Recently the Association of Medical Specialists released a report and business case for increased remuneration for medical specialists in New Zealand in an apparent effort to curb the departure of specialists to other countries, in particular Australia, apparently in search of the holy grail, an extra cupful of dosh. http://bit.ly/ledqef
Medical specialists are no different to any other type of employee. They need to earn sufficient to pay a mortgage, purchase consumables, gain membership to a golf club, drive a BMW and have some sort of social life to make up for their unsociable working hours. Why shouldn’t they chase the mighty dollar. Afterall around 30,000 Kiwi’s are expected to head across the ditch to Australia in the next twelve months.
The similarities with other workers continues in that salaried medical specialists also have to endure certain working conditions – just like you and me – just like a taxi driver or a hairdresser. Already I can see the medical specialists with their years of expensive training wringing their hands in despair at being compared to either a taxi driver or a hair dresser – except that we choose not to do without them either. Medical specialists report to managing medical specialists. One can only hope the high quality bedside manner of medical specialists transforms into high quality collaborative conversations when they take on managerial roles. If not, then I would want to head for Aus as well. If one has to work with an arsehole for a manager then one should work for the arsehole that pays the most money. All the sooner one can then move on from working for that arsehole.
Having said all this. We all know that money is not the single most important reason why people choose to work where they do. Don’t we? Of course your average medical specialist, being slightly more highly educated and therefore possessing of an analytical mindset will be working where they can be of the most benefit, in comparison to a taxi driver who may be doing what they do because their options are limited. This suggests your average medical specialists chooses where they will work for reasons such as access to mentors and teachers of quality, ability to combine research with work, opportunities to work on cutting edge medical problems and an environment of collegiality. Did you notice that so far I haven’t mentioned money?
Now let’s be upfront. It costs a medical specialist the same to live as it costs the average employee – maybe even a little more if one chooses to reside in Fendalton or along the waterfront in Auckland. So there is a business case for paying them the equivalent of other equally qualified employees in positions of responsibility – but perhaps not as much as the Captain of a 737. While the medical specialist may bring me back to life – I don’t want the 737 captain to put me in a place where I need the services of a medical specialist! Value is of course in the eye of the beholder. Ironcially someone laying on a guerney at this moment is likely to have a a similar perspective to someone flying over the Tasman to holiday in the Hamilton Islands. They both want the best paid and most highly qualified person at the helm.
As with any group of employee I have no argument with paying competitive remuneration, including to medical specialists. As a potential patient though, I am less interested in how much my medical specialist is paid and more interested in whether (s)he is up to date with contemporary medical practices, has good collaborative relationships with other medical specialists, is able to provide an accurate prognosis and can do all of this at the minimum cost to the taxpayer or insurer without detriment to me as a customer. Of course I would pay more for a decent bedside manner and an understanding that I am not an idiot and am someone that would appreciate an explanation of what is about to take place. Geez even my 737 captain talks me through the emergency procedure in great detail. As does my taxi driver and hairdresser.
Now here’s a thought. Next time someone comes into a hospital for treatment we should ask them to rate medical specialists in areas of communication, customer service, inconvenience etc – and then pay them a bonus based upon customer satisfaction. I’m sure the majority of medical specialists would manage to earn their bonus and avoid the need to move to another country.
Perhaps hospitals could retain the All Blacks and a naked granny to star in videos that explain various medical procedures. These could then be displayed on dvd screens attached to each bed and available for viewing between in-house movies. Now, if we could just program the robot that assembled my car to remove my kidney and stitch me back up – then . . . ! (K. Roberts, you are welcome to take this idea and use it – I will send you my bank acct details for royalties).
Some more thoughts for the day.