They line up for hours at hospitals in big cities around the country – anxious parents searching for treatment or a diagnosis for their child’s illness. It’s a wait that can

seem like an eternity and the consultation is often over in minutes.

The mainland has a shortage of paediatricians, with a little more than 93,400 practising in 2014, half the number needed, according to some estimates.

The specialists must contend with demanding workloads and parents who sometimes fly into violent rages when they receive unfortunate news. Medical experts expect the situation to worsen as the switch to the two-child policy begins to have an effect.

Sun Meiyue knows all too well the strain of working on the medical front line. She is a leading neonatologist at the children’s hospital affiliated with Zhejiang University’s School of Medicine. The shortage of paediatricians is a long-standing problem, yet little has been done to tackle it.

“No one is willing to be a paediatrician,” Sun said. “Compared with their counterparts in departments dealing with adults, paediatricians are busier, bear higher risks and earn far less than other doctors such as surgeons.”

She said the more pragmatic ones had left the field, so the doctors who stayed behind would become even busier.

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About 3 million more children are expected to be born every year under the two-child policy, which came into effect on January 1, and applies to all married couples. The Communist Party hopes the additional births will offset the effects of an ageing population and shrinking workforce.

“If [there is] no substantial change to the health care system, I’m not optimistic about the future,” she said.

For years authorities argued the one-child policy was key to raising living standards. It is thought to have prevented 400 million births.

Lang Hong quit her job at a big public hospital four years ago for a position at a private upmarket clinic for children in Beijing. Like others, at the public hospital she had to deal with demanding parents and felt “extremely exhausted and at too great a risk”.

Lang said about one-third of her classmates at Jiangxi Medical University had quit paediatrics and taken up jobs in hospital administration, blood testing and pharmaceutical research.

“In the [public] hospital, besides the excessive workload, I had to face pressure from parents,” she said.

“Parents have high expectations of doctors and often become worried and irritable. There’s always a high risk that they will vent that anger at medical staff.”

Sometimes that anger has boiled over into violence. Two years ago, a doctor in Hebei (河北) accidentally fell to her death from the window of her office as she tried to flee a mob of relatives who blamed her for the death of a seven-year-old boy, the magazine Caixin reported.

The shortage of paediatricians is having obvious effects on services for children. Many small and mid-sized hospitals across the country have closed their paediatric emergency departments in recent years because they do not have the people to staff them.

Ruijin Hospital’s Luwan branch in Shanghai was one such hospital, according to Its paediatric department had only three doctors: one retiree who had been rehired, one doctor who was about to retire, and another one who was the department’s director. The hospital was trying to find replacements but the specialists had little interest in going to a mid-tier centre.

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Parents, too, prefer the bigger centres even if they can get adequate care closer to home. Doctors at big public hospitals treat roughly 90 per cent of all cases.

Zhang Yimei said she and her husband had travelled more than an hour from their home in Shanghai’s Minhang district so their grandson, 5, could be treated for a cold and a cough at Shanghai Children’s Hospital, one of the city’s top four paediatric centres.

“The drugs prescribed here are the same as the ones from a community hospital near my home,” Zhang said. “But I still come. I trust the doctors here and I feel relieved after seeing them.”

Cases like this compound the workload on Huang Zhiheng, a gastroenterologist at Fudan University’s children’s hospital.

Huang said he saw as many as 180 patients a day and more than half had common ailments like a cold, cough or fever. “Sometimes I feel what I do is superficial since I rarely see difficult or complicated illnesses,” he said.

Shanghai is planning to ease the workload. With 250,000 more children expected to be born in the city each year, the city planned to train 300-500 paediatricians in the next few years, to add to the 3,200 already in the system, Wang Panshi, deputy director of the city’s health authority said.

Medical universities would enlist more students to study paediatrics and the government would encourage medical students who did not study paediatrics to train in the area, the authority said. If necessary, doctors who treat adults would be encouraged to do 10 months of training to be able to treat children.

But Huang is sceptical. “The official solution is not realistic,” Huang said.

“First, few medical students will apply to study paediatrics. Second, would any parent send their child to see a doctor with only a few months of training? I don’t think so.”
Additional reporting by Agence France-Presse

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