A shocking CCTV footage of a doctor coughing up blood in an emergency room in China has caused an outcry among the public, ringing alarm bells for authorities to look into the working conditions of medical professionals.

“This patient coughed three to five times in 10 minutes. He coughed up quite a lot of blood, almost 500ml per time,” said Dr Qin, who treated the doctor known as Zhang.

Bleeding in digestive tract caused by immense stress

In the footage, the 30-year-old cardiologist was seen placing one hand on his abdomen in pain while being assisted to rest on a bed, when he suddenly sat up, turned to his side and vomited a huge amount of blood on to the floor. He was immediately transferred to intensive care for transfusion of blood and fluids, and stabilised after a six hour-long operation.

“He grasped me and told me he was very, very scared,” said Xu, the hospital’s chief cardiologist.

It was reported that Zhang had just completed a 32-hour shift, and was facing a lot of stress from his postdoctoral qualifying examinations in addition to his intense workload. The build up of stress reportedly led to a disorder in his digestive system, leading to a bleed in his upper digestive tract.

“A 32-hour shift is inhumane,” said a user on Weibo following the footage. “It does not do any good to both doctor and patient."

“There are too many patients at big hospitals while doctors are never enough,” said another user in response.

Work stress also affects HCPs in Singapore and Malaysia

Not surprisingly, the situation in Singapore and in Malaysia does not seem to stray far from that in China.

In July 2015, Malaysians were outraged by reports of a 27-year-old anaesthesiologist who died in a motor-vehicle accident while on her way home after a long on-call duty in the hospital, with the public calling for the Government to loosen its rules on doctors, who often work between 24 and 36 hours when on-call.

“Although we can’t deny that the accident could have occurred due to fatigue, it could also be caused by other factors that need to be taken into account,” said Health Director General Datuk Dr Noor Hisham of the accident, adding that the Ministry of Health has taken note of proposals to improve working hours of healthcare professionals (HCPs).

However, he added at the time that all facts had to be scrutinised before any decision was made.

Many doctors have since turned to social media to recount personal experiences of being involved in car accidents following a long shift at work, leading to furious debate over the current system. While some state that house officers no longer work more than 24 hours in a stretch, others argued that medical officers still work for up to 36 hours when on-call, leading to fatigue and posing risks to their health and safety.

Healthcare professionals report dissatisfaction with working environment

The MIMS Career Survey 2016 involving over 700 doctors, nurses, pharmacists and allied health professionals from both countries revealed that close to 25% of HCPs are dissatisfied with their jobs, with reasons attributed to the high amounts of workload due to shortage of staff, disproportionate salaries in accordance to their workload and a distinct lack of work-life balance.

This situation is evident in Malaysia with the recent announcement of Full Paying Patient Services in public hospitals as well as the introduction of grade 56 between grade 54 and JUSA C in the civil service salary scheme for health professionals, both as attempts to retain specialists from the public sector from switching to private practice.

59.2% of Singaporean HCPs felt that higher salaries would perk up their work environment, while 58% of HCPs from Malaysia instead preferred better career planning and development. Additionally, 57.8% and 49.5% of HCPs from Singapore and Malaysia respectively believe that a better work-life balance would help improve the current situation.

As a result, HCPs from both countries would consider seeking a career beyond healthcare for better future prospects, better income, and for more free personal time as well as for fewer threats of litigation, though most agreed that the lack of better opportunities available holds them back from making a career switch, and revealed that despite the stress, the profession is prestigious, fulfilling and provides a good income. MIMS

Read more:
The changing landscape of healthcare professionals’ duties in Singapore
MIMS Career Survey (SG Results) - Executive Summary
MIMS Career Survey 2016 (Malaysia Results) - Executive Summary
Pharmacist Salaries: How competitive is Malaysia?