Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
EDITORIAL
Doctors and voluntary services
Ben Fong, MPH(Syd), FHKAM (Community Medicine)
Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hong Kong
Corresponding author: Dr Ben Fong (byffong@gmail.com)
Volunteer work is done with the wish to help
people, commonly arising from one’s passion,
drive, sense of social responsibility, and dedication.
Society is in need of volunteer services for health
education and promotion, be they health seminars,
exhibitions, patient self-help groups, or one-to-one
patient counselling services. Doctors are in a
privileged position to collaborate with other allied
health professionals in an interdisciplinary team,
so their service scope could be even broader and
more comprehensive, involving not only the general
public but also patients, their family members, and
their caregivers. Doctors are looked upon as social
models, at times even the untouchable citizens. They
are expected to have very high, if not the highest,
professional and ethical standards, as well as being
competent, just, honest, responsible, obliging,
caring, and approachable. Many doctors choose
to contribute to community services in various
roles and responsibilities by taking up honorary
positions in non-governmental organisations,
public bodies, government boards and committees,
educational institutions, non–profit-making health
organisations, and professional associations.
Many medical professionals serve outside their
working hours in emergency, rescue, and first-aid
forces, including the Government Flying Service,1 2
the Auxiliary Medical Service,3 the Red Cross, and
the St John Ambulance service. These volunteers
provide pre-hospital trauma and emergency
treatment and advanced life support, and share
their professional knowledge, skills and experience
to lay volunteers with the objective to improve the
standards and skill set of the entire volunteer force.
Such involvement of doctors reduces the need for
case transfers to hospital accident and emergency
departments, particularly at large public events.
Doctors, like all volunteer members, are “dedicated
and committed to the worthwhile cause of saving
lives and relieving pain of the injured, serving
all walks of life irrespective of their race, age, or
occupation”.3 Moreover, doctors are often called
upon to volunteer their services, both at home and
abroad, at times of major incidents, including natural
disasters such as Typhoon Mangkhut in 2018, or
the current coronavirus disease 2019 (COVID-19)
pandemic. These medical professionals and team
volunteers are highly regarded for contributing their valuable time and professional services to
the needed and to save lives in such potentially
dangerous environments.
Personal characteristics, such as religion,
marital status, having a family, and home stress,
as well as professional characteristics that reflect
autonomy and workload, such as type of practice,
work location, working hours, and professional
training, affect the amount of time a doctor
dedicates to voluntary services.4 The youngest and
oldest medical professionals are less likely to serve as
volunteers, but those with children are more willing
to do so. In addition, family doctors and those
practising in the rural areas have shown a more
personal and lifelong commitment to the society and
are more ready in responding to strong community
expectations of volunteering.4 Some doctors are
motivated to provide volunteer services to others in
trying to develop and maintain their own positive
identities. Such identities are associated with the
doctor’s desires to be perceived as a good doctor by
patients and colleagues. Volunteerism also creates
meaning and purpose in one’s life through personal
development and fostering social support from the
positive experience outside normal working lives.5
There are many benefits of volunteering, including
enhanced physical and psychosocial wellness,
increasing self-confidence, having a sense of
purpose and fulfilment in life, professional and social
networking, career development, etc.6
No matter what, volunteer doctors should
commit with the highest respect, dignity, and
equality to provide genuine assistance untainted
by personal ambition or pecuniary gains. Such
obligation has practical, professional, and
philosophical implications in all aspects of medical
volunteerism.7 At the same time, medical students
and junior doctors are very much inspired to serve
in voluntary community healthcare works by a
dedicated team of medical professionals with a
united vision.8 They will become a different type
of doctors, who do not regard medical service as
merely a profession that mainly benefits themselves,
but who also understand and respond to the needs
of the society, particularly the underprivileged and
minority communities.9 The Hong Kong Medical
Journal has previously interviewed a number of
outstanding healthcare professionals to recognise their contributions to the society,2 and the scope of
their service recipients is very broad—ranging from
children,10 11 the vulnerable groups,12 the general
public,13 14 15 practising physicians,16 and patients
in need of rehabilitation.17 18 They should be our
exemplary models to learn from.
Doctors are working as volunteers in many
parts of the world and under the auspices of a variety
of organisations. The services have been shown to
have far-reaching benefits to the individuals and
the host organisations, regions, and countries. The
doctors will broaden their skills base, promote
positive values of volunteerism, contribute to the
health, well-being and public health services and
social care to those being served. However, the
scale and scope of such activity is normally not well
documented, and the arrangement of the involvement
are mostly informal.19 A study has recommended to
address the need for volunteer preparation and to
evaluate the practice to maximise the benefits of
volunteering, reduce the risk of harm and, optimise
learning and accountability, through formal
development, standardisation, coordination, and
professionalisation. There are also issues of lacking
the structure and framework for debriefing, and
evaluation of the services rendered and validation of
outcomes, especially in the context of ethical quality.
Thus, written official guidance on the best practice in
voluntary services should be developed to enhance
the benefits while avoiding harm, like medical
errors.20 The guidelines should address the areas of
the principles of mission, partnership, preparation,
reflection, supports, sustainability, and evaluation in
medical volunteerism.21
Volunteer doctors are devoted and enjoy
serving people in need of assistance during good
times and difficult situations arising from daily
activities and unexpected emergency calls of the
nature. Giving back to the community allows doctors
to experience the joyful encounters and excitement
with non-financial rewards and satisfaction from
serving others and meeting the changing challenges
and needs of the world outside their professional
domain. To promote such invaluable services and to
maximise the contribution of volunteers, a structural
approach to facilitate and further develop a practical
framework of medical volunteerism, particularly in
response to disastrous situations, is highly desirable.
Formalisation of medical volunteers with effective
management support and positive publicity will
attract many more doctors to the services, drawing
the “untapped” professional resources to the social
capital. The government should consider the
inclusion of medical volunteerism in the emergency
response plan and work with medical organisations
to further enhance the impacts of doctors in their
role as volunteers.
Author contributions
The author contributed to the concept of the study, analysis
or interpretation of the data, drafting of the manuscript, and
critical revision of the manuscript for important intellectual
content. The author had contributed to the manuscript,
approved the final version for publication, and takes
responsibility for its accuracy and integrity.
Conflicts of interest
The author has disclosed no conflicts of interest.
Funding/support
This editorial received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
References
1. Government Flying Service. Service & operation. Available from: https://www.gfs.gov.hk/eng/service.htm. Accessed
19 Apr 2020.
2. Tsui M, Chan B. Part of a larger whole: serving in the
Government Flying Service. An interview with Dr Ralph
Cheung. Hong Kong Med J 2018;24:644-5.
3. Auxiliary Medical Service. Available from: https://www.
ams.gov.hk/eng/main.htm. Accessed 19 Apr 2020.
4. Frank E, Breyan J, Elon LK. Pro bono work and nonmedical
volunteerism among U.S. women physicians. J Womens
Health (Larchmt) 2003;12:589-98. Crossref
5. Reeser JC, Berg RL, Rhea D, Willick S. Motivation and
satisfaction among polyclinic volunteers at the 2002
Winter Olympic and Paralympic Games. Br J Sports Med
2005;39:e20. Crossref
6. Meszaros L. Physician volunteerism: The surprising
benefits for doctors who do it. Available from: https://www.
mdlinx.com/internal-medicine/article/2841. Accessed 19
Apr 2020.
7. Bauer I. More harm than good? The questionable ethics
of medical volunteering and international student
placements. Trop Dis Travel Med Vaccines 2017;3:5. Crossref
8. Favara DM, Makin L. Chesed Children’s Clinic: a nonprofit,
paediatric primary care outreach clinic in the
Eastern Cape created by junior doctors and volunteers. S
Afr Med J 2013;103:356-7. Crossref
9. Tungsubutra K. Primary health care and volunteer health
workers—an experiment in northeastern Thailand. JOICFP
Rev 1983;(6):32-6.
10. Chan WW, Lo AT, Wong K. Putting a smile on children’s
faces: an interview with Dr Bernard Sik-kuen Chow. Hong
Kong Med J 2018;24:87-9.
11. Lam C, Cheuk N, Yeung C. Healing hearts in paediatrics:
an interview with Dr Adolphus Chau. Hong Kong Med J
2019;25:416-8. Crossref
12. Yeung CH, Cheuk NK. Breaking down frontiers through
medical humanitarianism: an interview with Prof Emily
Chan. Hong Kong Med J 2018;24:208-11.
13. Chan B, Cheng HE, Lo MT, So N. Clinician and teacher,
sportsman and coach: an interview with Dr Henry Lam.
Hong Kong Med J 2019;25:260-1.
14. Chan JH, Kwok HH, Li VS. The secret to disease-free living:
a wholefood plant-based diet. An interview with Dr Irene
Lo. Hong Kong Med J 2018;24:432-3.
15. Xue W, Leung BPH. Duty and excellence—an interview with Dr Kin-hung Lee. Hong Kong Med J 2018;24:543-5.
16. Chan JH, Kwok HH, Li VS. Professor Kwok-yung Yuen:
embracing life with a beginner’s heart. Hong Kong Med J
2019;25:83-5.
17. Tsui M, Cheung M, Chan C. A pioneer in comprehensive
rehabilitation: an interview with Professor Chetwyn Chan.
Hong Kong Med J 2019;25:170-1.
18. Yau R, Lau N. World volunteer and carer for bones and
minds: an interview with Dr Chi-wai Chan. Hong Kong
Med J 2019;25:501-2. Crossref
19. British Medical Association. Doctors as volunteers. 7
December 2018. Available from: https://archive.bma.org.uk/collective-voice/influence/international/global-health/doctors-as-volunteers. Accessed 30 Apr 2020.
20. Eadsforth H. Professionalisation of international medical
volunteer work to maintain ethical standards: a qualitative
study exploring the experience of volunteer doctors in
relation to UK policy. Med Sci (Basel) 2019;7(1). pii: E9. Crossref
21. Stone GS, Olson KR. The ethics of medical volunteerism.
Med Clin North Am 2016;100:237-46. Crossref