Comments on: Much Ado About Nothing

By: Thrills

Thrills — Sun, 22 Nov 2009 18:42:55 +0000

wrong about the 138 already disappearing. They are maintaining the basic 299 against the general pop growth!

one leaving a week, one joining a day. crisis.

some incidentals: the NHS doesn’t want our doctors and Australian Medical school deans are lobbying to reduce the number being trained. Do you think they need ours? Where will the doctors who wanted to go to Australia or Britain want to go?

By: MacDoctor

MacDoctor — Sun, 22 Nov 2009 09:58:51 +0000

Thrills: Movement from 299 to 303 is significant- failure to appreciate it indicates ignorance of math.

I suspect it is you who are struggling with the maths. The extra 4 doctors per 100,000 represents 168 doctors (in a population of 4.2 million) which means there are 138 extra doctors that have disappeared into the system. Almost certainly, this is due to doctors who have reduced hours.

One thing you should understand: if the government pays for it (if it’s free) there is always going to be a doctor shortage. If people had to pay their own way at the current rates we would have a massive surplus of doctors.

I understand the principle of moral hazard very well, but I don’t see it applying in this case. If pricing controlled doctor numbers, why would the US have a significantly higher doctor to patient ratio than New Zealand?

By: Richard

Richard — Sun, 22 Nov 2009 09:42:26 +0000

Another related issue: aging of the medical workforce.
The Medical Council has published statistics on this, and from memory it is particularly pronounced in General Practice and Pathology: An alarmingly high proportion of doctors in these specialities are in their fifties and sixties, far fewer in their thirties.
While some of us believe ourselves immortal, and intend to carry on working forever, this may not be realistic!
Emigration is particulary high among young doctors, and not surprisingly. New Zealand is a small country, and many newly qualified doctors (correctly in my opinion) see it as essential to round off their education by working in bigger centres which offer more varied experience and the stimulation of exposure to different ways of doing things.
Most probably go on their OEs with the intention of coming back, but many are seduced by what they find.
The challenge is to make New Zealand a more attractive workplace, and that is not purely a matter of money. The crushing bureaucracy of the publicly funded health sector in New Zealand plays a not unimportant role in scaring young doctors off.

I totally agree that there is more to an attractive workplace than money. However, money helps a lot!

By: Richard

Richard — Sun, 22 Nov 2009 09:24:40 +0000

299 to 303 may look like a move in the right direction, but has to be interpreted in the light not only (as MacDoctor has pointed out), of less hours on average worked per doctor, but also of greater demands from an aging population. The eighty-plus age group makes by far the greatest per capita demand on doctors in almost all specialities, and it is a group that is increasing at much faster than the population as a whole.

Good point about the oldest old. They can be very demanding of resources, including doctors

By: Thrills

Thrills — Sun, 22 Nov 2009 08:12:56 +0000

OK, so we have one leaving a week and one entering per day. Movement from 299 to 303 is significant- failure to appreciate it indicates ignorance of math.

It just seems funny to me that the senior doctors are such poor communicators of basic statistics. the stats don’t back up their misguided viewpoint.