Home and Away

The Dom Post has run a series of articles on New Zealand doctors earning up to $8000 a weekend doing locum work in Australia. The MacDoctor is uncertain why this might be considered news as this practice has been going on for years. The take on the articles is that the doctors in question might suffer from “burnout”. This is obviously a bit silly, as few of the doctors in question would do this on a regular basis and variety usually prevents burnout, rather than exacerbates it. Some of the doctors in question are full-time locums, so the issue for them is utterly moot.

I suspect that the journalists are not really suggesting that doctors burn out, but that they become excessively tired working such long hours. While this may be true, it is no less likely that doctors would be just as tired doing short-change shifts on a normal hospital roster. As a full-time locum doctor a few years ago, I found the variety of locum work stimulating and less tiring than a normal hospital run. Technically, a full-time locum could work every weekend in Australia and have the entire week to recuperate each time – and earn more than double the salary of the average GP. This does not sound particularly exhausting to me!

I was fascinated by a number of comments to the first article that were essentially a snort of disgust that doctors could be so “greedy”. The sheer hypocrisy of this type of remark is quite breathtaking. The same commentators would almost certainly not have anything to say against a minimum wage earner who works overtime, yet they rail at a medic for doing essentially the same thing. I’ll bet they even hate doctors buying lotto tickets.

Even more bizarre is the commentator who links locum jaunts to waiting times in the ED! There is no evidence at all that rosters are not being filled (the hospital would not let doctors have a weekend off, if there were gaps in the roster). The wait in the ED is directly proportional to the number of doctors on the roster. The number of doctors on the roster is directly related (surprise, surprise) to government funding and very little else. If said commentator wants a shorter wait for service, I suggest he goes to an A&M and pays for it – because having extra doctors hanging around waiting to treat minor injuries and illnesses, that are not urgent, is extremely inefficient and expensive.

The only real downside to locum arrangements with Australia are, in fact, all on the Australian side. They pay extra money getting Kiwis across the ditch. There is also the issue of continuity of care and handover of patients, although this issue is normally not as much of a problem as it is made out to be. Many locums are for emergency departments where care is not continuous anyway. Even in the wards, the weekend team often hands over to another team on Monday. So, in the end, the only significant downside is cost.

Even cost is not so much of an issue. Doctors are regularly offered salaries for permanent positions that are 50 – 100% more than the equivalent New Zealand salary. This weekend’s Herald had a job offer for a GP in Adelaide for $AUD450,000pa + relocation costs. The offer was from a pharmacy chain that owns (amongst its portfolio) a couple of doctor’s practices and a couple of pharmacies in Adelaide (i.e. not a government institution). I have no idea if the offer is a salary or indicative earnings. Indicative earnings are contingent on a certain level of throughput of patients. Some job offers inflate the offer by using an unrealistic throughput. Even if the offer is indicative, the actual money is likely to be very substantially more than the average NZ GP’s salary. There is plenty of money in Australian medicine. $8,000 a weekend might sound a lot to us poorly paid Kiwis, but I suspect it is not far over the odds for a standard Australian weekend package.

Rather than beefing about doctors crossing the Tasman for weekend locums, we should be thanking our lucky stars that they are not crossing the ditch permanently. New Zealand is still a great place to practice medicine despite the incursions of bureaucrats and our tall-poppy-cutting blame culture. But pretty scenery and nice people will not keep doctors in the country if the gap between Australian and New Zealand doctor’s salaries widens. The MacDoctor has no desire to emigrate yet again, but even he was briefly tempted by the thought of doubling his income.

Only briefly. Sanity prevailed.

Related posts: