Karoshi (death from overwork) among doctors in China

Letter in BMJ from Dr Dai Cong of Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning:

Karoshi happens among doctors in China's large tertiary hospitals such as Wang Qi from Armed Police General hospital. Karoshi means “death from overwork”. The term is said to have originated in 1982 when three Japanese doctors published a book entitled karoshi that noted many victims of overworking and included research into their deaths. The victims were young men who were otherwise healthy, but worked more than 60 hours a week on average and had died on the job from heart attacks and strokes.
Recently there is an increasing outpatient workload in China's large tertiary hospitals. The reason is that there is no general practioner-based referral system in China and there is a huge difference between large tertiary hospitals and community hospitals in China. At the same time, the outpatient consultation fee is almost the same between large tertiary hospitals and community hospitals. Thus, these doctors from large tertiary hospitals are overwhelmed with heavy outpatient workloads. And these factors have led to Chinese doctors working more than 80 hours a week.
In a 2011 survey of 6,000 doctors by the Chinese Medical Doctor Association, 78% said they wouldn’t want their children to study medicine. And nearly 40% of medical personnel surveyed at 316 hospitals nationwide from December 2012 to July 2013 said they plan to give up their profession due to increased heavy workloads in hospitals. I hope that this correspondence might reduce the heavy outpatient workloads and avoid the karoshi of doctors in China.