Finding a way between citizen satisfaction and healthcare worker satisfaction

The real subject that prompted me to write in my last piece about YÖK's equivalency issue was the claim that health workers in Turkey are being forced to go abroad because of heavy working conditions. Truthfully, from my side the mixing of the equivalency issue with this subject is only a coincidence, but of course the two are not without a relationship to each other.

The equivalency issue is a serious problem especially in the field of medicine, and one dimension of this problem is, as much as it relates to YÖK as is assumed, the inevitable result of a medical education system already operating in Turkey and proven in its own right. That those who could not obtain the score to enter a medical faculty in Turkey but somehow obtained a diploma from abroad and returned should be subjected to strict supervision and an examination is something that the quality of medicine in Turkey also requires. For medical education in Turkey is truly a very difficult and arduous process. On this occasion, it would be unfair not to see and appreciate what a long and arduous journey medical workers take on, starting from the education stage itself.

Hence, when the discourses on equivalency and on the conditions of medical workers get mixed together, it becomes very difficult to carry out a healthy thinking-discussion. Yet on this occasion the following truth has once again appeared in its clearest form. Everyone is far more interested in the dimension of the problem that concerns them, perhaps the side that burns them. The rest becomes a detail to them. No one can view the subject broadly, and when looked at from a somewhat broader perspective, people react with the feeling that their own problem has been ignored. Without getting into any debate with anyone, it is very clear that a more empathetic approach, one that respects everyone's rights and due, is needed on this matter.

First, the matter of health workers. For example, requests from abroad to work in Turkey's health sector on certain project bases are something I have personally witnessed and been involved in. But people, starting from what they themselves have lived through, can easily say that such a thing is never possible. The existence of such a request or interest probably seems unbelievable against the weight of what the objecting friends have gone through, but it happens.

To those who say foreign capital is fleeing Turkey and none dares to invest, I can easily point, from my own experience, to foreign investors who are investing in Turkey, and in very risky fields at that. This does not require denying the existence of capital fleeing Turkey either, but it shows that the whole story of Turkey cannot be reduced to a few small experiences.

Meanwhile, it must never be concluded from what we say about health workers that we are ignoring their problems. In particular, the heaviest burden of the struggle against Covid19 has fallen on their backs on behalf of the whole society. We all see how worn out and tired a great many health workers, whose way of life and pace I have in some way come to know, have become in this process, and how, despite this, they are practicing their profession with great self-sacrifice.

As a society, no amount of thanks we give to health workers is enough. In a way of life in which, after working 36 hours without a break, getting very little rest and then continuing one's shift has become the routine of the profession, one must give up a great deal. A pace of life far from family settings, from conversation with friends, let alone vacations, from the most necessary rest. It is an indisputable fact that the biggest share of the relative success achieved in Turkey today in the struggle against Covid19 belongs to them. Perhaps because of Covid19 the lifestyle of health workers not only in Turkey but in all countries was very badly affected, and they worked more than normal. But we must say that in Turkey health workers worked taking on an even greater sacrifice in this regard, and the result is plain: Turkey produced a result far more in favor of its citizens against the epidemic than other countries.

Undoubtedly the difficulties of health workers' working conditions in Turkey are not related only to the conditions of the Covid19 epidemic period. Even under normal conditions, the weight of the health system, which has become a source of pride in the world in terms of medical education and service in Turkey, has to a great extent been placed on the backs of health workers. The education process is already longer, costlier and harder than other professions. A medical student who has to study at least 10 years until obtaining a specialization has to work during this time under a very heavy discipline, a very heavy workload, with on-call durations and problems that strain human nature.

It can be said that in Turkey during the AK Parti period a serious health reform, even a revolution, has taken place. This is seen when looked at from every part of the world. Both the quality and the cheapness of health service have reached a state that does not admit comparison even with the most developed countries. However, one must see that this service quality and cheapness, which give priority to citizen satisfaction and to a large extent provide it, have also to a large extent been placed on the backs of health workers.

The citizen has almost direct access to all physicians. The institution of family medicine in between was in fact conceived to reduce, by filtering, the patient density that flows directly to specialist doctors, but patients' tendency to go directly to their doctor renders this system inoperative. This produces a situation in which the patient load keeps growing without decreasing, while there is no parallel increase in health workers.

On this matter, for the health system, which has largely secured citizen satisfaction, to try from now on to secure the satisfaction of health workers as much as possible is also very important for the sustainability of Turkey's health system. Of course, on one side of the matter there is also economic justice. This great sacrifice and labor definitely deserve far more.