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Cape Town - A heavy workload, fear of litigation and the profession’s unprofitability are deterring many gynaecologists from practising.
This has emerged after Health Minister Aaron Motsoaledi said last week that South Africa was suffering a massive shortage of these specialists.
Dr Haynes van der Merwe, of the SA Society of Obstetrics and Gynaecologists, and a gynaecological oncologist at Tygerberg Hospital, described working conditions in the field as “extremely difficult”.
While those in the public sector often had to deal with overcrowded maternity units, sometimes 160 percent full, in private practice gynaecologists had to pay around R250 000 in medical insurance.
“Obstetrics and gynaecology is supposed to be one of the nicest and most fulfilling specialties, as it is about saving the lives of women and babies, but in recent years working conditions have become terribly hard.
Today, there are lots of gynaecologists who have become alcoholics and stopped practising due to litigation, which has increased tremendously in the medical profession. It seems law firms are targeting the industry. Somehow we seem to be the soft targets,” Van der Merwe said.
Motsoaledi told Parliament’s oversight committee on health last week that many gynaecologists had abandoned the profession as it had become less profitable and therefore “not worth it”.
“These days, you go to public hospitals - no gynaecologist; go to private hospitals - no gynaecologist. Doctors feel that being a gynaecologist is not worth it.”
Peter de Jong, a gynaecologist from Netcare Christiaan Barnard Memorial Hospital, said many gynaecologists were emigrating due to the “difficult medico-legal climate” in South Africa.
“I know of many gynaecologists who have gone overseas because it’s better pay for them and they are not sued so much. Doctors go to private practice because they want to earn a decent living, but this is no longer rewarding.
My first 90 deliveries in a year cover my insurance premiums only before any overheads. Gynaecologists have become soft targets (for lawyers) because they know that there’s always mishaps with birth and pregnancy,” he said.
Dr Carol Thomas, specialist gynaecologist and secretary of the SA Menopause Society, said given the years of study it took to specialise - about 13 years - and the workload, gynaecology had become unprofitable.
“It is a very labour-intensive job, and from what I see… doctors are not prepared to lose valuable things such as family life to do something that gives them very little financial rewards.”
But Professor Silke Dyer, deputy head of the department of obstetrics and gynaecology at UCT and Groote Schuur, said: “Yes it’s very labour-intensive , but it’s a hugely rewarding speciality. People who train as gynaecologists have a lot of dedication and passion for what they do”.
She said the shortage of gynaecologists resulted in poor maternal outcomes; and was one of the reasons South Africa would not improve its maternal health in 2015, she said.
The country had only 0.2 specialists for every 1 000 patients,while the international recommendation was 0.4.