AMA Safe Hours Audit 2006 - Hospital Doctors Still Working Long and Stressful Hours

The AMA Safe Hours Audit 2006 has found that 62 per cent of Australian hospital doctors are working unsafe hours - classified as high risk or significant risk - with one doctor reporting a continuous unbroken shift of 39 hours.

The survey is the first of its kind in Australia for five years and follows the groundbreaking AMA Safe Hours Audit 2001.

Dr Haikerwal said the 2006 survey exposes work practices that contribute to doctor fatigue and stress levels that ultimately impact on the quality of care and patient safety in the public hospital system.

"All Australian governments must take a close look at the results of this survey and urgently put in place measures to dramatically improve the work conditions and work practices for doctors," Dr Haikerwal said.

"Fatigue and stress are taking their toll - we have to stop overworking our medical workforce, which is already becoming a scarce resource.

"Our junior doctors all come up through the hospital system and we cannot risk turning them off medicine or forcing them out of the full-time workforce.

"Thing have improved marginally since the last survey, but reform of hospital work practices is too slow and inconsistent across the country.

"The public hospital system is a major and vital pillar of Australian health care, and is the first port of call for many Australians seeking medical care and treatment.

"We must not let our public hospitals and the doctors who work in them fall into neglect.

"Safe hours for doctors equals safe hours for patients," Dr Haikerwal said.

Conducted in May 2006, the audit tabulated responses from more than 550 public hospital doctors of all ages from all States and Territories.

The on-line survey collected data on the hours of work, on-call hours, non-work hours, and sleep time experienced by doctors working in the public hospital system over a full working week.

The most stressed discipline is surgery, where 85 per cent of doctors fall into the significant risk and higher risk categories.

There are minor improvements over the AMA's 2001 survey results, where 78 per cent of respondents fell into the significant risk and higher risk categories.

Some other indicators show signs of improvement. For example, for doctors in the higher risk category the longest continuous period of work fell from 63 hours to 39 hours.

Doctors had more full days off work during the audit week and more opportunities for meal breaks when working.

But in the AMA's view, shifts of 39 hours are no more acceptable than 63-hour shifts.

Even doctors in the lower risk category are working shifts of up to 18 hours, while the average longest periods of work at the significant risk and higher risk levels are the same or worse than before.

The average of total hours worked in the 2006 audit week was the same as in 2001. However, the longest hours worked by individuals during the audit week actually went up - to 91 (from 86) and 113 (from 106) for the significant risk and higher risk categories respectively. This indicates that the riskiest work patterns are still commonplace.

Dr Haikerwal said that in any other industry or profession, these 'improved' figures would be cause for deep concern and immediate remedial action.

"We now have awareness and recognition that the old culture of onerous hours has to change for the good of doctors and their patients.

"Translating this into practice remains a challenge.

"The AMA's National Code of Practice - Hours of Work, Shiftwork and Rostering for Hospital Doctors should be adopted by all States and Territories as an absolute minimum."

The AMA will write to all State and Territory Governments urging them to act on the findings of the AMA Safe Hours Audit 2006, which is available in full on the AMA website at /node/4051