Working Yourself to Death

I find it quite amusing that a state sector inquiry is voicing concern about doctor’s long hours, especially since there is some degree of hypocrisy involved in their concern. Doctors have always tended to work very long hours and even now the average worked by junior hospital doctors is 55 hours. Many rural medical officers work 65 hour weeks , although some of this is “on call” work. You can see the hypocrisy in this statement:

“The commission says some blamed the collective agreement between the DHBs and the Resident Doctors Association for the long locum hours because compliance meant RMOs were rostered to work no more than 55 hours a week on average.”

This suggests that what is causing the hospitals to whine is not the “dangerousness” of the “long” hours (because they would apparently like their junior doctors to work more than 55), it suggests that the true reason for their discomfort is the large amounts of money they are paying for locums. Deborah Powell of the RDA hits the nail dead centre when she says:

“Association secretary Deborah Powell said the main cause of the resident doctor shortage was that DHBs could not retain enough because they did not pay enough.”

Exactly. While you pay a junior doctor an average of $23.00 per hour and s/he can get $75.00 as a locum, why would they not work as a locum?

The hypocrisy of DHBs does not stop there, however. The real problem of long hours is not the weekly total but the length of time and place on duty. Sixteen hours as a medical registrar is not as exhausting as the same in an emergency department (believe me, I have done both). 24 hours on call in a small rural hospital is less tiring than 10 hours in a busy A&M (I’ve done both of those, too). Yet hospitals often ask junior doctors to do extra shifts or work as a solo doctor where there are normally two (and therefore see double the number of patients). And this has happened to me as well.

I have seen administrations deliberately offer absurdly large volumes of work to a single locum, without regard to the safety of the issue. doctors are generally regarded as no more than names to place on a roster and locum doctors are regarded as entirely expendable. If you ever wish to feel undervalued and under-appreciated, all you need to do is sign on to a junior doctor position in a large hospital. You are paid badly and rarely treated as an individual.

It is little wonder that the larger hospitals have such a problem with retention of junior staff.

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