Dozens of Emergency Physicians in Gilan Given Deadline to Receive Bonuses by Year-End

Emergency physicians at public hospitals in Gilan have issued an open letter to the head of the province's medical university, protesting the non-payment of their bonuses over the past year. According to the media group 'Shargh', the letter, signed by over 100 doctors, warns that if their demands are not met by the end of the year, they will stop providing services to non-emergency patients starting from Farvardin 1404 (March 2025). The protesting doctors state that they have held several meetings with the head of Gilan's medical university and the university's treatment deputy in recent months, but no results have been achieved so far. One doctor mentioned that officials have promised that, at best, some doctors might receive three months' worth of payments. However, the doctors insist that these promises are no longer acceptable. They have warned in their letter that if the arrears are not paid by the end of Esfand (March), they will only accept critically ill patients from the beginning of Farvardin 1404 and will not consult patients classified as levels 3, 4, and 5 (non-emergency). According to the report, one protesting doctor described the working conditions of himself and his colleagues: 'An emergency physician can sometimes see over 150 patients in a 12-hour shift. However, our monthly income, if paid on time, is only 14 million tomans, a figure that bears no relation to the difficulty of the work, responsibilities, and high stress of this job.' He also emphasized that in many small hospitals, general practitioners are forced to manage all emergency patients alone. This doctor added that hospitals like Manjil, Fuman, Masal, and Siyahkal do not even have emergency medicine specialists, and general practitioners must treat all patients, from heart attacks and strokes to road accidents. Another emergency physician, referring to the long delays in bonus payments, stated: 'Emergency physicians are forced to work overtime, but when it comes time for payment, we are told there is no budget for overtime.' He criticized the disparity in government payments, noting that in other government agencies, some employees without stress earn several times more than emergency physicians, who save patients' lives but must beg for their basic salaries. One doctor remarked: 'Out of respect for medical ethics and the Hippocratic oath, we have not involved financial issues in patient treatment, but do the officials who receive high salaries agree to work for a month without pay?' He warned that if this trend continues, many doctors will be forced to leave public hospitals, emigrate, or change their career paths. Some young doctors announced that after completing their service period, they would no longer be willing to work in public hospitals. One of them told Shargh: 'After my service, I will never return to the emergency departments of public centers. Our financial situation is so bad that we cannot even cover basic living expenses.' This doctor added that our colleagues who have emigrated to Australia see a maximum of 30 patients per shift and earn several times more than domestic physicians, while emergency doctors in Iran are forced to see over 100 patients and beg for their salaries. Previously, the government newspaper of the Islamic Republic reported on December 20 that the 'migration of 11,500 healthcare personnel' in less than two years is a 'bitter reality' and emphasized that 'if a solution is not found soon,' we will witness 'the decline of the medical community and its detrimental consequences nationwide.' This issue has raised alarms among experts in recent years. Factors such as the lack of primary services, high unemployment, poor housing, low wages, limited career prospects, workplace violence, professional discrimination, lack of economic stability, administrative corruption, political instability, and the threat of war are cited as significant factors in the migration of healthcare personnel. Experts also believe that good living conditions, low unemployment, better wages, good career prospects, better working conditions, and job satisfaction are crucial factors attracting these personnel to destination countries.