Counties should hire part-time doctors to plug staff shortage
A doctor attends to a patient at Aga Khan University Hospital. PHOTO | FILE
Fellow columnist Mike Eldon’s article on the “gig worker” a week ago elicited some remarks from health workers. In a discussion on emerging trends for healthcare workers and the implications for system administrators, the trend is apparently also being noted in our hospitals.
Traditionally we have had the “locum” doctor, where a doctor fully employed elsewhere, supplements his main job with occasional after-hour engagements in-facility or at a different facility.
The younger generation of medics in our field are opting for the freedom that comes with such fulltime locum arrangements. In such a setup one is not fully employed but moves from hospital to hospital for several hours depending on the availability of work in these facilities.
The implications for health managers are there, part of which is that such workers have no sense of belonging or “ownership” of the enterprises in which they work on such loose terms: it is a business arrangement.
Lack of a long relationship or attachment to such a workplace, weak inter-staff relations and other ingredients necessary for cultivating teamwork are often missed.
It feels that this absence of attachment with the locum workplace could be a reason some patients who regularly visit hospitals are gauging their visits as “mechanical”. Such workers may not expend the effort to try create rapport or “sell” the business.
The two sides represent the personal or employee point of view and a management viewpoint. From a personal point of view, the freedom that young doctors crave and the flexibility of determining when, where and who to work for seems to be a major factor. The modern day young medic is highly mobile and may be engaged in several places or occupations on a part-time basis.
For those pursuing studies in particular, the convenience of working after classes seems to be a key reason for choosing such an arrangement.
As management, such arrangements are favourable for the employers too as a cost-containment tool. Shift workers generally tend to earn less than their full time workers.
They are also not entitled to employee benefits like pension, professional indemnity, medical insurance, transport and extraneous allowances as well as other staff packages permanent employees benefit from.
In today’s rising labour unrest from health workers’ unions, locum employees offer a cushion from such happenings.
Because they are casual employees, they are not entitled to being unionised or participating in strikes. As such at the very minimum they can act as a buffer from total paralysis of hospital operations.
For hospital managers a healthy staff ratio is to have at about 30 per cent of staff as locum. The situation on the ground is however different with some facilities having up to 70 per cent on locum shifts. The short coming from an administrative point is the effect such an arrangement brings with it.
Continuity and familiarity are good components in a hospital staffing plan especially as the elderly population’s health services consumption increases. One major complaint for this age group is the frequency of new faces especially for those on chronic care.
While locum workers are common in the private sector, the public side however seems slow to embrace this. Short term shifts on a rotational basis especially for highly skilled workers could be a means to attract and fill gaps in remote areas struggling to attract and retain doctors.
County health administrators should rethink how private sector workers can locum in public facilities.
