Spot The Problem

A recent MJA journal article published on

As with a lot of cases of gripe, there isn’t a clear goal/obstacle to tackle. So what is really the problem here?

a) Low amounts of clinical contact with patients?
— This needs defining. What counts as ‘clinical contact’? Does re-inserting of a cannula into a petechial and well-worn arm count? I bloody hope so since no one else is going to do the job. Certainly not for our colleagues higher up the hierachy. I sometimes wonder (on a general basis) if our consultants can do cannulations any better than we do.

b) Too much clerical work?
— Its related to point (a), I know. But someone’s going to have to make the referrals, someone has to write the discharge summaries, someone has to rewrite the scripts and someone has to do the notes on the ward round. We want to get to know our patients, but we do have other responsibilities as well. Its not as if we went on our tea break <smirk> As much as we do deserve them <smirk>

c) Modern junior doctors are lazier?
— My cynical side says yes because the traditional role of the houseman has changed quite a bit over the decades. Bureaucratic work certainly does numb the mind and definitely numb the will.

d) Modern junior doctors don’t know enough?
— This begs the question, “how much are we supposed to know?”. There have been much written on these and I think the personalities in medical training have followed it and followed it well to a large extent. I know that my APO patient needs an ABG, and I know how to read them, and correct them (in general terms). But if you are going to blast me for being unable to say the 4th or 5th cause for a 1-2 drop in PaO2…then I don’t know what to make of that.
— I do certainly have no excuse for those who are absolutely shocking and especially those who make no attempt to correct themselves.

e) Are there actually more errors despite the generational change?
— I have yet to see evidence that the junior doctors of today are any less competent than their counterparts decades ago. All we have are hearsay which can be biased by personal pride and non-inclusive of the changes medicine (if not, life and culture) has gone through in the 20-21st century.

I certainly revitalized my dream of changing the system to one of having on-site consultants which are present in the unit throughout the day. I’ll write up an “Imagine…” post about this next time. Remind me.



~ by shybeg122 on November 4, 2009.

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