For most prime ministers, the task of running the country is enough.

But not so for the multitasking prime minister of Bhutan, who spends his weekends at an operating table and tending to patients.

Dr Lotay Tshering was one of Bhutan’s most highly regarded doctors before he entered politics last year, and while his prime ministerial duties occupy him during the week, on weekends he returns to the hospital as a way to let off steam.

“Some people play golf, some do archery, and I like to operate,” Tshering told AFP as he tended to patients one Saturday morning at Jigme Dorji Wangchuck national referral hospital, describing his moonlighting medical work as a “de-stresser”.

“I will continue doing this until I die and I miss not being able to be here every day,” he added. “Whenever I drive to work on weekdays, I wish I could turn left towards the hospital.”

Far from finding the two roles hard to juggle, Tshering said he had found that there was unexpected crossover between prime minister and surgeon. “At the hospital I scan and treat patients. In the government, I scan the health of policies and try to make them better,” he said. He has also put healthcare reform at the heart of his political agenda.

After a first failed election attempt in 2013, Tshering was voted in as prime minister of Bhutan in November 2018. He is the third democratic leader since the country – which is known best for being the birthplace of measuring “gross national happiness” – transitioned from an absolute monarchy to a democracy a decade ago.

It is perhaps a uniquely fitting pastime for the prime minister of Bhutan, a kingdom tucked between India and China with a population of just 750,000 people, which has chosen to eschew many of the profitable but damaging ways of modern life, seeking instead to preserve its cultural identity and traditions.

Tourists must spend $250 a day to protect the nation’s temples and forests Photograph: Mark A Paulda/Getty Images

Nature is revered, meaning the country’s forests are left untouched, it is forbidden to kill any living creature and the country is carbon negative. In order to protect the country’s ancient mountain temples and untouched forests from marauding tourists, a $250 minimum daily spend is imposed on visitors.

Bhutan is consistently ranked the happiest country in Asia, though it is far from a utopia, still struggling with the same issues as some of its neighbours, including high youth unemployment, a 95% national increase in the crime rate and a rising number of health-related issues such as diabetes and obesity.

For the people of Bhutan, it is a privilege to be treated by Tshering, who also spends his Thursday mornings giving medical advice to trainee doctors.

At Jigme Dorji Wangchuck hospital, Bumthap, who had just undergone a five-hour bladder-repair operation carried out by Tshering, said he was thrilled with the work of his high-profile surgeon.

“Now that I have been operated on by the prime minister, who is considered one of the best doctors in the country, I feel more relieved,” said Bumthap.