Chinese pediatricians face a crisis: should they stay or leave?

Chinese pediatricians face a crisis. Not only is there a shortage of pediatricians, but their numbers are actually decreasing. In 2012, there was only 0.43 pediatric specialist for every 1000 children, or ∼96 000 pediatricians for the 220 million Chinese children aged ,14 years. By comparison, in the United States, the ratio is ∼1.46 pediatricians for every 1000 children. Based on this ratio, China is short at least 200 000 pediatricians. A recent event called attention to this shortage. At a 2013 recruitment event for medical staff for the Women and Children’s Medical Center and Children’s Hospital of Dalian, no one was willing to apply for any of the 22 open pediatric positions. Of the 27 physicians who had been offered a position within the public institution system via open recruitment, 9 declined their offers. Among the 18 physicians who did report to work, 3 resigned after ,1 month because of the high job pressure and low salary. Similar dilemmas are present in pediatric hospitals in Anhui, Zhejiang, Shanghai, and other provinces in China. Individuals recruited through open recruitment by public institutions in China have a regular salary and a career-long job there until retirement, regardless of their performance, but even with these advantages, pediatricians still choose to leave. Because of the shortage of pediatricians, many Chinese hospitals have been forced to dissolve their pediatric departments. According to the Pediatric Society of the Chinese Medical Doctor Association (PS-CMDA), although children account for 20% of the total population in China, there are only 68 specialized hospitals for children with a total of ∼258 000 beds, representing only 6.4% of all hospital beds. Compared with the huge demand for hospital care, pediatric medical resources are limited. In particular, almost all of the large pediatric hospitals are in big cities. As a result, large volumes of pediatric patients swarm to the limited medical resources, leading to long wait times and difficulty in seeing a pediatrician. According to data provided by the PS-CMDA, during the busiest time in Beijing Children’s Hospital, there can be, on average, 4000 visits to the pediatric outpatient clinics in a single day. Because the department has between ∼40 to 50 pediatricians, each physician is typically responsible for 80 to 100 visits each day, and sometimes up to 150 visits per day. Based on this scenario, the average patient encounter is 6 minutes. Pediatricians hardly have time to eat or use the bathroom. Similar conditions have also been seen in other pediatric medical centers, AUTHORS: Wei Xu, MD and Shu-Cheng Zhang, MD