There's nothing wrong with doctors trying to earn a little extra

October 19, 2022 | 04:42 pm PT
Quan The Dan Doctor
Under the command economy of the second half of the last century, all doctors were employed by the government, giving them a steady but very modest income.

Though their earnings could hardly cover living costs, doctors were prevented from offering private medical services due to disapproval from society and government alike.

I still remember the image of my father, a doctor, riding a patched-up bicycle as thin as himself. He was secretary to the director of a major hospital in Hanoi. Talented, proficient in three foreign languages and acting as scientific advisor to the director, he earned a high-tier salary but nevertheless we struggled to make ends meet. Hunger was a norm in my family.

After office hours my father had to do extra jobs. With his physique, any kind of intense labor was out of the question. He became a teacher to factory workers to earn a few pennies and extra perks. For instance, when he taught at a wood factory near the Red River, he had the "perk" of buying a big bag of sawdust at a discounted price, a necessity during the era when every household used wood stoves for cooking. Occasionally the factory workers even sneaked a few small pieces of leftover wood, which would light my family’s stove for a longer period, a small but kind gesture in those harsh days.

In the 1980s, due to the trade embargo by the west, life became more extreme by the day.

Society stopped frowning upon those who took extra jobs as essentially every person needed to do to survive. Those with medical skills were highly valued.

My father no longer had to do extra work outside of his profession anymore. Every day after office he would cycle to his patients' homes to check their health and give them medicines. As he was excellent at his job, more and more patients started coming to him, which took up all evening most days.

Due to his hard work, the living condition of my family slowly became better. Meals with meat, a luxury those days, became more frequent.

Nevertheless, despite the social acceptance, the government still severely criticized doctors who worked overtime as private doctors.

In 1984 Resolution 55 on "medical service for the foreseeable time" aimed to "eliminate private trade in medicines and private medical services."

As I grew up I followed in my father's footsteps and became a doctor. As I graduated from medical school Vietnam was in the last few years of the command economy. Doctors like me could work all night for meager compensation. On some nights we would earn less than the cost of half a bowl of noodles for hours of work.

Naturally we all gravitated toward extra work for survival, the most common of which for us doctors was as bicycle parking attendants in the evening. The hospital where I worked divided this privilege of working for the hospital's parking lot between doctors in various departments.

Besides this, each doctor found other ways to make ends meet: Some inherited their family craftsmanship while others knitted sweaters to sell.

Only after the 1986 doi moi economic reform that the private sector was formally recognized by the government. Pharmacists were allowed to privately sell medicines, and doctors were allowed to open private clinics.

Services slowly opened up, improving living conditions for us doctors.

Now, almost four decades after the economic reform, private medical services do not stop with small clinics but have continued to develop into large, highly advanced private hospitals.

More and more doctors work full-time at these private hospitals, while a majority switch back and forth every day between public and private ones.

To me, this is an encouraging trend: patients have more options, doctors have more incomes and the public health system has less pressure.

According to WHO, in 2018 Vietnam had an average of one doctor and two nurses for every 1000 population, lower than the average for low-income countries. This showed the great social demand for medical personnel.

Legally, doctors, even if formally employed by public hospitals, are allowed to take extra work privately if approved by their managers.

Younger generations now may not understand why doctors were not allowed to offer private medical services under the command economy.

Doctors like me sometimes do not understand why we needed to labor outside of our profession while we could have contributed intellectually and professionally and met a persistent social demand.

As a young country, Vietnam undoubtedly made mistakes. But this is not a time to complain about a bygone era, only learn lessons so that those mistakes never happen again.

Every society faces its own challenge. Can we learn how to prepare our society to adapt to future challenges better?

Talking about my profession, in my opinion, Vietnamese society remains very harsh on doctors who have private clinics. We should develop tolerance for those who work honestly and legally to make a living.

Especially since doctors save lives.

*Doctor Quan The Dan is deputy director of Tri Duc Thanh General Hospital in Thanh Hoa Province.

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