Doctor loyalty without extra dosh

Salary increases are not the key to keeping medical staff, says Health Workforce New Zealand executive chair Professor Des Gorman.

Medical oncologist Dr Jim Edwards’ departure from Wellington Hospital in June will leave the hospital with just three cancer specialists. They will serve a region that includes greater Wellington and the Wairarapa. His departure announcement prompted a statement from Association of Salaried Medical Specialists executive director Ian Powell last week. He said Wellington's shortage highlighted a wider specialist workforce shortage in New Zealand’s medical industry.

“Most public hospitals, both big and small, suffer serious senior doctor shortages in many specialties, not just cancer. Unfortunately public hospital salaries and other conditions are simply too low to overcome this specialist workforce crisis.”

Prof Gorman said this just wasn’t the case. New Zealand did have some skills shortages – in psychiatry, for example. However, the World Health Organisation had highlighted these as areas of global shortage.

New Zealand had a steady intake of new doctors each year: around 1500 nurses and 500 doctors. Figures from Statistics New Zealand for medical professionals emigrating to New Zealand last year showed around 300 more medical practitioners arriving to settle than departing.

He said the growth in demand for medical services was exceeding the industry’s capacity to train. However, he disagreed that salary was the best way of encouraging employee loyalty. “If a job’s undesirable, good pay doesn’t make it better.”

Mr Powell said New Zealand was losing too many of its younger doctors and public hospital senior doctors overseas. “[We are] struggling to recruit in a very tight and internationally competitive market.”

Prof Gorman said the salaries for similar jobs did not differ greatly, when comparing the United Kingdom, New Zealand, and Australia. Where salaries appeared higher, this could come at the cost of good working conditions. Some Australian general practices paid per patient treated. Prof Gorman said doctors could end up seeing a patient for around seven minutes before moving on to the next. “Sometimes high fees are matched by very high through put”.

Efforts were being made to steer junior doctors towards areas of shortage.

The leakage of New Zealand’s senior doctors had been largely stopped by tax cuts, he said. “But feeling valued in the workplace is also important.” Often minor grievances such as lockers or too-long hours were, at their root, about feeling under-appreciated. It was equally important to take care of “baby junior doctors”.

“If we show them we care about them [then] that’s how we keep them as senior doctors. It’s not rocket science.”