Hong Kong is heading for a critical shortage of doctors that soon will begin affecting our public health system and - unless the authorities begin corrective improvements - could eventually create massive medical problems across our society. The cause of this impending critical situation is a combination of factors, the most important being that more and more of our younger doctors are migrating to foreign countries where they can enjoy successful and very prosperous careers. Other notable developments include the premature retirement of too many of our doctors easily capable of working for several more years, and the knock-on effects of the fact that, thanks in part to the high standard of our current public health services, Hong Kong people are now living longer.

The other side of our "silver society" enjoying those extra years is that they will require increasing medical assistance to counter the emergence of lifestyle-related diseases and complaints like cancer from smoking too much, obesity from eating fatty meals from fast-food outlets. It's also the inevitable results of their not continuing regular check-ups from long-serving family doctors because of their ever-increasing charges, often related to the escalating rents for their clinics.

Another highly relevant factor in this gloomy scenario is the ongoing loss of newly-trained female and male nurses who, too, are moving overseas to take much better-paying positions in hospitals and clinics. They quickly prove their worth in the wards, cheerfully performing extra hours when emergencies arise. The unpleasant truth is that nurses are accorded a relatively low status in the medical world, but by doing the "heavy lifting" they make a large contribution to the curing process for patients.

The community has traditionally held doctors in high regard because of the lifesaving work they perform, and the capacity of young trainees to perform jaw-dropping amounts of overtime with minimal time off to sleep. Sadly that image of heroic doctors always struggling to restore the health of patients in a critical condition is changing to one where they are perceived as being driven more by financial gain than the highest principles. The five highest-paid specialists are claimed to be orthopedic surgeons, cardiologists, dermatologists, radiologists and specialists in treating serious gastric problems.

The fact is that the medical scene has continued to evolve to keep pace with many life-saving breakthroughs we have seen in recent decades. But arguably one of the most significant developments in Western countries has been the unstoppable growth of the global pharmaceutical industry, which churns out zillions of pills every year with two objectives - to save or prolong lives, and to keep the cash registers ringing merrily by fair means or foul.

Doctors who set up their practices, particularly those specializing in a single medical field, soon find themselves being bombarded with propositions from pill-peddling salespeople to promote their companies' palliative products, including of course a complementary opening stockpile which they argue will quickly prove how efficacious their products truly are. Trials of these handout products may instead show they are merely fair to good, and the doctor is not convinced. The salespeople might then propose an "arrangement" whereby a juicy commission will accompany future batches of his company's products. Thus some doctors are lured into lucrative deals over future supplies of medical products.

Yes, the unfortunate truth is that the profession had come a long way since the times when indefatigable medical pioneers like the Louis Pasteur and the Curies experimented day and night to find cures or comprehensive, effective treatments of the many diseases then existing but long since conquered by patient and persistent research.

Moving on, after establishing the beginnings of a good reputation here talented young doctors who emerge from the arduous medical education process including on-the-job training can either join a practice here as a junior partner or look for opportunities in the US, Canada or Australasia. Openings abound in all, and successful newcomers from overseas are encouraged to apply for citizenship. Some of these migrant medicos arrive with a wife; others are single but quickly assimilate into Chinese communities in the main cities where they now work and live, and soon have regular Chinese partners.

One significant redeeming factor has emerged about the inevitable doctor shortage - the authorities are well aware of this impending emergency. The situation is under study by our Food and Health Bureau thanks to a recent in-depth report it commissioned on "Healthcare Planning and Professional Development".

(HK Edition 09/27/2017 page8)