Junior doctors burning out

Transcript: AMA Queensland Committee of Doctors in Training Chair Dr Rob Nayer, ABC Brisbane, Breakfast with Loretta Ryan, Wednesday 22 June 2022

Subjects: Junior doctor pressures

LORETTA RYAN: Well, there was $23.6 billion for the health system in this year's budget, plus $9.7 billion over the next six years to create an extra 2000 odd beds in existing and new hospitals. What was there for staff? We're talking about the pressures on doctors, particularly junior doctors, because advocates for junior doctors say their peers are turning their backs on the hospital system and choosing locum or substitute work and it's having a big effect on Queensland's doctor shortage. Dr Rob Nayer is chair of AMA Queensland’s Committee of Doctors in Training. Good morning, Dr Nayer.

DR ROB NAYER: Loretta, how are you?

LORETTA RYAN: Good, thank you. Look, firstly, this is like a gig economy. If we're talking about these junior doctors turning their backs on the hospital system, how is health becoming a gig economy?

DR ROB NAYER: Well, what we're seeing right now is that our hospitals are under unprecedented pressures. There's huge demand for public hospital service, and doctors in training are getting burnt out. Our hospitals are frequently understaffed and as a result of that, a lot of people are starting to turn their back on full time work and they're leaving the hospital system and becoming locums. And what that means is, you know, it's not far off really being an Uber driver in terms of how they choose their shifts. They can pick when they work, they pick which shifts they want, what hospitals they want to work at. And they have a lot more control over limiting the number of hours they work to make sure that they look after themselves as well.

LORETTA RYAN:   What's that doing to the hospital system?

DR ROB NAYER:   Well, putting a lot of pressure on those who are still working full time in the hospital system. At the junior doctor level, some hospitals have up to one in five positions that are vacant right now. It's up to 20 per cent of doctors that aren't available in our hospital system to fill the rosters and help with the workload. It just puts a lot of pressure on everyone really. And it also increased costs, since locums do tend to get paid a bit more money than the full-time employees.

LORETTA RYAN:   And then thinking about other young, I say, students who are studying, thinking about becoming a doctor, what message does this give to them?

DR ROB NAYER:   Well, locum doctors tend to be a bit less invested in the departments they're working in and the hospitals they're working in. And it puts the future supply of specialists at risk as well. One of the benefits of working full time and working within the health system is that we progress our careers as doctors in training. We receive education, we receive training, and we keep getting better in our jobs and move towards becoming a specialist. When people leave the hospital system and become locums, they don't get that same type of training and they don't progress through their careers. And what we've seen is a lot of people in the middle ranks of the junior doctors are getting stuck and they feel like even working full time, they're still not getting training and progressing their careers. And that leads to a bit of despair, really. Medicine selects some very high functioning, high achieving people, and when we can't keep moving through our careers, we tend to get quite burnt out and then leave the hospital system as a result.

LORETTA RYAN:   And how many hospitals in Brisbane is this affecting?

DR ROB NAYER:   It's affecting a lot of them. I know we heard just a couple of weeks ago about several doctors in training resigning from the Caboolture Hospital, but it really is the statewide shortage at the doctor and training level that's really putting a lot of pressure on our hospital staffing.

LORETTA RYAN: On the one hand, you can't blame the doctors if they're overworked and it's their mental health they're trying to look after, but on the other hand, you're thinking, well, how is it going to affect healthcare in this state?

DR ROB NAYER:   Oh, definitely. And it's something that AMA Queensland is really keen to work with the government to address. We don't want to see short term fixes. What we want to see is the Queensland government really investing in their staff, making themselves an employer of choice so that we can retain permanent staff that will reinvest in making our hospitals better and providing that quality patient care, both now and into the future. We need these doctors in training to receive their training and become specialists, that we have a strong medical workforce in the future as well.

LORETTA RYAN:   And in saying that, was there anything for you in the state budget to help?

DR ROB NAYER:   Well, yesterday's state budget, the Queensland government committed to increasing graduate intakes across lots of different disciplines and increasing training capacity, but this needs to be done with collaboration with the Commonwealth. We need to make sure that the training supply meets the actual workforce needs. Really, we need the states and federal governments to stop blaming each other for various shortfalls and work together to make sure that we have a really strong medical training system here in Australia.

LORETTA RYAN:   What would your immediate concern be then at the moment about the state of health in Queensland? Is it something that you say is a real worry at the moment for us in the future?

DR ROB NAYER:   It definitely is. And we're really worried about the mental health and wellbeing of the staff, and particularly the doctors in training throughout Queensland. And that's why we've called on the Health Minister to hold a mental health and wellbeing summit. And I am happy to say that she has verbally agreed to have this summit for the whole of the healthcare workforce later this year. We welcome that commitment and we're really happy about that.

But we want to take it a step further. We want the government to look at legislative changes to make hospital boards of directors and health services legally responsible for the psychosocial safety of all their staff. We've seen other states do that, such as South Australia. We think really by having those in charge be held accountable for the wellbeing of their staff, that could go a long way to making things better for those of us on the front lines in the hospitals.

LORETTA RYAN:   Certainly. Well, we need you all, and we need those young doctors as well to think about that career and want to continue it long-term for everybody. Dr Rob Nayer, thank you so much for that.