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Sunday, September 6, 2009

Is This The Obamacare Future? Overworked Doctors in Australia Worried They Are Killing Patients

Australia has a health care system which is similar in some aspects to what the Democrats are proposing. There is a public plan which covers about 70% of the country and private insurance which covers the rest.  In a short time (the system was set up in 1983) the country became divided into one group that gets good medical care (private insurance) and the group whose insurance is not as good.For example those in the public system have to wait longer for surgery.

There are also extensive waiting times for non emergency surgeries at public hospitals. Although waiting lists for the most urgent elective surgery for heart disease and cancer are almost nonexistent, there are long waiting lists for orthopedic surgery (median wait for total hip replacement is 88 days; 10% of patients waited over 345 days in 1999 to 2000), and cataract surgery (median is 73 days; 10% waited more than 316 days). One of the attractions of private  health insurance is the ability to bypass public hospital waiting lists.

One of the reason for the long waits is a shortage of Doctors. In fact Doctors in one Australian State are worried that they are working so hard, their exhaustion is causing them to make errors and lose patients:

Patients dying at the hands of doctors working for days on end
Matthew Fynes-Clinton and Michael Crutcher
EXHAUSTED Queensland doctors have confessed to killing and harming patients, falling asleep during surgery and crashing their cars because of marathon shifts.

The public hospital medicos claim to be so tired on the job that they are working "like drunks".

More than 100 of the doctors have vented guilt and anger in a confidential survey. Almost 60 per cent admitted to fatigue-induced errors while performing procedures.

The State Government wants to push through a new pay and conditions deal for doctors that offers only limited respite.

"We are killing people, and that's the truth," a shaken surgical registrar said.

The survey three months ago of mainly junior doctors at the state's 173 public hospitals paints a grim picture.

In the Salaried Doctors Queensland document, obtained exclusively by The Courier-Mail, two doctors revealed their fatigue contributed to the deaths of two patients.

One of the doctors said he was still haunted by nightmares after forgetting to check on an elderly patient who consequently died from an overload of intravenous fluids.

The doctor had worked 45 consecutive hours.

Others reported "micro-sleeping" while operating, "shaking", prescribing wrong drugs and making "grossly flawed decisions". Some fell asleep driving home – one case leading to a crash with a truck.

The last pay deal between Queensland Health and doctors expired more than a year ago.

The State Government and the Queensland Public Sector Union have reached an "in-principle" agreement for a 12.5 per cent pay rise over three years for doctors.

But Salaried Doctors Queensland, an alternate doctors union, says the fatigue provisions are woefully inadequate.

All doctors risk losing the full pay rise if the agreement changes. The State Government had decreed that any deals not done by last Tuesday would only get a three-year wages rise of 7.5 per cent.

SDQ is standing firm, saying its primary concern is conditions, not money. It says the new deal delays for two years a reduction in maximum rostered daily hours from 16 to 12.

Health Minister Paul Lucas did not directly answer questions asked but his office provided a statement stating the "Government has committed to employing 3500 more doctors, nurses and allied health professionals in three years".

QPSU general secretary Alex Scott said the union did not believe the fatigue provisions went far enough, but thought it was in doctors' best interests to reach an in-principle agreement with Queensland Health.

"Our members who are doctors believe this agreement doesn't go far enough in terms of the fatigue issues. But we believe the government isn't going to move on that," Mr Scott said.
These doctors in Queensland work for the government. As far as I have been able to read in the Democratic party private options, there is nothing that says Doctors will become public employees.  That doesn't mean we wont face the same shortage of doctors. 

The Government intends to "save money" by squeezing the fees they pay doctors, even beyond what they do with Medicare. Many doctors today have "had it" and refuse to take medicare. When 70% of the public is on a government plan doctors will have two choices, take the government insurance and the cut fees, or leave the profession. Projecting ahead, medicine may not be the lucrative career it once was driving some students to different professions.  Now combine that with the fact that under Obamacare we will be insuring millions of new people and you have the same sort of shortages you see in Queensland.

You might just be looking at the future of American health care if the President, and his liberal buddies get their way.

1 comment:

Unknown said...

I'd say that is what public schools already look like in the US, so it's not much of a stretch. The real issue is a shortage of doctors, period. Or, a shortage of nurse practitioners and p.a.'s. We need to restructure the education system so more students can go straight into health care without the extra load of superfluous, costly classes.