None of us is willing to sign a contract forcing us to practice bad medicine- Letter from a Registrar.

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None of us is willing to sign a contract forcing us to practice bad medicine- Letter from a Registrar. #qldpol #smoqld #keepourdoctors

Dear Mr. Trout and Mr. King,

I write to you today regarding the current impasse over doctors contracts as both a concerned doctor and a terrified citizen of the Far North. I address you both as despite still being currently enrolled in the seat of Cairns, I have very recently relocated to the Barron River electorate, and this is clearly an issue that crosses electoral boundaries. I apologise in advance for the essay, but I have a deep attachment to this issue and I hope my genuine feelings and concerns will be effectively conveyed below and hope you can dedicate the time to try and understand why this is such a significant issue.

I have lived in the Far North since I was a young man. I completed most of my schooling and all of my medical training in North Queensland, working in Cairns since I graduated from university in 2009. As such, I have seen our local health system from a variety of perspectives including, importantly, as a patient, and let me tell you that medicine in North Queensland is a complicated beast. Unfortunately, we have a very sick population with illnesses rarely seen anywhere else in the country. That’s not to mention the unique cultural, social and logistical factors of our vast catchment area which all play such an important role in clinical medicine.

Despite having spent the entirety of the past 10 years devoted full time to my training, I am not yet an SMO but continue to learn my art as a Registrar in Adult Medicine. This position requires teaching from a wide pool of specialists, and in Cairns we are exceptionally fortunate to have a dedicated and expert team, many of whom have been in the region for well over a decade. These specialists not only commit their time to treating patients, but to research, developing protocols, advocating for the local population, and teaching students, junior doctors and registrars. They also carry with them a wealth of local knowledge that is utterly irreplaceable.
 

It should come as little wonder that these same dedicated people should be so shocked and offended to be accused of being lazy, money grubbing, disruptive and easily replaceable. The number of hours of their own time that these doctors have spent dedicated to helping my training alone makes these accusations absurd, let alone the clear fact that they could all be earning much more money in private practice but choose to remain in the public service.

It is true that the vast majority of doctors in the public health system do not work the number of hours that appear on their time sheets. I can vouch from personal experience that the real hours worked are VASTLY more. I can honestly say that in the past 4 years, I have left unclaimed nearly a full years wage worth of overtime, literally tens of thousands of dollars. I accept that there may be some specialists within the system who work fewer hours than for which they are paid, and it would be appropriate to identify these people and address it with them personally, if any misconduct or fraudulent activity can be proven. To instead use these allegations as fuel to attack the credibility and integrity of an entire profession is unfair, dishonest, and a big part of why the medical community want more than vague reassurances before accepting the Government’s word.

The proposed contracts, despite the ‘addendum’, are offensive in their content and the perceived lack of respect to medical staff shown in the public conversation are equally so. No doctor in their right mind would chose the proposed conditions, where our responsibility to meet targets set by bureaucrats overrides our responsibility to patients, where we can expect to be sacked without notice for disagreeing with management or speaking out for our patients, and where there is no security of location, roster or pay. These conditions will absolutely see a compromise to the care of patients, and despite the unfathomable comments made in parliament last week, this is the single biggest concern of the vast majority of SMOs I have spoken to. Particularly, I fear for the health of those in rural and remote areas where it is already extremely difficult to retain staff.
 

I completely stand beside our local SMOs on this issue and if a mass resignation is the only way to have their concerns acknowledged, then I support them in this also. Unfortunately, should a mass resignation occur, my own training will be affected. I understand that several of my direct supervisors have already submitted their intent to resign. The junior doctors of Far North Queensland will not be able to work without adequate supervision, and adequate supervision cannot be found overnight, requiring registration with AHPRA and accreditation of qualifications by the various specialist colleges. To bring in a specialist from overseas takes most of a year at best, often several years. The more likely outcome is that I, and most of my colleagues, will be forced to move interstate to continue our training.
 

Mr. Trout and Mr. King, please understand that we are all dedicated to working in Queensland, for Queenslanders, but none of us is willing to sign a contract forcing us to practice bad medicine. When the time comes that I am an SMO, I would be very disappointed to leave this state, but would certainly not sign this contract. The threat to Queensland’s public health system is real, and the knowledge and experience of our local specialists will take decades to replace. The continual dismissals of being ‘greedy’ or ‘hysterical’ do little to assuage our fears, and I see on a daily basis the frustration and bewilderment growing within all of my colleagues which is slowly turning to the resignation of having to leave behind their life’s work and the city that has become their home.

I hope that as our local representatives, you can help your colleagues to understand the gravity of this situation. I sincerely hope that this issue can be resolved soon, with genuine negotiation and legislative change, though it will take a great many years to fix the damage to morale and staffing that has already been done.

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