Scandal at hospital: doctors exempt from on-call duties putting elderly patient care at risk

A troubling situation within the Romanian healthcare system has brought to light serious dysfunctions that directly affect the quality of care received by elderly patients. At a major county hospital, approximately 70% of medical staff are not taking part in the on-call rota, citing health problems — yet many of these exemptions raise serious questions.

The problem is particularly acute for elderly patients, who typically require emergency medical care outside normal working hours. Vital departments such as neurosurgery — where many older patients arrive in critical condition following strokes or trauma — are among the hardest hit by this shortage of available doctors.

The paradoxical situation described by hospital management reveals that some doctors, including those under 50 years of age, are being granted medical exemptions from on-call duties on the grounds that they cannot remain on their feet for more than two hours. At the same time, these same specialists are regularly observed visiting gyms or spending time at entertainment venues, raising serious doubts about the authenticity of the health conditions they have cited.

Direct impact on the care of older people

For elderly patients and their families, this situation can have dramatic consequences. Medical emergencies in older people — heart attacks, strokes, osteoporosis-related fractures, or diabetic complications — occur frequently during on-call hours. An insufficient number of doctors on duty can mean delays in diagnosis and treatment, and in elderly patients such delays can mean the difference between life and death.

The problem grows still more complex when one considers that many older people arrive at hospital by private ambulance or specialist medical transport, expecting to find the medical staff needed for prompt intervention. When on-call rotas are understaffed, these emergency services lose much of their effectiveness.

Oversight measures and reassessment

Following reports of these irregularities, the central authorities have decided to intervene by dispatching the Control Corps to investigate the situation. The Occupational Medicine Commission will also be asked to carry out a medical reassessment of all on-call exemptions, in order to verify whether each one is professionally and medically justified.

This investigation is essential for protecting the rights of elderly patients to quality medical care. It cannot be acceptable for a doctor to hold restrictions only within the public health system whilst working without any difficulty in the private sector, at a time when older people on modest pensions depend exclusively on state hospital services.

The issue of medical on-call cover is not new to the Romanian healthcare system, but its scale at this hospital reveals a crisis that demands urgent reform. The authorities have announced plans to introduce a tiered system of on-call categories, and are examining the possibility of reducing shifts from 24 to 12 hours where feasible, with the aim of making on-call duties more attractive to doctors and more effective for patients.