Beat Medical Blog

Doctors dissatisfied with their workplaces turning to locum work

Posted by Beat Medical

It may not come along as a surprise to many, but according to a recent survey conducted by Beat Medical, the major reason for undertaking locum work is "dissatisfaction with the health system in my state".

Although we thought that "dissatisfaction" may be a major factor in the decision to become a locum, we also thought other reasons such as financial advantage, flexibility, travel, etc would come out on top in the list of reasons.

In some locations around Australia, doctors are rising up to take back control of their work - even to the extent of threatening to resign en masse. Recently, the ABC reported that VMOs in one hospital in QLD said they would walk out the doors in response to deteriorating standards, and the lack of employment agreements for over 18 months.

This type of situation is what is commonly reported to us by candidates working with Beat Medical as locums in emergency, general practice, anaesthetics, intensive care, and orthopaedics. Similar problems seem to extend to doctors working in all of the specialty areas we work with.

Based on our survey, the top 5 reasons for doctors working in locum positions are:

1. Dissatisfaction with the health system in my state
2. I am "trying before I buy" with potential employers
3. I am deciding on a specialty
4. Dissatisfaction with my current role
5. To supplement my regular income


Some interesting results - what are your thoughts? Click on Comments below.

Jayant Patel found guilty, but who else is to blame?

Posted by Beat Medical

Yesterday, Jayant Patel, the Bundaberg surgeon accused of gross negligence was found guilty of manslaughter and grievous bodily harm.

Appeals will most likely commence from here, but for the families of his victims, it will hopefully be some resolution.

Alongside the news on the case in the media, this article in The Australian was published today. Tony Morris highlights that there are two issues at play in the case - that of Patel's incompetence and the subsequent deaths, and that of the process that enabled him to work unsupervised as the Director of Surgery in a regional QLD hospital.

It was a complex case, with a number of contributing factors. There were so many preventable events that took place before his employment that it is almost impossible to imagine how Patel was granted registration in the first place:

-the recruitment agency did not adequately check the documentaiton
-the medical board did not complete the requisite checks, and granted registration
-the hospital appointed Patel to a position outside of the scope of his medical registration
-there was internal pressure against the 'whistleblower', who brought matters to the attention of the health service


It is absolutely the responsibility of each person in the medical recruitment process to ensure that they scrutinise, and question the veracity of CV's, references, professional documents. If something feels out of place, dig. If it still feels out of place, keep digging.

It is human to be blinded by pressure to find a doctor for shift, position, or job - and create a false gap between what you actually see, and what you want to see. It is the individual responsibility of us all in this industry to speak up if something is not right, and unless you are completely satisfied of a medical professional's competence and background - do not give them the job.

Consider the deaths of Patel's patients, and their families - who have felt the deepest cut of his behaviour and the omissions of his employers. It is up to administrators and recruiters to work towards preventing this from happening ever again.

The medical recruitment company involved dismissed a staff member, and most likely felt a level of corporate shock they never will again. The health service and the medical board were held to account, and a whistleblower's life and career still stands deeply affected by the events.

We ask the same question Tony Morris asks: should there have been other people in the dock?

Click on 'comments' below to have your say

Down the rabbit hole - the curiousness of health services

Posted by Beat Medical

If you have experience in healthcare at any level - a clinician, manager, cleaner, administrator, window washer - you were most likely nodding in agreement with this fantastically written piece in today's Age.

As a medical recruiter, and (I am a little embarrassed to admit it) former health service manager, I can see some palpable parallels between working with the health system, and the absurd (but all to familiar?)  characters in Alice in Wonderland.

It must have taken a Mad Hatter to design the current system for working as a locum in one Australian state (....to remain nameless). Not only are locum doctors expected to read over 450 pages of policies, and complete hours worth of online learning - they are encumbered by their current employer's consent to work as locums in areas of critical medical workforce shortage. It's also not a walk in the park for the the front line rostering people, who are restricted in terms of how much they can pay locum doctors in accordance with arbitrary geographical zones (which seem as though they were decided upon at a health department tea party). Here is the crux - the people making these decisions, however well meaning, are often at a critically dangerous distance from the reality of health care 'in the trenches'.

What is the point of these polices? To provide better health care, of course.  I've noticed how well it has worked - have you? Well, maybe not.

The aim is, of course, cost reduction. There is a Queen of Hearts in every health service, exacting sharp fiscal control on areas she may or may not have any understanding of, and proclaiming "Off with their heads" at the slightest hint of dissent or creative thought. New health service managers are often given no training, no expectations, no targets to meet, except "reduce the budget".  When I started in a hospital, I felt like Alice, tumbling down a hole to who-only-knows-where, as there is only one way to reduce the budget - to reduce medical staffing. Trying to explain to a high level administrator that it is less expensive to pay our own staff slightly more to work unpopular shifts, than it is to bring in hundreds of expensive outside locums of questionable quality and skills was almost like putting my head through a wall.

More dangerous than the Queen of course, is the Cheshire Cat, the duplicitous sycophant whose sharp teeth are covered by a flurry of nonsensical and vexing arguments. These people are the worst enemy of medical recruitment - swiping away any attempt to boost staffing numbers, citing an endless array of policies, precedents, and alluding to the opinions of a distant CEO who is always at arms length. Here is a common scenario - we need a new emergency specialist. Can we advertise? "No, too expensive". Can we attend a conference to attract potential candidates "No, too expensive. Perhaps try a sandwich board in front of the train station". In their heart of hearts, they know it is less expensive to keep a position vacant than it is to fill it.

I can't help but think that we are compelled to reject the reality presented to us by the looking glass - now is the time to agitate, question the system, and find your way out of the rabbit hole. What do you think we can do to change the system? Is it too late to turn it around?

Alice: But I don't want to go among mad people.
The Cat: Oh, you can't help that. We're all mad here. I'm mad. You're mad.
Alice: How do you know I'm mad?
The Cat: You must be. Or you wouldn't have come here.
Alice: And how do you know that you're mad?
The Cat: To begin with, a dog's not mad. You grant that?
Alice: I suppose so,
The Cat: Well, then, you see, a dog growls when it's angry, and wags its tail when it's pleased. Now I growl when I'm pleased, and wag my tail when I'm angry. Therefore I'm mad.

Specialist recognition for GPs – thanks to the AMC and RACGP

Posted by Beat Medical

From February this year, the Australian Medical Council will be accepting applications from international medical graduates to be assessed as GPs under the specialist category, possibly negating the need for complex area of need registration, and the like. This is a fantastic move which will hopefully make it a more transparent process for GPs to make the transition to working in Australia. Candidates from the UK, Ireland, Canada, United States, and South Africa will particularly benefit from the level of recognition provided for their qualifications and experience.

Well done AMC and RACGP – a positive move in what is already a complex and difficult system. Next stop…. national medical registration!