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Two Months, Eight Chinese Physicians Suffered Sudden Death

  • GuanYang Kang
    Affiliations
    Department of Cardiology The Fifth People's Hospital of Dongguan The Dongguan Affiliated Hospital of Medical College of Jinan University (also called Taiping People's Hospital of Dongguan) Dongguan, Guangdong China
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      To the Editor:
      I read with great interest the paper recently published in this Journal by Dr. Hoffer.
      • Hoffer EP.
      America's health care system is broken: what went wrong and how we can fix it. Part 3: hospitals and doctors.
      His article afforded an opportunity to comment on the health status of physicians in China.
      Sudden deaths have frequently occurred among Chinese physicians in the past 2 months (Table).

      Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      Why are there so many sudden deaths happening among young and middle-aged physicians? One of the most important reasons is overwork.

      Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      Wenjing G. Don't let more doctors have sudden death. Available at:http://zqb.cyol.com/html/2014-10/31/nw.D110000zgqnb_20141031_7-02.htm. Accessed August 8, 2019.

      • Shi X
      • Liu R.
      Sudden cardiac death in physicians: an alarming problem in China.
      • Song XN
      • Shen J
      • Ling W
      • et al.
      Sudden deaths among Chinese physicians.
      Young and middle-aged physicians are in the critical period of their family and career development. Not only do they hope to make breakthroughs in medical services as well as academic research, but they also face pressure from patients and their families. The escalation of contradictions between physicians and patients has also become an increasing mental burden in the practice of many physicians.

      Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      Wenjing G. Don't let more doctors have sudden death. Available at:http://zqb.cyol.com/html/2014-10/31/nw.D110000zgqnb_20141031_7-02.htm. Accessed August 8, 2019.

      • Shi X
      • Liu R.
      Sudden cardiac death in physicians: an alarming problem in China.
      • Song XN
      • Shen J
      • Ling W
      • et al.
      Sudden deaths among Chinese physicians.
      TableDemographic Data of the Chinese Physicians with Sudden Deaths
      NumberAge of Death, ySexDepartmentTertiary HospitalDate of DeathWorking Place
      141FemaleDermatologyYes6/14/2019Zhejiang
      248MaleBreast surgeryYes6/28/2019Henan
      332MaleOphthalmologyYes6/30/2019Beijing
      456MaleHealth statisticsYes7/4/2019Sichuan
      531MaleLaboratoryYes7/4/2019Hunan
      631FemaleDermatologyYes7/10/2019Liaoning
      730MaleLiver surgeryYes7/11/2019Shanghai
      857MaleTransplantationYes7/24/2019Beijing
      According to the Chinese Medical Association's 2018 White Paper on the Practice of Chinese Doctors, 2 the average weekly working hours of Chinese physicians number more than 40 hours. Less than a quarter of physicians are able to take annual legal leave, which means their right to rest is not protected. According to the Beijing Youth Daily,

      Wenjing G. Don't let more doctors have sudden death. Available at:http://zqb.cyol.com/html/2014-10/31/nw.D110000zgqnb_20141031_7-02.htm. Accessed August 8, 2019.

      the data from a survey showed that nearly half of the Chinese physicians currently have to work at least one night shift per week. Eighty percent of physicians have no more than half an hour of rest at noon. Many of them have only 10 minutes for lunch. Almost all physicians have been working continuously for more than 24 hours; half of them have been working continuously for more than 36 hours, and about 20% of them have been working continuously for more than 48 hours.

      Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      Wenjing G. Don't let more doctors have sudden death. Available at:http://zqb.cyol.com/html/2014-10/31/nw.D110000zgqnb_20141031_7-02.htm. Accessed August 8, 2019.

      • Shi X
      • Liu R.
      Sudden cardiac death in physicians: an alarming problem in China.
      • Song XN
      • Shen J
      • Ling W
      • et al.
      Sudden deaths among Chinese physicians.
      • Zhang HF
      • Li FX
      • Lei HY
      • Xu SY
      Rising sudden death among anaesthesiologists in China.
      In addition, some physicians still have to keep working even when they are ill or injured. A minor illness could become more serious, and the early stage could be dragged to the late stage.

      Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      Sudden death among Chinese physicians has become an urgent problem that needs a solution. The government is duty bound. Therefore, in order to create a better practice environment for doctors both physically and mentally, increasing financial support, strengthening the training of talented teams from different ages, accelerating the implementation of referral reformation, and safeguarding the dignity and legitimate rights and interests of doctors are imperative.

      References

        • Hoffer EP.
        America's health care system is broken: what went wrong and how we can fix it. Part 3: hospitals and doctors.
        Am J Med. 2019; 132: 907-911https://doi.org/10.1016/j.amjmed.2019.03.010
      1. Weichun C. Working overload in Chinese physicians. Available Accessed August 8, 2019.

      2. Wenjing G. Don't let more doctors have sudden death. Available at:http://zqb.cyol.com/html/2014-10/31/nw.D110000zgqnb_20141031_7-02.htm. Accessed August 8, 2019.

        • Shi X
        • Liu R.
        Sudden cardiac death in physicians: an alarming problem in China.
        Anatol J Cardiol. 2018; 19: 158
        • Song XN
        • Shen J
        • Ling W
        • et al.
        Sudden deaths among Chinese physicians.
        Chin Med J (Engl). 2015; 128: 3251-3253
        • Zhang HF
        • Li FX
        • Lei HY
        • Xu SY
        Rising sudden death among anaesthesiologists in China.
        Br J Anaesth. 2017; 119: 167-169

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      • The Reply
        The American Journal of MedicineVol. 134Issue 6
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          In his comments on my article,1 Guan Yang Kang, MD, tells us that Chinese physicians are overworked and attributes an outbreak of sudden deaths among young and middle-aged members of the profession to the stress of long hours and inadequate time off. Dr Kang's comments provide a good opportunity to segue into a discussion of the effects of stress on American physicians. Each year, over 400 physicians in this country take their own lives. Although, among the general population, low-skilled workers have the highest rates of suicide (often attributed to alcohol and drug use),2 the rate of suicide by physicians is higher than that of other professionals.
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