Bloomberg News reports that pharmaceutical companies in China are poaching thousands of trained physicians, many of them recent grads, to become sales representatives in the massive push to take advantage of China’s exploding drug market. The companies can offer salaries that are two to three times those the physicians would earn otherwise, and Bloomberg’s sources estimate that as many as 14,000 more Chinese doctors will become marketers in the coming five years.
The hiring boom is hampering China’s three-year, $131 billion effort to stem a massive shortage of doctors in rural and peripheral areas and provide basic health insurance to at least 90 percent of the population. Paradoxically, it’s that same push, and the demand for drugs that it has created, that’s providing the incentive for big pharma’s Chinese campaigns. One pharmaceutical representative told Bloomberg that China is expected to overtake the United States as his company’s largest market within the decade, and companies have been budgeting accordingly.
Foreign drugmakers like Sanofi and their local affiliates will hire at least 35,000 sales staff by the end of 2014, Aon Hewitt China estimates, based on a survey of 24 companies. The same employers had 33,000 on staff at the end of 2010. About 30 to 40 percent of people recruited for sales jobs will have a medical degree, said Jarroad Zhang, a consulting director with Aon Hewitt in Shanghai.
In a collaboration between the California HealthCare Foundation Center for Health Reporting and the San Francisco Chronicle, the center’s David Freed ventures into rural Mendocino County in northern California to explain and examine the ongoing (and worsening) shortage of physicians in American rural areas.
Ukiah emergency room physician Marvin Trotter says that within the next five to seven years, the shortages will grow into a “full-blown health care crisis.” It’s a crisis about which the 58-year-old doctor speaks with eloquence and force.
“You’re going to see more complications and a lesser quality of life,” said Trotter, who puts in 12-hour days three days a week in the emergency room at Ukiah Valley Medical Center, the town’s only hospital. “You’re going to have your foot cut off more as a diabetic. You’re going to have more heart attacks because nobody’s taking care of your cholesterol. You’re going to have more people lose their vision because they can’t get in to see an ophthalmologist. That’s all a function of physician accessibility, and accessibility’s going away.”
Trotter’s quote is a reminder that, for rural America, “doctor shortage” means far more than just primary care. For a broad overview of the growing rural physician shortage, I recommend the “Older doctors, fewer hours” subheading on the story’s first page. The following subhead, “Scarcity at critical levels,” offers a deeper look.
In the second story in the package, Freed looks at how rural communities are working to solve the shortage, and why their efforts keep falling flat.
Program Draws Medical Students to Fresno: A program for third-year medical students is hoping to fight something long intractable: a shortage of doctors in rural and impoverished areas.
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The Telegraph‘s Andy Bloxham writes that the European Union’s 48-hour-a-week average working time limit is under review, at least as far as doctors are concerned.
The limit has been in place since August, 2009, and doctors have a limited opt-out clause. According to Bloxham, European health providers have been hit hard by the rule, which cut back their hours “drastically.” Critics have said that “junior doctors, who used to work very long hours, were being stopped from learning or building up experience as quickly as in the past.”
The EU has committed to either reviewing or overhauling the law, and Bloxham lists a few possible modifications.
One way of altering the rules could see doctors’ hours spent on call at hospital rather than on duty counted differently to the hours spent treating patients.
It might also permit them to return from their breaks sooner than the law currently allows in cases where staff shortages are more severe.
The weekly average for American doctors is around 51, which is down from 55 in 1996.
For more European health news, see AHCJ’s Covering Europe initiative.
David Wahlberg, the health and medicine reporter at the Wisconsin State Journal, has embarked on a project to examine “the challenges of providing health care services to rural communities.”
The first piece of the series focuses on the doctor shortage in rural areas as well as programs intended to help full the gap. There are a number of sidebars about aspects of the doctor shortage, including one about a hospital that employs a doctor with a felony conviction. That hospital’s CEO says, “But in a rural market like this, you can’t not consider keeping him.”
The second piece looks at the aspects of rural life that hinder good quality, consistent health care. The story cites doctor shortages, hospitals that don’t perform specialized services and an abundance of patients who are poor, elderly or have little or no insurance as factors that make health care in rural areas precarious.
The fragile, fragmented care in rural settings is thought to be responsible for a startling mortality gap nationwide: The death rate, adjusted for age, dropped only slightly in rural America the past two decades while declining significantly in cities, according to the U.S. Department of Agriculture.
Wahlberg said in an e-mail that he expects future installments to come roughly once a month.