Dec 4, 2008

Stop blaming doctors for the health system

To a man with a hammer, everything looks like a nail. And so John Menadue, who has undeniably hit a few nails on the head in his time, continues to bang on for 30 years, writes Dr Graham.

To a man with a hammer, everything looks like a nail. And so John Menadue, Director of the Centre for Policy Development, who has undeniably hit a few nails on the head in his time, continues to bang on for 30 years. I do not want to disagree with everything he wrote in Crikey recently — some comments are quite fair — and I certainly have a vested interest in this debate, but some comments just get my goat.

“Work practices that are virtually unchanged from the 19th century”? He cannot be referring to clinical practice, so I assume he was referring to role demarcations and organisational structures. That is, after all, the filter through which bureaucrats see health. Perhaps my job as an intensive care specialist tints my own view of just how much has changed since it became law that doctors actually had a degree, or since the same happened for nurses 80 years later.

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2 thoughts on “Stop blaming doctors for the health system

  1. Michael Sedwell

    Regarding the article “Stop blaming doctors for the health system” – can “Dr Graham” provide some actual examples of the income levels of our “relatively poorly paid” rural doctors? I’m sure this will be a tale of terrible suffering and woe.

  2. Marcus

    Hear hear Dr Graham!

    Michael, rural doctors are universally less well paid than their urban colleagues, generally are on call more frequently. There is a mass of evidence out there and you can find plenty of examples quickly through google, through the online Medical Journal of Australia, the AMWAC reports into the medical workforce, the Federal Department of Health or various other reputable and trustworthy sources.

    Also importantly, given that you seem to be obliquely criticising how much doctors earn you should consider what sacrifices are made to get there and what responsibilities they take on. I have done 6 years of medical school and 5 years of postgraduate training. I won’t be fully qualified for at least another 2 years. When I started my hourly rate was actually slightly less than the hourly rate I had earned stacking shelves at Woolworths. Even 5 years out I earn less as a doctor than some of my friends do working as accountants, nutritionists, physiotherapists, electricians or even (shock horror) nurses! Is the effort worth it? A number of my colleagues think not – they’ve already quit medicine for easier or more financially rewarding career pathways.

    It is easy to blame doctors, just as it is easy to blame politicians and policy makers for the problems in the health system. It’s easy to be as simplistic and sweeping as Menadue was. However the reality is somewhat different. Yes, some doctors are overpaid. Some doctors are not good at what they do. Most however earn a comfortable living by working their butts off providing an essential service which is expensive to provide, takes years of training and despite claims to the contrary cannot easily be replaced by less trained individuals. Graham identifies himself as an ICU specialist. If you were sick enough to need his care, ask yourself who you would choose – Graham, a nurse practitioner, or John Menadue?

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