Doctors Strike - Right Wrong?

[Winston001]

Can't see a thread on the strike itself.

So, whaddaya reckon? Fair enough? Or greedy young people wanting everything their way?

As I understand it, the hospital boards are tied into staffing levels for junior doctors which are out of kilter with actual need. For example, 9 doctors on a roster when 4 - 5 are needed?

Yes they work long hours - but they often aren't actually working at all. A senior Christchurch doctor related the example of a junior doctor who reports in, hands his pager to a mate - and goes rock climbing for the rest of his shift. Great work if you can get it.

What is unsaid is that many junior doctors fly off to other hospitals when off-roster and work as locums which is very well-paid. But they are exhausted when they return to work and blame it on their employing hospital.

Furthermore the doctors rep, Deborah Powell has agreed - on Closeup - that NZ junior doctors lead the world for their conditions of work. In other words, they are better off here than in Oz, UK, and USA.

[Str8 Jacket]

I had a very similar attitude to you until someone said to me just the other day, "if they dont strike they will probably never get a pay rise". That got me thinking, now im undecided.... Im not a doctor so I dont know what there job really consist of, all I know is that a large majority think they dont get paid enough for what they do!

[Ixion]

Well, I am the last person to question the right of a worker to strike.

However.

These particular workers are already well paid compared to much of society. And have an expectation of almost guaranteed automatic pay rises to VERY high levels - certainly higher than is justifiable.

And they are in a community-essential job - which they knew when they took it on.

And the conditions are (as noted) nowhere near as bad as they try to maintain. There are a HELL of a lot of workers being paid a fraction of what they are , and working in jobs where tiredness could be a major public safety hazard, who have much worse conditions.

And there are plenty of ways to put pressure on an employer , other than a stright forward strike.

So, no, I don't think strike action is justified here, and I wouldn't have been calling for it if I were a job delegate.

[James Deuce]

$18/hr isn't good pay.

[Krayy]

I'm a bit biased, as my mum has been knocked back on a (life saving) operation that was scheduled for the 20th :nono:

I feel for them. I used to do shift work and it f**ked me over big time physically and mentally, but all the docs at once? How about a phased strike which would affect only certain areas rather than the whole damn lot at once.

Hope the govt fronts up the readies to finish it up quick. Ask that c**t Cullen if he can chip in 8% of his rise to fix the prob.

[Beemer]

What I find difficult to reconcile is the fact that these junior doctors are still learning their trade and yet they are expected to work such long hours. I don't think it's just about the money - it's about having some quality of life and not making mistakes because you are so damned tired you can't think straight. Truck drivers aren't allowed to work such long hours and while I can see that a truckie dropping off to sleep could have terrible consequences, surely a junior doctor making a mistake could be just as bad?

I had to go to hospital last week for a jaw operation. I pay a fortune for medical insurance so I don't have to spend years on waiting lists so I was lucky enough to go private, but I still have to find about $1000 to pay the balance the insurer doesn't cover.

I think it is criminal that so many potentially life-threatening operations have been put off but I don't blame the junior doctors, I blame the hospital system and the big wigs who run it. Striking may be the only way anything changes.

[Lou Girardin]

As an 'organ donor' (bike rider), I'm damn sure that if I end up at A+E I want my Doctor to be bright eyed and bushy-tailed raring to save my life.
Not someone asleep on his/her feet.

[The_Dover]

As an 'organ donor' (bike rider), I'm damn sure that if I end up at A+E I want my Doctor to be bright eyed and bushy-tailed raring to save my life.
Not someone asleep on his/her feet.

Next you're going to tell us you want them to speak fluent, comprehensible english too, right Lou?

Keep dreaming...

[Karma]

Next you're going to tell us you want them to speak fluent, comprehensible english too, right Lou?

Keep dreaming...

Well she could at least be fit and wearing a skimy outfit :blip:

[Winston001]

What I find difficult to reconcile is the fact that these junior doctors are still learning their trade and yet they are expected to work such long hours. I don't think it's just about the money - it's about having some quality of life and not making mistakes because you are so damned tired you can't think straight. Truck drivers aren't allowed to work such long hours and while I can see that a truckie dropping off to sleep could have terrible consequences, surely a junior doctor making a mistake could be just as bad?


Yes and I used to think the same. Three points:

1. Young doctors don't nescessarily "work" while on shift. They just have to be available, so they can be asleep as long as they can respond to a page. So the long hours aren't exactly correct.

2. Doctors don't work the hours they used to. Until fairly recently, 80 - 100 hour weeks were the norm. That's too much and it has been cut down.

3. There is a reason for the long hours. The principle is that doctors need to learn how to respond and use their training under stress. Medical work in the real world will involve emergencies at any time. Medical calls don't coincide with shifts. So a young doctor has to experience the stress in a safe environment before being allowed out into the big wide world.

This training through stress is accepted by doctors world-wide as being highly effective. NZ has simply inheirited the system from other countries. Sounds horrific but it seems to work. I have doctor friends who agree.

However for a more informed view here is an article by Atul Gawande http://www.slate.com/id/2666/ This surgeon is worth reading on other medical topics too. Just bear in mind that NZ doctors are way ahead of US doctors on thjis issue and have already achieved reduced hours.

[Hitcher]

I am a bit conflicted on this matter.

Part of me supports the right of people to strike for better terms and conditions of employment.

Another part of me sees the "plight" of junior doctors as a rite of passage that they have to endure before gaining their wings and gouging health consumers and accumulating unimaginable wealth over the balance of their careers. What's wrong with "paying it forward" to taxpayers and prospective patients?

[ZeroIndex]

all they need to do is cut back on TVNZ 7pm programs (campbell or whatever).. judy bailey getting $700,000 a year and what not.. redistribute the money to the people who deserve it..

[Swoop]

all they need to do is cut back on TVNZ 7pm programs (campbell or whatever).. judy bailey getting $700,000 a year and what not.. redistribute the money to the people who deserve it..
No, What they need to do is get rid of the paper pushers in the health sector.
The equivalent of 1 administrator for every bed is simply over the top.:nono:

[Paul in NZ]

With regards to employment law.. My leanings are to the left rather than the right.. I believe that given the opportunity, most large organisations will trend to disadvantaging their employees rather than clients.

However, in regards to the medical profession...

For many years they have maintained one of the strongest trade unions and maintained a stranglehold on their market. They have limited the numbers of doctors and lined their pockets very very well.

I have a generally low opinion of the lot of them quite frankly and their political arm... humpf..

[James Deuce]

However, in regards to the medical profession...

For many years they have maintained one of the strongest trade unions and maintained a stranglehold on their market. They have limited the numbers of doctors and lined their pockets very very well.


Centuries actually. Pretty much since they started burning midwives as witches in the 12th Century.

Mind you I don't really object to burning midwives all that much, but Doctors have REALLY lost their way since they came up with that concept, their one good idea to date.

[Paul in NZ]

Centuries actually. Pretty much since they started burning midwives as witches in the 12th Century.

Mind you I don't really object to burning midwives all that much, but Doctors have REALLY lost their way since they came up with that concept, their one good idea to date.

Ah, nothing like settling down in front of a roaring fire in the winter months eh!

Mind you, if we start burning midwives... Well we would soon run out but IF we started burning administrators.. Well, the energy crisis would be over and old people could stay warm all winter. We would need a place to stockpile them over summer though

[Winston001]

I should be doing some work but I cannot let the canard about administrators go by.

Hospitals today are mega enterprises. Patients are the easy part. They have to have a Board, with support services for the members. They have to respond to media questions which means finding out info, tracking down the right answers etc. Deal with ACC, Patients Advocates, the Health Commissioner, police, health and safety, politicians, local interest groups (heart, cancer, stroke etc). Recruit new doctors and nurses, calculate their hours, sick pay, holidays, find locums to fill in, find and arrange specialists to visit, deal with employment law problems, the list goes on and on.

Apart from all that, there are medical supplies to be ordered, equipment to monitor and replace, new treatments/drugs to be considered and decided upon.

Do you really want highly trained doctors and nurses doing all that? It would be an absolute waste of their abilities.

We don't live in a simple world anymore. Hospitals are almost crushed by the administrative burdens.

An example. A friend does press liason for a hospital. There is a plane crash. She gets called down to the hospital at 6:00am on a Saturday morning to deal with TV1, TV3, and press reporters clammering to know about the survivors. I'd have said - sod off - but you can't these days.

Sunday night at home, more journalists ringing about a battered child admitted to the hospital. She knew nothing about it so that was the evening taken care of.

[Pixie]

Michael Cun..sorry..Cullen,recently:
"don't expect a pay increase this year"
like the one I just got

[The_Dover]

So why can't they tell the press to fuck off and mind their own business?

"I'm sorry, we're here to treat sick and injures people so please fuck off and let us do our jobs?"

Most administrators are nothing but a financial burden and added layer of bureaucracy, look at that tart on shortland st.

[junglegirl]

So why can't they tell the press to fuck off and mind their own business?

"I'm sorry, we're here to treat sick and injures people so please fuck off and let us do our jobs?"


Hear! Hear! If it wasnt for the ever watchful pack of vultures known as the news media we would all have much simpler lives. Far too much time is wasted in reporting utter bullshit that many of us have little or no interest in. As for the junior drs, well realistically, any one of them could have gone to a fully qualified dr and been made aware of the conditions that they would be training in. I say tuff bickies. They make a hell of a lot more than your average joe, and yes they deserve it, but they need to pull their heads in and get on with the job inhand instead of risking the health of thousands of peopkle throughout the country that cant do anything to help them.

[Paul in NZ]

I should be doing some work but I cannot let the canard about administrators go by.

Hospitals today are mega enterprises. Patients are the easy part. They have to have a Board, with support services for the members. They have to respond to media questions which means finding out info, tracking down the right answers etc. Deal with ACC, Patients Advocates, the Health Commissioner, police, health and safety, politicians, local interest groups (heart, cancer, stroke etc). Recruit new doctors and nurses, calculate their hours, sick pay, holidays, find locums to fill in, find and arrange specialists to visit, deal with employment law problems, the list goes on and on.

Apart from all that, there are medical supplies to be ordered, equipment to monitor and replace, new treatments/drugs to be considered and decided upon.

Do you really want highly trained doctors and nurses doing all that? It would be an absolute waste of their abilities.

We don't live in a simple world anymore. Hospitals are almost crushed by the administrative burdens.

An example. A friend does press liason for a hospital. There is a plane crash. She gets called down to the hospital at 6:00am on a Saturday morning to deal with TV1, TV3, and press reporters clammering to know about the survivors. I'd have said - sod off - but you can't these days.

Sunday night at home, more journalists ringing about a battered child admitted to the hospital. She knew nothing about it so that was the evening taken care of.

yeah - well - I was gunna say beaurocrats but i couldn't spell it.....

[Lou Girardin]

Next you're going to tell us you want them to speak fluent, comprehensible english too, right Lou?

Keep dreaming...

Que?
10 char

[oldrider]

I made preliminary enquiries for an application for a Senior management position at a DHB facility and the one thing that stood out to me was this issue.
Not their money and conditions as such but the ridiculous hours that they work. (Trouble just waiting to happen, stood out like dog's balls.)
The hours are tradition based not on an as required basis, as far as I could determine, I did not pursue the position.
Other than this I know nothing about the realities of this issue. :shutup: John.

[madboy]

I can't say I have too much sympathy for the junior doctors. Why do you go into medicine? To help people or to make money?

If you're doing it to help people then stop striking and start helping. The money and working conditions should be irrelevant. You don't see Greenpeace workers striking about how friggin cold the water being sprayed at them from the Japanese whaling ships are, do you?

If you're in it for the money, then stop whinging. Your student loan will be paid off in a few years with your way above average incomes that you'll be on fairly quickly, and then it's all cream from there. Short term pain for long term gain. By 40 most of you will have more money than 95% of society, by 50 you'll be in the 98th percentile... by retirement if you've played it right you'll be top percentile easy.

[Winston001]

The hours are tradition based not on an as required basis, as far as I could determine, I did not pursue the position.
John.

Exactly. The junior doctors managed to negotiate over-staffing and long hours years ago. The hospital boards now want to be flexible about staffing levels.

Incidentally the "hours" on shift are 50 - 58/week for a junior doctor. I can believe they do 70 hours sometimes but it isn't the norm.

Interestingly enough, about 50% of doctors are at work in Auckland and a fair percentage elsewhere. There isn't the support that Deborah Powell makes out.

Furthermore she is an independant contractor. She isn't a practising young doctor herself. This is (apparently) her career - union negotiator for doctors. Essentially she is a legal representative who needs to win. Thats ok, but lets be open about it.

[Pathos]

This is capitalism folks, people should be paid as much as the market can afford. Its up to society to put price on how much they are willing to pay to save peoples lives.

The medical system demands that doctors put their patients at risk as a bargaining tool to contest their pay and working conditions. The administration use this fact to deter strikes.

If you don't like it start a revolution so medical staff are forced to work at a fixed rate, try change the system, or become a doctor.

[metric]

I can't say I have too much sympathy for the junior doctors. Why do you go into medicine? To help people or to make money?

If you're doing it to help people then stop striking and start helping. The money and working conditions should be irrelevant. You don't see Greenpeace workers striking about how friggin cold the water being sprayed at them from the Japanese whaling ships are, do you?

If you're in it for the money, then stop whinging. Your student loan will be paid off in a few years with your way above average incomes that you'll be on fairly quickly, and then it's all cream from there. Short term pain for long term gain. By 40 most of you will have more money than 95% of society, by 50 you'll be in the 98th percentile... by retirement if you've played it right you'll be top percentile easy.


totally agree with all of the above...

it's the same as working as a lawyer in a big law firm, or as a suit at a corporation, the list goes on

as a young blood you've got to put in the long hours, do your time etc

[James Deuce]

I don't know where you guys get the idea the TIs and House Surgeons get paid above average rates.

TIs get between $20,000 and $28,000 a year, depending on DHB. Junior House Surgeons get around $40,000. Most truckies do better than that.

Senior House Surgeons get Police Constable money.

If you want to make money as a Doctor, you become a GP and fiddle your Govt. Subsidy.

[Ixion]

From the NZ Medical Nov 2002




the salaries paid to full-time RMOs in Christchurch are summarised in Figure 2;

free hospital meals are provided for RMOs, but not for other staff;
full reimbursements are provided for vocational training expenses;
the limits on hours and rostering for RMOs include:
no more than 72 hours’ work in any seven day period;
must have every second weekend off work and cannot work more than 12 consecutive days;
no more than 16 hours in any consecutive period unless a special exemption is granted;
cannot be rostered off during week days.
leave provisions include:

22 working days’ annual leave;
48 working days’ sick leave provision for the first five years;
12 weeks’ study leave across the training programme (maximum of six weeks a year in the year of the examination);
time in lieu for working any of the 11 public holidays.



Figure 2 is attached, shows modal salary value as $80000 to $89000 pa

[James Deuce]

RMOs are Senior House Surgeons and Registrars.

We're talking TIs and Junior House Surgeons, and the ones I know at the Hutt do not have packages like that.

Vocational Training is not paid for, meals are not free, they do not earn overtime, and only get one weekend a month free.

[Hitcher]

If you want to make money as a Doctor, you become a GP and fiddle your Govt. Subsidy.
Or become an orthopod and repair people's knees for the same price as a new Bandit. Or become a plastic surgeon and perform all sorts of heinous acts on middle-aged women...

[Paul in NZ]

Or become a plastic surgeon and perform all sorts of heinous acts on middle-aged women...

Oh? Can I charge plastic surgeons rates for performing all sorts of heinous acts on one middle aged woman? Well attempting them anyway - I think her resolve is weakening...

[Winston001]

If you want to make money as a Doctor, you become a GP and fiddle your Govt. Subsidy.


Actually Hitcher has it right. To really do well in medicine you need to specialise. That's where the real money is. Obstetrics, gerentology, proctology, urology, cardio-vascular etc. GPs don't earn huge incomes which is one reason why new doctors aren't doing it.

I don't mind young doctors being paid properly, and working reasonable rather than extraordinary hours. I do mind that tax-payers are loaded with an overstaffed hospital system and the hospital boards can't adjust staffing to fit the need.

[Hitcher]

Oh? Can I charge plastic surgeons rates for performing all sorts of heinous acts on one middle aged woman?
I suspect if you expected payment you may have to involve BayCorp...

[James Deuce]

Actually Hitcher has it right. To really do well in medicine you need to specialise. That's where the real money is. Obstetrics, gerentology, proctology, urology, cardio-vascular etc. GPs don't earn huge incomes which is one reason why new doctors aren't doing it.

I don't mind young doctors being paid properly, and working reasonable rather than extraordinary hours. I do mind that tax-payers are loaded with an overstaffed hospital system and the hospital boards can't adjust staffing to fit the need.

Aaargh, I was taking the MIckey.

My wife used to flat with one of the guys who set up Pacific Radiology. That was always his plan, from year one. Specialise in Radiology, create a practice, create a brand, get rich, retire early.

It seems to be working.

However DHB based Senior Consultants struggle to hit $200,000k, which in most developed countries would be an insult.

It's not just young doctors that need a pay adjustment.

[Ixion]

,,
However DHB based Senior Consultants struggle to hit $200,000k, which in most developed countries would be an insult.

It's not just young doctors that need a pay adjustment.

$200000 - ferking hell , can I please be insulted. I need a pay adjustment too.

My heart bleeds for the poor buggers, having to scrimp by on only $200000 per year.

Must mention it to the next bus driver I see, make him aware how well off he is compared to some people.

[madboy]

Yep, $200k is an insult. 99.9% of society who don't earn that sort of money have tremendous sympathy for them. I'm the first to preach capitalism, but capitalism says you go where the money is - if you want to make money you don't stay in the public health sector. Most can make as much money on the 1 day a week they work privately as they will in the other 4 they work in public. Go ask an established opthamologist or plastic surgeon who do private work what they declared to the taxman last year - bet they'd be having trouble making the payments on the Aston Martin.

Sure, it's all relative - overseas the potential is much greater. But everything overseas has more earning potential, that's how it is. It's not just limited to the medical profession. Was chatting with a mate on the weekend who lives in the US. He's in IT. He's bringing home more dollar for dollar than he can in NZ, has much much greater earning/promotion potential, has better tax breaks, cheaper housing (where he is), cheaper clothing, cheaper cars (way way waaaaaaaaaaaaaay cheaper). But does that mean we should all pack up and go off to the US? I accept that by living in NZ I have the limitations that being in a small geographically isolated country entails. Doctors should to.

Which brings us to the next point - where all the doctors are buggering off overseas...

[Winston001]

Which brings us to the next point - where all the doctors are buggering off overseas...

UK, USA, Canada, Saudi.................

And our doctors come from India, Sri Lanka, Nigeria, Malaysia......................

Funny old world isn't it. :yes:

[placidfemme]

I see this as a long term problem. A junior doctor now striking and using what I class as 'Extreme' methods to get payrises. Risking people lives is extreme.

And think of this way... if they want more money while training... then they will want even more money when fully qualified and experienced... therefore resulting in more expensive operations and medical services... therefore longer waiting lists... more work... more stress... and OMG that might just justify another strike for another payrise...

Nice that they are striking and delaying cancer operations and treatments (and other life saving operations).

Don't doctors take oaths to save peoples lives... no-one told me they added a new clause "Only if we think we're getting paid enough". The Dr's oath is a load of crap and just there to make them feel good about themselves... its a job... they chose the job, they should do the job.

And if they really get paid so shit, surely there are other methods then putting people lives at risk...

[James Deuce]

I see this as a long term problem. A junior doctor now striking and using what I class as 'Extreme' methods to get payrises. Risking people lives is extreme.


When Nurses strike you risk people's lives. When Junior Doctors strike it means there's more food left over in the cafe at the end of the day. The reason Ops are postponed is to force the Junior Docs back to work by giving the PR firms an emotional lever to make the Junior Docs look like Scum.

Realistically the core product of a Hospital is managing patient care. The Ops can still be done by the Consultant and Registrar surgeons. The Surgical House Surgeons are generally in the theatre to learn and observe, not do.

[placidfemme]

When Nurses strike you risk people's lives. When Junior Doctors strike it means there's more food left over in the cafe at the end of the day. The reason Ops are postponed is to force the Junior Docs back to work by giving the PR firms an emotional lever to make the Junior Docs look like Scum.

Realistically the core product of a Hospital is managing patient care. The Ops can still be done by the Consultant and Registrar surgeons. The Surgical House Surgeons are generally in the theatre to learn and observe, not do.

Then if they don't actually do the operations, then what are they wanting more money for?

[Winston001]

Then if they don't actually do the operations, then what are they wanting more money for?

Operations are a small part of a hospital's work. Much of it is treatment, assessment, and monitoring of patients. Surgery is a last resort.

In a nutshell,the junior doctors want more money and 100 more young doctors in hospitals.

Can't blame them for striking - how else does any person make a point except by withdrawing their labour? I think their cause is ill-conceived but respect their right to strike.

[placidfemme]

Operations are a small part of a hospital's work. Much of it is treatment, assessment, and monitoring of patients. Surgery is a last resort.

In a nutshell,the junior doctors want more money and 100 more young doctors in hospitals.

Ok... The more money thing I get... everyone wants more money, doesn't matter how much you have, more can't hurt any (cept the person paying... of course)

They want 100 more Dr's? For one hospital? Or spread out over the country...

I don't fully understand that, but how will striking help get more Dr's? If they want more Dr's they should be making the profession of a Dr seem like a good thing for students to start studying shouldn't they? (Don't know if that makes sense but it does in my head lol :yes: )

[Ixion]

,,

Can't blame them for striking - how else does any person make a point except by withdrawing their labour? I think their cause is ill-conceived but respect their right to strike.

I can think of at least 20 ways to make life hell for the hospital administrators without major impact on patients. Part of a good union delegate's job is to find ways to put pressure on the employer whilst minimising negative effects on the workers themselves or "inncocent bystanbders" (customers, public, other workers etc).

[Winston001]

They want 100 more Dr's? For one hospital? Or spread out over the country. .

For the whole country I think.


If they want more Dr's they should be making the profession of a Dr seem like a good thing for students to start studying shouldn't they? (Don't know if that makes sense but it does in my head lol :yes: )

You'd think so wouldn't you? But in NZ the number of medical students is controlled by government and the Medical Council. Government only funds a certain number of med school placements each year, thus restricting the number of potential doctors. The Medical Council have input on the number.

Why limit? Med schools are very expensive - despite student fees, most of the money comes from taxation. Dentistry is slightly worse. Also the academic standards to get into med school are very high, so many students miss out. After all, we don't want dumb and dumber as our doctors. :blip:

In Australia, if you miss out on med entry, you can still proceed paying your own way. Interesting twist and worth trying here. But we should mainly expand the numbers allowed in each year.

To stop young doctors from leaving, the government could offer to write-off their loan on a year for year basis. I could live with that. It seems such a waste to educate these people who then move overseas.

[twinkle]

I remember the union rep saying several times that they didn't care about the money much, that what they wanted was not to have to work 12 day weeks at 10hrs a day (shift work too).
I think thats where the shortage of junior doctors came in, not enough staff available to work less hours.