Physician Distribution Problem Must Be Solved! Republican People's Party Ankara Deputy Dr. Aylin Yaman said that there is not a shortage of doctors in Turkey, but a problem of doctor distribution between regions.
Member of the Health, Family, Labor and Social Affairs Commission and Ankara Deputy Dr. took the floor during the Health proposal discussions at the General Assembly of the Turkish Grand National Assembly. Aylin Yaman; "Methods such as contractual work and performance-based work leave the physician insecure, exhaust him and destroy ethical values," he said. In his speech, CHP's Yaman stated that the number of physicians in our country is insufficient and that the differences in the number of physicians between regions should be resolved. In his speech, Yaman said; “With the 22nd article of the health proposal, it is intended to increase the number of positions to be distributed in a year from 4924 thousand to 27 thousand by making an amendment to the existing Law No. 36 regarding the employment of contracted health personnel in places where there is difficulty in recruiting personnel. In short, 9 thousand more physicians are given the opportunity to work under contract in places where it is difficult to find physicians,” he said.
There are 100 Physicians per 346 Thousand People in the West and 151 Physicians in the East!
Underlining that the main thing when offering solution suggestions is always the correct diagnosis of the problem, CHP member Yaman said, “Therefore, if we look at the problems, it is true that the number of doctors is low. As a matter of fact, the number of physicians per 100 thousand people is 228. This number was obtained from the news release, not from the health statistics of 2022, which have not yet been announced, and is well below the European Union average of 397, but there is a distribution problem rather than a shortage of physicians. While there are 100 physicians per 346 thousand people in Western Anatolia, there are only 100 physicians per 151 thousand population in Southeastern Anatolia. When we look at the specialist physician in particular, the situation is more dire. He determined that while there are 100 specialist physicians per 157 thousand people in Western Anatolia, there are only 69 specialist physicians in Southeastern Anatolia.
Distribution of General Practitioners is Worse!
Stating that the situation is even worse for general practitioners, Dr. Aylin Yaman said, “The number of general practitioners per 100 thousand people in the whole country is only 63. Moreover, in Istanbul, which is dominated by specialists, the number of general practitioners is much lower than the country average. This is one of the main issues that consumes physicians. What needs to be done is clear: primary care should be centralized and strengthened. For this reason, the number of family medicine specialists and general practitioners needs to be increased. "However, a delivery chain must be established to ensure controlled flow," he said.
The Health System Should Not Be Indexed to the Number of Physicians
CHP Ankara Deputy Aylin Yaman emphasized that although there are many healthcare professionals such as nurses, midwives, psychologists and audiologists, it would be insufficient to increase the number of physicians alone. CHP member Yaman said, “The increase in the number mentioned here belongs only to the physician. Unfortunately, the health system is indexed only to the number of doctors. Health is a team effort, and the most important approach to preventing burnout and escalating violence is a healthcare team with a clear job description and equipped with competent staff. Auxiliary healthcare personnel are of great importance for physicians who are forced to care for patients in five minutes. "When establishing the system, physician/nurse ratios according to branch must be taken into account," he said.
Contracted Work in Health Should Be Abolished
In his General Assembly speech, CHP's Yaman stated that the form of employment in the public sector is based on directing them to contract work and "with this type of work, healthcare workers can receive higher wages." Our suggestion is that the higher wage to be given to contracted employees should be given as a basic wage to permanent staff in accordance with Law No. 657. Methods such as contract work and performance-based work leave the physician insecure, exhaust him and destroy ethical values. While increasing some branches of specialization, long-term programs must be made. For example, the specialty of internal medicine is often used as a subspecialty transition. There is no internal medicine specialist available for disease groups that require a general internal medicine approach. "When planning, not only the number but also the department-specific situation should be considered," he said. Finally, in his speech, Yaman underlined that physicians are burnt out and said, “Burnout is the biggest obstacle for physicians. The most important way to prevent burnout is to give the physician back the dignity he has lost. Refund can be achieved by securing the physician, not by employing him under contract. It is necessary to reward them for their efforts both materially and spiritually. Financial matters are not the only problem; "Encouraged patient complaint lines, disciplinary and fines imposed with this bill, and administrative follow-up mechanisms that are held over them like sticks at all times are issues that consume physicians more than the heavy patient load and make them feel worthless," he said.
