Wednesday, 8 January 2014

In Shanghai, doctors shun ambulance service

If you are wondering why it may take more than an hour for an ambulance to arrive when you dial 120 in Shanghai, the head of the city's emergency response centre can give you several good reasons - and lack of ambulances isn't one of them.
Shanghai has more than enough ambulances, but not enough qualified 'first responder' emergency specialist doctors to staff them, according to Dong Jun, deputy director of the city's emergency service said.
The city of 24 million has only 164 qualified ambulance staff to cover the city centre and a quarter of them resigned last year. Two years ago the city ambulance service had 311 doctors but 234 of them have since resigned and only a few replacements could be recruited. Many of these are trainees and cannot yet operate as emergency physicians on ambulances, Dr Dong said.
The ambulance service finds it hard to recruit emergency doctors because the work is seen as low paid, high pressure and with long hours. It is also seen as having poor career prospects, he added.
The city therefore has introduced a triage system in which 'first aiders' are sent out in ambulances when the operator believes it is a less urgent illness. The service also tries to dissuade the public from using the ambulance service as an 'efficient taxi service' for people with minor illnesses, he adds.
Doctors are reserved for more serious cases, but there still are not enough to cope. Dr Dong says it has been impossible to recruit local doctors to the service since the year 2000, and they now advertise nationwide.
According to a report in the Eastern Daily, the Shanghai ambulance service is under such pressure that staff often have to exceed their shifts by several hours to catch up on paperwork and to help clean and disinfect the vehicles. Dr Dong himself has had to step in and act as a driver or even to carry stretchers, he admits.
However, there are still delays and this is the source of many complaints from the public. Staff are sometimes assaulted when they arrive late to a call. Without adequate resources and better career structures, it will continue to be difficult to provide medical staff for Shanghai's ambulance services, he concludes.

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