Long work hours and overwork are causing one out of every 10 trainee anesthetists to quit, while more than half of trainees consider leaving the profession after finishing their training, Taipei Veterans General Hospital vice superintendent Ho Shan-tai (何善台) said.
The public may be aware of a shortage of new doctors and a high turnover rate in emergency rooms and hospitals’ departments of surgery, internal medicine, obstetrics and gynecology, and pediatrics, but they are not aware that the same problem in anesthetics poses a threat to the entire medical community, Ho said.
With the support of the Ministry of Health and Welfare, Ho recently mailed a questionnaire to 777 anesthetists across the nation and received 474 replies, or 60 percent of the total.
Eighty percent of the respondents were male and 70 percent of them were younger than 50. Eighty percent of respondents worked at hospitals and more than 50 percent had more than 10 years of clinical experience.
While most of the respondents said their ideal work hours were an average of 50 hours per week, their actual work hours came to about 60; and most felt that one anesthetists should be in charge of only two to three operating theaters, when in fact most were tasked with four, the survey showed.
Fifty-five percent of respondents said they do not wish to pursue their line of work anymore, giving as their top three reasons high rates of conflict with patients’ families, long work hours and being overworked, while 50 percent of respondents said that their wages are too low.
According to statistical data from the Taiwan Society of Anesthesiologists, deaths from anesthetics in Taiwan occur at 12 times the rate in the UK, the US and Japan.
A quarter of the respondents said they do not wish to continue their line of work due to their inability to spend time with their family, the questionnaire showed.
Comparing the US and Taiwanese systems, Ho said that in the US anesthetics subsidies are applied as follows: The fees of an anesthetist attending a first surgery per day are fully subsidized, the fees for a second surgery is subsidized at a discounted rate and a third surgery is not subsidized at all.
This means that US anesthetists only have to tend to two surgical tables per day, and were paid on an individual basis and not according to the method of anesthetization, Ho said, adding that US anesthetists usually earn about US$320,000 a year.
Taiwanese anesthetists do not receive the same subsidies from the National Health Insurance (NHI), with NT$1,500 given for para-anesthesia and NT$3,800 for general anesthesia, Ho said.
He said the NHI subsidized fees based on how the patient was anesthetized and not what the risks of surgery were due to the patients’ condition.
He added that most surgeries were handled in a “package” manner to ensure that the surgical department retained their “cut” of the income.
Ho said that there are enough people in the anesthetics field, but the amount of work required of them is too much, adding that the department at his hospital has to handle 1,500 NHI-subsidized cases every year, as well as an additional 200 cases.
The government is not so much to blame for this situation as the medical community itself, because most of the rules were written by the community, Ho said.
Different departments in the medical community should get together and find how to better balance the situation, he said.