GUEST COLUMN
Death by a Thousand Paper Cuts Dr Arusha Miocevich is a RMO at Royal Perth Hospital with a cautionary tale about generational change and the practice of medicine. It’s not an uncommon occurrence to hear it proclaimed that ‘junior doctors are not the same breed’ as they once were. Overtime? Protected working hours? Parttime work? A medico Jedi Master had no need of these things back in the good old days, apparently. Nothing makes a junior doctor roll their eyes more than hearing the words, ‘back in my day’. And, to be fair, I guess senior doctors are pretty sick of us whining about how much paperwork we have to do. Well, we all have to get used to it because for the first time in history we have four generations stuck with one another in a patchwork system that’s struggling to keep up. With the advent of a more intense medicolegal environment, an increasingly ageing population and an exponential improvement in information technology, the role of the junior doctor is shifting to more administrative and clerical roles. And that simply does not translate into particularly challenging or stimulating medicine. It’s often slow, painful and frustrating. It’s a bit like a paper-cut, at first irritating and
Yet when I look at my colleagues from university, I still see compassionate, intelligent individuals buried somewhere underneath the paperwork.
distracting but if you get enough of them it feels like the practice of clinical medicine has morphed into death by a thousand cuts. There’s no doubt that issues such as unrostered and unpaid overtime, reduced training exposure and the pressure to join increasingly competitive and expensive training programs has led to a perfect prescription for poor workplace mental health. New doctors are now a mixed demographic of undergraduate, post-graduate, local and international students most of whom are not the beneficiaries of a free education. And they pop out of the system with large debts!
So what do all of us, we four generations of doctors, actually have in common? Surely it has to be our ‘calling’, the love for our craft, and compassion for our fellow human beings. The required dedication, combined with the fortitude to push through tough times during our medical training, is about something more than money or prestige. And a lot of us have been pretty dedicated already! We’ve raised funds for PMH, volunteered with Dr Yes to tell young people about the risks of substance abuse and working late into the night assembling birthing kits. Yet when I look at my colleagues from university, I still see compassionate, intelligent individuals buried somewhere underneath the paperwork. It’s wonderful that there’s an increasing recognition of mental health issues such as burnout and suicide amongst doctors. Young medical professionals are being asked to run a vastly different gauntlet compared with their predecessors. Surely there must be a way of streamlining the clerical workload? But, most importantly, we need to champion things that really count – clinical teaching, genuine curiosity and compassion for others.
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JULY 2017 | 29