Call to implement shift system for public healthcare doctors

PETALING JAYA: To prevent brain drain and burnout involving doctors at public healthcare facilities, Putrajaya should consider switching to a shift system, says Malaysian Medical Association president Dr Azizan Abdul Aziz.

The proposed shift system, said Dr Azizan, is similar to the European Working Time Directive (EWTD) which requires the working week to be an average of 48 hours, while in Australia, doctors work an average of between 35 and 38 hours a week.

She said doctors at Malaysia’s public healthcare system generally work 60 to 84 hours per week.

“To mitigate burnout and further brain drain, we are proposing that the government adopt a shift system for all doctors doing active on-calls in public healthcare – three shifts per day while introducing a flexi-allowance for medical officers (MO), specialists and subspecialists,” she said.

Dr Azizan also said under the public healthcare system, MOs and specialists work on an on-call system where those on active on-call duty work their normal shift 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 – a total of 33 hours straight.

“This must not go on. We cannot expect doctors to perform and deliver their best outcomes,” she said.

Citing figures from the World Health Organisation in 2021, Dr Azizan said deaths from heart disease and stroke associated with working long hours increased by 42% and 19%, respectively.

“The harrowing realities of the Malaysian brain drain is further corroborated with the recent release of a study by the Statistics Department.

“If left unchecked, our public healthcare would be facing impending collapse,” she added.

Hartal Doktor Kontrak spokesperson Dr Muhammad Yassin said the numbers provided by the Health Minister may not reflect the actual situation of doctors leaving the civil service.

To resolve the issue of doctors leaving the public service, Hartal proposed that government doctors be paid salaries and on-call allowances which are more competitive than the private sector.

“Create clear and attractive career development paths in the government sector by offering opportunities for specialisation and postgraduate education.

“This can help doctors build their expertise while working in the public healthcare sector,” he said.

Yesterday, Health Minister Datuk Seri Dr Dzulkefly Ahmad told the Dewan Rakyat that more than half or 54% of the 1,696 medical officers in the country left the public service sector in 2022, with wanting to work in the private sector being the main reason.

The ministry also found through a survey that 4.5% of the doctors who quit the civil service are currently working abroad.