Doctor shortages in Asia – especially in rural and primary care – are driving up healthcare costs and overwhelming hospitals. However, the solution is not as simple as just “more doctors”. This piece explores how digital tools, clinical decision support, and smarter workforce strategies can empower frontline care and relieve system strain.
Across Asia, a growing imbalance is threatening healthcare system sustainability: too few doctors, particularly in rural and primary care settings. The result is familiar – patients bypass community care and crowd into tertiary hospitals, not because their conditions necessitate it, but due to limited alternatives. Specialists and residents in turn are overburdened and burnt out, further exacerbating the issue.
This shortage is not confined to low-income countries. Developed health systems are also under pressure. In early 2024, South Korea faced a widespread trainee doctor walkout in response to the government’s plan to increase medical school admissions. While the aim was to address chronic shortages outside major cities, the resistance from the medical community reflected deeper issues, including professional burnout and dissatisfaction with public sector conditions.
Meanwhile, in developing countries, rural health centers frequently operate without a single full-time doctor. India, for example, reports one doctor per 1,456 people (2019) – well below the World Health Organization’s recommended 1:1,000 ratio – with rural regions even more underserved. In these settings, nurses and community health workers shoulder a disproportionate burden, often without the tools or training to do so effectively.
The downstream effects are stark:
- Overburdened specialist outpatient clinics: Tertiary hospitals spend valuable resources managing routine cases that could have been handled in the community.
- Increased healthcare costs: Specialist visits, diagnostic testing, and hospital-based care are significantly more expensive than primary care management.
- Patient burden: Families often travel long distances to access care, incurring travel costs, lost wages, and emotional strain.
Governments across the region are under increasing pressure to “right-site” care or develop integrated care models which may entail shifting patients from specialist outpatient clinics to community or primary care. However, without real investment in capacity and infrastructure, this transition will be difficult.
Contributors to the shortage
This issue is complex and rooted in long-standing structural challenges:
- Brain drain: Many doctors seek better training, pay, and working conditions abroad. This is especially pronounced for developing countries.
- Urban-rural disparity: Trained physicians gravitate toward larger cities where opportunities and amenities are concentrated.
- Public sector disincentives: High workloads, limited career progression, and underfunding deter clinicians from working in government or rural roles.
- Narrow scopes of practice: Frontline healthcare providers are often constrained from managing more complex conditions – sometimes due to a lack of skill or financial incentives.
- Infrastructure gaps: Many rural or primary care settings lack the necessary diagnostic, pharmaceutical, and digital tools.
Strengthening clinical teams with digital solutions
While these challenges are not new, digital health tools – like clinical decision support (CDS) systems, electronic health records (EHRs) and telemedicine – offer an opportunity to extend the capabilities of primary care teams and ease the burdens on overworked clinicians in hospitals.
These tools can:
- Support better decision-making: CDS tools provide real-time, evidence-based guidance to clinicians, enabling them to manage a wider range of conditions with confidence.
- Facilitate upskilling: They serve as continuous learning platforms, supporting the development of clinical knowledge at the point of care.
- Empower team-based care: With access to trusted decision support, non-physician allied health professionals like pharmacists or nurse practitioners can take on greater responsibilities safely and effectively.
- Reduce unnecessary referrals: Equipped with accurate guidance, frontline providers can resolve more cases independently, easing pressure on hospitals and specialists. Medical record sharing also facilitates more coordinated care.
- Generate meaningful data: CDS usage trends and EMR data can help identify gaps in knowledge, inform training priorities, and guide policy.
Many countries are already exploring such strategies. In Singapore, general practitioners who are keen to join the Healthier SG initiative may receive grants to upgrade their clinic management systems. In the Philippines, Wolters Kluwer’s UpToDate® was piloted in rural clinics to support non-specialist primary care providers. Thailand’s long-standing CPIRD project has also improved retention among rural doctors and serves as a model for the region.
A call to action
While there is no single solution, regional examples and case studies show that strategic actions can deliver meaningful impact:
- Strengthen public sector practice
Improve compensation, reduce administrative burden, and create structured career pathways for doctors in the public sector, including community and rural settings. - Expand scopes of practice with the right support
Equip doctors, pharmacists, and nurses with upskilling opportunities and decision support tools to manage more complex cases safely. - Institutionalize evidence-based medicine
Integrate evidence-based resources into daily clinical workflows and ensure that access is universal across care settings. - Invest in enabling infrastructure
Provide digital tools that are user-friendly, mobile-compatible, and integrated with existing workflows, including multilingual patient education and EMR systems. - Use data to inform planning
Analyse clinical activity and digital engagement to inform policy and resource allocation. Leverage usage data from tools to identify knowledge gaps and improvement opportunities.
Turning challenges into opportunities
The shortage of doctors in Asia is more than a workforce challenge – it is a systemic risk to the efficiency, equity, and sustainability of healthcare. However, this challenge also presents a clear opportunity: by integrating digital tools, empowering team-based care, and rethinking workforce strategy, health systems can strengthen primary care and reduce overreliance on tertiary services.
Now is the time for action – before demographic pressures and chronic disease burdens widen the gap further. Asia’s healthcare systems must invest not only in more doctors but in supporting existing ones and leveraging systems that enable every clinician to do more with confidence.
How to start addressing the challenges
Join the HMA Webinar, Tackling APAC’s Doctor Shortage and Burnout with Innovation and Technology, on May 14, 2025, 2:00 am EST/May 14, 2025, 2:00 pm GMT+8. Gain expert insights, explore digital health innovations, and learn practical strategies to strengthen primary care.
