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Overworked and Understaffed: Polish Healthcare Faces a Crisis

HEALTH & MEDICINEOverworked and Understaffed: Polish Healthcare Faces a Crisis

Forty-eight hours a week – that’s how much a doctor can work according to the European Union directive. “If we wanted to apply these regulations, it would turn out that some facilities would have to be shut down overnight due to staffing deficits,” assesses Prof. Dr. hab. n. med. Łukasz Krzych, head of the Department of Emergency Medicine at the Medical University of Silesia. Today, doctor overwork is one of the most serious concerns in healthcare.

According to data from the Central Statistical Office (GUS) in 2022, the number of doctors living in Poland and having the right to practice was 158.9 thousand. This is slightly more than the previous year, but it does not change the fact that staffing problems are still one of the biggest issues in healthcare. According to the European Commission report “State of Health in the EU”, Poland is one of the countries with the lowest number of healthcare workers in the Union per thousand inhabitants – in the case of doctors, it is 3.4. This is significantly less than the average for the entire EU, which is 4.1. The report indicates that in some regions, especially rural areas, there is a significant shortage of doctors.

This situation translates into a greater workload for medics of various specializations. Although according to the EU directive from 2003, a doctor cannot work more than the accepted working time set at 48 hours a week, this limit is routinely exceeded in our country.

“EU regulations dictate how much we should work per day and per week, how much we should rest, regardless of the function we perform in the hospital as healthcare workers. This applies equally to doctors and nurses employed on contracts. If we wanted to apply these regulations, it would turn out, unfortunately, that some facilities would have to be shut down overnight due to staffing deficits,” says Prof. Dr. hab. n. med. Łukasz Krzych to the Newseria Biznes news agency.

The shortage of staff in Polish healthcare leads to a situation where both doctors and nurses work in various facilities on multiple contracts in different forms of employment. According to a study conducted by PZWL for the “Report on Salaries in the Medical Sector”, 63.8% of doctors indicate excessive workload as a non-salary factor affecting dissatisfaction with their job. Interestingly, in the same study, only 34.8% of respondents believe that their earnings are adequate to the effort and commitment they put into work. Importantly, 58.9% of respondents are not satisfied with their total earnings, and two-thirds believe that increasing their salary is possible by taking additional work in a public or private facility.

“The limit per position amounts to 140-160 hours on a monthly basis. It is very easy to exceed this by working, for example, in a duty system, because if we work 24 hours, de facto there is only one, at most two more days of work in a week to fulfill this norm, and on other workdays, someone else must work,” explains Prof. Łukasz Krzych. “It is very difficult to find a doctor who works 140 or 160 hours a month, most work more, although not always willingly, sometimes simply must, to ensure the continuity of the hospital’s work, if it is a large hospital.”

The main reason for this state of affairs is the staffing deficit. The Supreme Audit Office also mentions this in its report from August 2023. According to the institution, other irregularities include: overwork and entering into additional civil law contracts with employees for the same type of work. The Supreme Audit Office notes that there are cases where the heads of facilities did not try to effectively address these problems. In controlled cases, it happened that the provision of services in clinics and some hospital departments was interrupted.

“A tired doctor is a danger to the patient, we do not want to be tired because we know that then the quality of our work and the services we provide is suboptimal. Each of us would like to find time for ourselves, our loved ones, but we still remember that we work for patients and our decisions must be balanced in this sense. Therefore, we decide ourselves to work more hours to help society, to help the patient, because there are still among us those who chose this profession as a mission,” says the head of the Department of Emergency Medicine at the Medical University of Silesia.

According to the latest GUS data published in August last year, among doctors authorized to practice, the dominant group (over 20%) are people aged 50-59. This age group’s dominance is greater among male doctors than female doctors.

As of December 31, 2022 (the most recent data published by GUS), the lowest number of doctors per thousand inhabitants is in the Lubusz Voivodeship (2.38). It is slightly better in the Opole Voivodeship (2.43). The best statistics in this regard are in the

Łódź Voivodeship (4.28) and the Masovian Voivodeship (4.14).

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