Intended for healthcare professionals


The poor health of paediatrics in China

BMJ 2018; 361 doi: (Published 14 June 2018) Cite this as: BMJ 2018;361:k2567
  1. Yue Liu, research fellow in medicine1,
  2. Rui Song, researcher2,
  3. Peter C Hou, instructor in emergency medicine3,
  4. Li Zhang, professor of medicine4,
  5. Yin Zhang, research fellow in medicine5
  1. 1School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
  2. 2To Cure Autism Institute, Burlington, MA, USA
  3. 3Division of Emergency Critical Care Medicine, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
  4. 4Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China
  5. 5Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
  1. Correspondence to: Yin Zhang drzhangyin{at}, yin.zhang{at}

A specialty in crisis because of worsening conditions and poor pay

Physician wellbeing is paramount for the health of a nation.1 Doctors who experience professional satisfaction and fulfilment promote clinical efficiency, improve patient experience and outcomes, and potentially reduce medical costs.1 In many countries, physician burnout has greatly threatened patient care. In the United States, more than 50% of doctors have experienced symptoms of burnout.1 In response, the US National Academy of Medicine has launched collaborative action to identify solutions for improving physician wellbeing.1

The ongoing crisis in the paediatric workforce in China is an excellent demonstration of the damage to doctors, patients, and public health that can ensue from poor attention to physician wellbeing. In China, paediatrics is a shrinking specialty that has faced an increasingly harsh working environment since the two child policy was introduced in early 2016.2

With a baby boom that will result in an estimated 290 million children by 2020,3 delays in paediatric care have …

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