Turnovers in the public healthcare sector are high, resulting in reduced efficiency of the healthcare system. In Singapore, students who enrol into medical universities are required to be “contracted” to a public health institution upon graduation.

While this seems to be effective in retaining talent within the sector, it is observed that after the contractual period has been served, these doctors tend to leave the public practice to either join an existing private medical institution or to open their own clinic.

Here are some of the reasons behind this trend in Singapore, and what can be done to reverse it.

Control and ownership


Firstly, a public healthcare institution has to consider the welfare of the wider public. Hence, any healthcare professional working in a public organisation has to adhere and be aligned with its mission.

More often than not, these healthcare professionals do not have a hand in the planning of the organisation’s strategy to improve the overall level of patient care. However, the smaller size of private practices gives healthcare professionals the opportunity to play a part in moulding the overall strategy and direction in the provision of care.

Above all, it allows doctors to exude the values that they hold firm to themselves. In fact, the idea of being their own boss seems to be a more attractive proposition rather than an employee of an organisation.

As doctors gain more control and ownership of their career path, it allows greater control in other aspects of life as well, for instance, greater flexibility to spend time with their loved ones.

Reduction in red-tape


Bureaucracy is defined as the bane of many organisations as it stifles growth and innovation. In the public healthcare sector, doctors are not only expected to be on standby 24/7 for any emergency cases, but also carry out administrative tasks.

As a result of these additional tasks, they become overworked workers with inadequate rest. According to a 2016 study, of the 57 doctors, about a quarter of the work day was spent with patients. Nearly half of the doctors’ day was spent on desk work, or filling in electronic health records.

The purpose of being a healthcare professional is to focus on providing quality care to patients. Instead of being bogged down with arduous paperwork, one can better focus on the mission at hand in a private organisation of a sizeable scale. They are also able to dictate the level of “red-tape” processes in the operations.

Higher incomes


The income of healthcare professionals is directly tied to the performance of the healthcare institution. Public hospitals have to cater to the healthcare needs of society, including low-income individuals. For instance, a single knee replacement surgery in a public hospital that is unsubsidised would cost as low as SGD6,500, while in a private hospital, the lowest would cost SGD7,500.

In a private medical institution, patients can choose to pay for premium services which will provide greater quality of care. On the other hand, public hospitals are more restrictive in terms of provision of care.

Private medical practitioners have an opportunity to explore different areas of service and can choose to generate revenue from varying sources in the provision of medical care. This certainly can contribute to the overall income of the doctor over time and is therefore seen as a lure to the private practice.

Measures to retain doctors


To retain talent in the public healthcare sector in Singapore, several steps have been taken.

1. Increase compensation


Compensation was increased for those serving in the public healthcare sector. In 2015, it was announced by Singapore’s Ministry of Health that the “senior doctors in the public sector will get a 9% pay raise”. This was to give doctors recognition for their hard work and dedication in meeting the healthcare needs of the public.

2. Harness technology to decrease workload


Secondly, public hospitals and clinics can use technologies to speed up productivity such as introducing an automated system for paperwork and using a virtual assistant to help with common queries. In Singapore, an IT system was adopted to minimise administrative tasks.

In essence, the retention of talent in any healthcare organisation can be distilled down to providing a good roadmap for career progression and reducing the amount of administrative tasks allocated to doctors. Healthcare professionals will then be less keen on switching to the private sector as the medical services provided will not only allow their patients to receive quality care, but encourage growth of the individual for their future ahead. MIMS

Read more:
Why are healthcare professionals leaving traditional job roles?
Factors influencing the pursuit of family medicine
Private and public hospitals in Singapore: Doctors working together for better healthcare services

Sources:
http://health.asiaone.com/health/health-news/are-doctors-nurses-leaving-public-hospitals-money
https://www.geraldtan.com/medaffairs/manpower-doctors-public_sector_doctors_leaving.html
http://www.todayonline.com/voices/hospital-doctors-risk-their-health-being-call-24-hours
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http://www.straitstimes.com/singapore/health/more-transparent-fees-a-positive-step
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