More pediatricians needed for children's health

Third, the worsening brain drain is aggravated by professional peculiarities of pediatrics. For example, in part because patients are children, pediatrics is inherently associated with greater risks, easy to trigger medical disputes. While the escalating tension between doctors and patients has been widely reported in China, including attacks on medical professionals, pediatricians appear to be even more vulnerable.

Many Chinese physicians earn commissions from pharmaceutical companies for the medicines they prescribe－among other additional incomes to compensate their low salaries. And quite a large number of hospitals also tie physicians' prescriptions to their bonuses, which in general account for half of their real take-home incomes. But because the variety and amount of medicines that can be prescribed to children are significantly less, pedestrians' incomes tend to be much lower, further undermining their morale. Heavy load, higher risk and dispute-prone together with relatively low income have made pediatrics an avoided profession in the medical circle, exacerbating the brain drain.

Without doubt, addressing the shortage entails concerted efforts by several ministries, the healthcare sector and the education system. Early this year, the healthcare authorities announced that 140,000 more pediatricians would be trained by 2020. Despite this good move, two caveats warrant attention.

First, staff retention is as crucial as recruitment. More comprehensive measures are needed to create conducive environment for pediatricians, such as pay increase and the government guiding hospitals to alter their remuneration system to narrow the income gap between pediatricians and other physicians.

Second, while the long wait of children and parents and the overwhelming workload of physicians are certainly attributable to personnel shortage, the weak referral system is also responsible for the matter. Partly because of the lack of trust in community doctors, most patients, especially those in cities, have become accustomed to seeking care directly from specialists of tertiary hospitals which are constantly crowded.

This has not only led to huge wastes of medical resources, but also further increased the burden for tertiary hospital doctors. Hence, the primary healthcare system with essential pediatric capacity needs to be strengthened.

The author is an assistant professor in the Department of Asian and Policy Studies at the Hong Kong Institute of Education.