XI’AN, China (Xinhua) – China’s introduction of the two-child policy this year has caused worry that the change will further aggravate a current shortage of paediatricians.

The number of paediatricians in China dropped from 105,000 to around 100,000 within five years, according to China’s public health statistical yearbook in 2015. On average, there are only 43 doctors per 100,000 children.

Wang Baoxi, a paediatrician with the Shaanxi branch of Chinese Medical Doctor Association, told Xinhua that the situation was even worse in smaller cities and counties. In Weinan city, which is about 70 kilometres away from Shaanxi’s capital Xi’an, they only had 17 doctors to care for 100,000 children.

The Lingnan branch of Number 3 hospital affiliated with Sun Yat-sen University posted a notice telling people emergency treatment services in the paediatric department were cancelled due to a lack of doctors.

“Since the department was established in 2011, we have employed eight doctors. Four left in the following years,” said Shan Yutao, who works in the hospital’s medical management office.

In 2014, the number of patients in the hospital exceeded 63,000. The number increased 12 per cent in 2015.

The shortage of paediatricians has made it difficult for parents.

In the Tangdu Hospital, one of the best hospitals in Xi’an, capital city of northwest China’s Shaanxi province, the waiting area for the paediatric department and surrounding corridor was swarming with hundreds of parents and sick children, with cries ringing out continuously.

The department, which receives more than 500 patients daily, has 36 doctors in total.

“In the mornings I receive more than 100 outpatients,” said Wang Baoxi. He said such high demand means he can only spend only a few minutes with each patient.

In Xi’an Central Hospital there are 16 paediatricians, among whom only three are senior doctors.

“We have lowered our standard, but still we don’t have enough paediatricians,” said Luo Zhijuan, director of the paediatric department.

Statistics by the health and family planning commission of Shaanxi showed that among all the paediatricians only less than one-third are university graduates, and another one-third are graduates from junior colleges.

Low salary, high pressure and high risk are the main causes behind people’s reluctance to become paediatricians, said Luo.

Doctor Fu Rong told Xinhua she works treating outpatients two days per week, does group consultations for two days and visits the ward every day. “My working time a day is, on average, more than 10 hours,” she said. Every four days she works a 24-hour shift.

Even when a child is given treatment, conflict arises. Child patients are usually too young to give a precise description of their symptoms but parents have high expectations from the doctors.

“Conflicts are not rare,” said Li Pei, a nurse with the Xi’an Central Hospital. “We always find ourselves facing anxious parents yelling at us.”

However, paediatricians are not well-paid. “Paediatricians earn 30 per cent less than other departments, because the department earns less income,” said Xia Ling, another nurse.

In China, medicines and examinations are the primary source of income for a medical department and children are prescribed less medicine than adults. The dosage for 10 to 15 children equals that of roughly one adult.

A decrease of paediatric graduates has also fuelled the shortage.

In 1998, the Ministry of Education abolished paediatric departments in universities.

Qian Xueming, a political adviser who attended the “two sessions” – the meetings of the local legislature and political advisory body – in southwest China’s Guangxi Zhuang Autonomous Region only knew five universities with paediatric departments. Most stopped accepting paediatric majors.

“Without timely measures, the situation will become worse,” he said.