Tuesday, September 26, 2006

BB's Darker Days

Barbados Butterfly has just finished a series of posts entitled "The Darker Days" which are revealing yet insightful posts as always. Like any other profession, medicine is full of unsavoury experiences, often exacerbated by the expectations and pressures that society places upon doctors and nurses.

Working hours are often excessive, and there is no doubt that ridiculous >24 hour waking shifts should be outlawed, as well as on-call shifts where it is fully expected you will be kept awake.

I worry, however, about the needle swinging too far in the opposite direction... the doctor who in 5 years time struggles to find 38 hours of work to do each week. Last week I met some second-year paramedics, and some ICU nurses. I realised that my hourly pay is less than each of theirs, and the only thing that maintains gross income parity is the long hours I work. Imagine halving your income and doubling your training period because of the reduced patient exposure!

In her athlete analogy: "Sometimes their frequent injuries prevent them from reaching the heights they dreamed of, or force early retirement."

I must add that sometimes doctors do not realise that they do not have to reach the pinnacle of medical seniority in order to lead a full and productive professional life. There are a multitude of hidden and secret pathways into a long term medical career short of completing specialist and GP training. Unfortunately the options that are readily visible (e.g. career hospital HMO) are financially and professionally unrewarding in our current salary environment. I think it is inevitable this will change, though it has major implications for the structure of the Australian hospital system.

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