Why doctors work long hours . . .
This needed a separate post to explain why some of us work more hours than is safe. The causes are multifactorial, but this is a very brief summary:

Once you leave Uni with a shiny MB,BS you are not actually qualified to do anything other than work in a public hospital under supervision. This came about in my second year if training (1995), with the powers-that-be deciding to limit provider numbers only to those with a specialty or in training for one. Provider numbers are what one uses to charge Medicare for services to patients - and, as the Government wanted to cut costs at the time, stopping doctors from charging the public purse until they had specialty training was a way to do it. Nothing to do with quality of training - all for cutting costs.

Specialty colleges restrict their numbers admitted for training each year for a number of reasons: a big one is to maintain standards. The year I got into surgery, 8 people from my state were admitted for training. The Government again feels this isn't enough, so they have a novel way to increase the numbers: *make* the colleges admit more people; the new system also allows trainees who have never touched a scalpel to start training to be surgeons. Will this solve the problem? I have junior trainees whose ego is far, far bigger than their surgical ability - they were admitted just-out-of internship, and they believe they are the "chosen ones," as opposed to the likes of us (work for 3-4 years to earn a place). I weep for the future if this specialty if these little kiddies get to finishing. And will it make their hours better? No - see below.

Finally, three things further contribute to my shitty hours:
1. Convention - my bosses had crappier hours than me ('tis true - 1 in 1 on-call, being given *one* day off for your own wedding!) and expect the next generation will do the same. Since these guys choose who gets through, best to keep them happy.
2. Ego - when there are four of you on a unit, and you've been on-call all night, you don't really feel like working the next day. Your colleagues may ask if you need someone to cover the list - invariably you will say no (they're not really offering, they're wanting to see if you're weak enough to go home). Terrible, but there it is.
Ditto with hospital admin. They will only pay certain hours or work, and unnecessary overtime is frowned upon. Easy solution for the guys who wants to make a good impression on his boss - don't document your hours properly, clock off on-time and hang about to finish the work.
3. Another government initiative, called National Medical Registration. Most people don't realise there is no legal requirement to have a FRACS to operate (Degree from the College of Surgeons). Anyone can do it - and there are some people not trained as surgeons, or even doctors who operate in this country.

Hot on the heels of this, and sensing a way to save a buck, our wise Government has decided to have one body to administer all health professionals (run by the Government - at the moment each area of health is run by members of the profession - nurses govern nurses, doctors govern doctors, etc), with the ultimate aim being to substitute a health professional in an area if cost allows. In plain English, if having a physiotherapist in upper Whoop-Whoop is cheaper than the surgical trainee, there is a law that allows it to happen. Even more worrying, "fringe" allied health (Naturopathy and Chinese Medicine) are accredited by the same body. These guys are very keen for the system to go ahead, as it increases their credibility by association.
The draft of this law has already been passed in one state here, cloaked in secrecy, as the despots in charge knew it would cause an almighty shitstorm. The plan is to have it introduced under the public nose, as a "fait accompli" where we will all just get used to it.



That's a part explanation for why I don't go home on time . . . the last one for me is a personal responsibility to make sure my job is done before I leave, so as not to leave crappy jobs for the next guy.






Footnote: I personally don't believe in fringe medicine, and don't suggest it to any patient as a treatment. I like to see hard, scientific evidence a treatment works before I use it. Some people disagree with this; more power to you - the point above was not intented to piss people off - my opinion only.
( Mrs Legless . . . belongs to, well, you know . . . :), Sun 14 Mar 2010, 2:19, 4 replies)

UH...
Most people don't realise there is no legal requirement to have a FRACS to operate (Degree from the College of Surgeons). Anyone can do it - and there are some people not trained as surgeons, or even doctors who operate in this country.

Wait. WHAT?
( HairyCanary as Ann B. Davis as Alice, Sun 14 Mar 2010, 2:41, closed)

Yes,
that's right. You don't NEED surgical qulifications to operate.
There is no law against starting up a surgical practice (and there are two individuals I know of who do it) without an MB,BS. Unfortunately, their fuck-ups end up being referred to "proper surgeons" to fix.
Oh - and you can't receive a Medicare rebate if the guy who does the operation cannot charge Medicare in the first place. So, thousands of dollars for an operation that would cost nothing in public-land.
( Mrs Legless . . . belongs to, well, you know . . . :), Sun 14 Mar 2010, 2:51, closed)

That is really fucked up.
I would rather have a wide awake unstressed doctor treat me and pay more tax thank you. I used to work on major IT projects and the macho no sleep more work culture was very prevailent there. I lasted about 8 years. Good job you doctors are made of sterner stuff. Once again, thanks doctors.
(porkylips looks better as the sun goes down., Sun 14 Mar 2010, 12:05, closed)

alternative medicine
www.howdoeshomeopathywork.com/
(AndySpanners not working too hard on, Wed 17 Mar 2010, 10:57, closed)