualified enough. According to a study conducted by professors from Tongji University, National Yang-Ming University and University of New Mexico, Chinese medical students usually show positive tendencies for critical thinking (Huang et al. 3). And from the same article, it said “CT (critical thinking) is a prerequisite for safe practices in medicine. Medical students who are skillful and able to think critically will excel in the modern, complex hospital environment” (5). Greenhand doesn’t equal to danger. Every skilled doctor starts from a greenhand. I believe, giving qualified students chances to do practical work earlier can not only improve their professional capability, but also decrease doctors’ work pressure.

    To save those respectable doctors from overwork death, I believe my proposal could make a big difference. It would be a great an honor for me if you could consider my suggestions and make it into truth. Best Wishes!

 

Sincerely,

Joy


The author's comments:

Works Cited

Gao, Xiujuan and Yangjiang Xu. “Overwork death among doctors a challenging issue in China.” International Journal of Cardiology, vol. 289, 15 Aug. 2019, p. 152,  internationaljournalofcardiology.com/article/S0167-5273(19)32009-1/fulltext. Accessed 16 May 2022.

Huang, Lei, et al. “Chinese medical students’ disposition for critical thinking: a mixed methods exploration”. BMC Medical Education, 16 July 2021, doi.org/10.1186/s12909-021-02801-w. Accessed 16 May 2022.

Liang, Jun, et al. “A Preliminary Study on the Abnormal Deaths and Work Burden of Chinese Physicians: A Mixed Method Analysis and Implications for Smart Hospital Management”, Frontiers in Public Health, vol. 9, no. 803089, 4 Jan. 2022, frontiersin.org/articles/10.3389/fpubh.2021.803089/full. Accessed 15 May 2022.

Shan, H.P., et al. “Overwork is a silent killer of Chinese doctors: a review of Karoshi in China 2013–2015”. Public Health, vol. 147, June 2017, pp. 98-100, sciencedirect.com/science/article/pii/S003335061730080X?via%3Dihub. Accessed 16 May 2022.

Wang, Weimin. “Medical education in china: progress in the past 70 years and a vision for the future”. BMC Medical Education, vol. 21, no. 453, doi.org/10.1186/s12909-021-02875-6. Accessed 23 April 2022.


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