Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
Afr J Prim Health Care Fam Med. 2021 Mar 23;13(1):e1-e5. doi: 10.4102/phcfm.v13i1.2799.
South African doctors work up to 60 h per week to ensure 24-h service delivery. Many doctors are physically and emotionally exhausted, neglecting families, self-care, patient empathy and innovative thinking about complex health issues. Exposure to clinical work hours demonstrated a dose effect with burnout, suggesting cause and effect, affecting up to 80% of doctors. To retain good doctors, their complex needs must be recognised and allowances made for flexible work options.Taking a risk: George Hospital, a large regional training hospital in a rural district, converted some full-time medical officer posts to part-time posts. This was in response to doctors' requests for more flexible work options, often after returning from maternity leave or in response to burnout. Perceived risks revolved around institutional resource security and that part-time post vacancies would be difficult to fill.Reaping the benefits: Employing doctors in part-time posts has created stability and continuity in the health team. The hospital had generated a cohort of young professionals who care with empathy and have emotional resilience to train others and plough their skills back into the healthcare service.
Reducing working hours and creating flexible options were concrete ways of promoting resilience and retaining competent doctors. We recommend that training and work of doctors be structured towards more favourable options to encourage retention, which may lead to better patient care.
南非医生每周工作 60 小时，以确保提供 24 小时的服务。许多医生身心疲惫，忽视了家庭、自我护理、对患者的同理心以及对复杂健康问题的创新思维。临床工作时间的暴露与倦怠呈剂量效应，表明存在因果关系，高达 80%的医生受到影响。为了留住优秀的医生，必须认识到他们的复杂需求，并允许他们选择灵活的工作方式。冒险之举：乔治医院是农村地区的一家大型区域培训医院，将一些全职医疗官职位转换为兼职职位。这是对医生提出的更多灵活工作选择的回应，通常是在休完产假后或因倦怠而提出的。人们认为风险涉及机构资源安全，而且兼职职位空缺很难填补。收获效益：聘请兼职医生为医疗团队带来了稳定性和连续性。医院培养了一批年轻的专业人员，他们富有同理心，具有情感弹性，可以培训他人，并将自己的技能回馈到医疗服务中。
减少工作时间和创造灵活的选择是促进韧性和留住有能力的医生的具体方法。我们建议对医生的培训和工作进行结构化，以提供更有利的选择，鼓励他们留下来，从而可能为患者提供更好的护理。
