to wish doctors weren't going on strike

[MissTriggs]

After 5 months of misdiagnoses, being sent to the wrong person, explaining why suggestions weren't helpful, holding my GP's hand and fighting to get to the right person I'm now booked in to have the test I need on 2nd December, the day after the strike.

If my test was on 1st December I'd be pretty upset

I then read a post on here from a junior doctor claiming s/he could make more money "as a manager at Greggs" and that tipped me over the edge.

I saw lots of posts from doctors saying they already work weekends but it turns out they get paid extra for this at present.

I think doctors have no idea what it is to work in a job where you can be sacked easily, where you don't know whether work is coming in from day to day, where your employers have no interest in getting you back to work after a career break and where you either have no pension or the value of your pension can fall from year to year and be worth nothing.
I also think they don't realise that, whilst a generation ago doctors might have been unusual in working antisocial hours, nowadays all professionals are expected to be available all the time.

I might be wrong, but I don't think I'm being unreasonable here.

Could not agree with mamadoc more.

We can have the same service 24/7, routine operations, investigations and clinics 7 days a week if that's what the government want. But they will have to fund it. They will have find extra staff to manage that. Either that or a poorer service 7 days a week. They cannot have it both ways.

MrsTriggs A doctor would never disrespect the public by saying that their patients are quite often complete morons. I've had clients where the accounting staff are not up to scratch. We do talk to management about staffing when we see a gap and they do listen to us. What are doctors supposed to do? They can't exactly withhold care?!?

I also think under-management of the NHS is not the issue. I think it is gross mismanagement. The pay is not the way to solve the issue with the NHS, it is the working conditions. I have been helping my Dad get care in the UK and the amount of waste is just boggles my mind. Having lived abroad and received medical treatment in Denmark, America, Canada and the UK the standard of care in the UK has consistently been the lowest. It isn't the fault of the doctors and nurses but of management.

Just booking an appointment for my father took the GP surgery writing a letter, the consultant at the hospital having someone respond and then my Dad (well me) call around numerous times to reschedule the appointment to a suitable time. Here in the US you get a script from your GP and call yourself to book the appointment at a time that works with your schedule. A robo call starts calling 2 days before your appointment and if it isn't confirmed 24 hours beforehand the office staff will physically call you themselves to confirm the appointment. That cuts down on a lot of wasted appointments through confirmation but also on staff hours through using an automated system.

The system is not too bad at all.
Some things could be better but that's always true.

There is no-one who needs a GP appt at 3am almost by definition.
There are people who think they need A&E at 3am in the morning and in fact could wait to see a GP but that is not lack of availability it is lack of.... Brain cells maybe??

(That's a bit harsh. I have actually taken my own child to A&E at 3am and realised sheepishly later that it could have waited. I was pregnant and exhausted at the time and not thinking straight)

The solution is co-located GP OOH services at A&E so that the misguided people can be redirected.

Hear hear galbers.

A dear friend of mine (junior doctor in the 80's) died whilst crossing the road on her way home after one of those punishing shifts. It was the early hours of the morning, little traffic, and the only explanation seemed to be severe sleep deprivation.

It doesn't seem that the OP has any experience in the field, but comes up with bitter comments about other people paying for doctors pensions. If you're so pissed off about it - why didn't you train in that field yourself originally or retrain to do so now?

So we have a shortage of doctors and what, a 10:1 ratio of students applying for medical school. WHY ARE THEY NOT EXPANDING MEDICAL SCHOOLS?!?! It is really that basic. The supply of doctors is there..... we just need to train them.

In the short term why are we not paying fees in excess of current tuition fees for doctors to study abroad in places like the Caribbean, Canada, Australia, Prague, Budapest, Krakow and other European countries on approved programs taught in English with rotations completed in the UK? It would solve a lot of problems regarding staff shortages in less than a decade.

YABVVVU! They are right to strike, the this government are a joke! I can earn more than a junior Dr whilst working 9-5, no weekends and having spent less time at university! We need for them to be properly compensated!

I should add that I don't, because I'm too lazy but some of my less lazy colleagues do.

I haven't anything to add that other, better equipped have said...

But as the mum to a 23 yr old junior doctor.. who has just worked 12 days straight... on her massive salary of 22k...to pay her rent and her 50k worth of medical school debt...

Thank you to the majority of people on here who understand why the junior doctors are striking..why it matters and why it's not primarily about the money... which as we have seen, is not that great.

My dd1 is currently in oncology.. caring for seriously/terminally ill patients. Today the F2 was absent, the consultant is stretched between several clinical areas... today it was just her. One 23 year old trying to keep people alive, to answer every bleep, sort meds order tests, do bloods , and help terrified families.

She chose medicine because she cares..because she wants to save people. She could have had a lucrative career in other areas but she chose medicine because she wanted to help people.

That's a hell of a lot of responsibilty for very little pay. Her nurses keep her functioning some days... they literally poke a drink and a chocolate bar at their young doctors to keep them going.. and when DD1 had to tell a family today that the young mother of two was terminal... the lovely nurse hugged her in the office when she had 2 minutes to shed tears for what she had had to do.

That is the reality of her job as a young newly qualified doctor.

And Jeremy Hunt is determined to make this even worse, even less safe, and it is wrong.

medusa and for your fantastic daughter .

Supermum I think your point of view is interesting

Most Drs however honestly don't think of the patients as a downside. It gives me perversely more joy to help out someone disadvantaged than someone more like me. If someone is poor, chronically disabled and friendless I try to go the extra mile for them just as part of a public service ethos. I don't expect them to thank me and I am surprised if they do. If they are angry, shouting or blame me unfairly I take it on the chin and I remind myself they are sick and vulnerable and worried and I let it go.

It is more the organisation I work for (and not just my specific one I don't think) that I feel dissatisfied with. Like you say stuff like a more generous study leave budget that actually went anywhere near paying for my compulsory CPD, some free refreshments sometimes, a contribution for a staff Christmas party. Feeling a bit valued and to have the organisation value my work not the patients who I don't put that on. Whereas in fact we get missives about not stealing the biros or the patients biscuits, a ban on catering for all internal staff events (can still schmoose CQC or the CCG) and its up to me as the consultant to subsidise my junior Drs Christmas meal and put in a contribution to the ward nurses Christmas party.
Of course we can't be seen to waste public funds but there must be some token ways we could do this.

I'm in psychiatry. Unfortunate to hear Minnie that anaesthetics is in such a similar position, it always seemed to be popular back in my day when I was training. Obviously the hours are considerably worse than psychiatry of course so I suppose its not surprising.

Actually MissTriggs I have no objection to management consultants at all . We have some management consultanty types in at the moment and I'm all for anything that might make our services run better I've also been trying to persuade them to tell me how to manage my chaotic life and house too but they tell me this is a misunderstanding of their role whilst backing off slowly I also think that our management colleagues work extremely hard for far less recognition and that it is very important the NHS is well run.

As to your questions as to why my colleagues left. Locally, we had a lot of cuts and service reductions including to frontline staff and services. My view is that doctors tend to be a particularly anxious bunch when it comes to job security - some of the people who go into medicine do so partly because its a very clear understandable career and career path with a fairly guaranteed job. Then when you start work you realise that for years and years you have to change jobs every 6 months to a year, potentially moving many miles with very little notice about where you will be placed. Suddenly having to do peculiar shifts to fit with the EWTD 60 miles from where your family are is a) tiring and b) very expensive. When you finally pop out the other end as a consultant then the idea of having to change jobs yet again when you had different expectations were different is not appealing. I think the mentality is that if you have to move then there is no point in moving to another deteriorating service in this country when it would be better to move somewhere else where you have job security, interesting specialties, research, support and yes, more money. I know my colleagues are much happier now they are on the other side of the world for those reasons.

I do think money has something to do with it though not in the way you think. This is perhaps a little different than the issues with juniors but it is linked. I think its a surprisingly small amount of doctors who are mainly motivated by money but there are some. However, the contrast between what we might earn elsewhere is dramatic and irritating when faced with a paycut. So my colleagues who have moved to Australia are earning double what I am for less hours and all the benefits I've mentioned. I know I could with ease earn several thousand a week as a locum if I were prepared to lose my current job stability and travel a bit. I get several e-mails a month which I delete whilst covering my eyes with my hands from various locum agencies in the UK and overseas recruitment agencies trying to encourage UK doctors overseas. Several colleagues from other specialties have moved to the middle east to earn several hundreds of thousands of pounds a year.

Pay also has an effect on recruitment as well as retention. So we tried to appoint to a post that has been vacant for a couple of years. The one candidate we had wanted several tens of thousands a year more than the national contract. We said no thanks and so did he because he knew he could get more money as a locum. The post is still vacant.

There is easily the capacity to train more medical students but the problem is that the government puts a cap on the number of medical school places because they cannot afford to pay for more Drs.
We could get more junior Drs right now if we wanted to but where will the money. Come from to pay them? Once you train more junior Drs you will in the end have more senior Drs and the NHS could surely use them but it hasn't got the funds to pay.

Oh dear - that took me so long to type the conversation has moved on somewhat!

Hi Kittlekattle. Nice to meet a fellow psychiatrist.

I have also just had a much valued colleague emigrate to NZ and when he's gone we can add his vacant post to the 4 already vacant some unfilled for 2 years.

At our last appointment attempt for what seemed an attractive job in a desirable place we had 2 applicants neither meeting the minimum standard. The time before that we had no applications at all. Some of the gaps the rest of us are just sucking up and others we are paying agency locum rates. We tried to offer the guy who has been doing the agency locum for 2 years a substantive post but he pointed out it was not in any way worth his while.

At a junior level it is no better. Our juniors did get a band 3 payment for the last 6 months after many, many monitoring exercise and BMA involvement. It was very well deserved for the few left standing after everyone else left or went off sick. The last locum junior Dr I had for my current maternity vacancy I had to let go after 2 weeks as he was so incompetent he was unsafe despite the Silly money we paid the agency.

Psych has always been unpopular and not because of the hours which are ok (probably because of stigma) but watch out the rest of medicine because this could be your future. A&E is there already and I had already heard from others that anaesthetics is going the same way which surprised me as it always used to be popular.

I totally support the junior doctors. All the reasons why have been already been given very eloquently above.

By the way, expanding the number of medical students will not help if

a) the trained doctors then leave the UK because the pay and conditions are shit

b) the trained doctors then leave for different career because the pay and conditions are shit

Hello mamadoc!

Yup, I completely recognise the locum story. A large proportion of CVs we get through from locum agencies at both junior and consultant level are unappointable and those that look they might not cause a major incident or who merely aren't on GMC restrictions are usually snapped up within hours by someone, whatever money they are requesting. Some of the CVs I've seen . Its hard to believe some managed GCSEs let alone med school. I certainly wouldn't let some of them anywhere near a patient.
I think we managed to appoint less than 20% of posts in our area at the recent trainee recruitment round.

Poor quality but expensive locums (and nursing agency staff too) are one of the major reasons for debt in our Trust.

As you say, this is where the rest of medicine in the UK is rapidly heading.

Miss Trigger, your vitriol has been linked to the Junior doctors contract forum page on Facebook. I'm sure you can imagine the response you're getting.

When you say that nowadays all professionals are expected to be available all the time what exactly do you mean? What do you do at 8pm, 10pm, 11am, 12am etc - basically every hour of the night until 9am when you might finish work? Do you put epidurals in screaming women begging you to take away the pain when you can hardly keep your eyes open yourself? Do you tell the parents of a 17 year old motorcyclist that their son has an unsurvivable head injury whist trying not to burst into tears yourself? Do you? No, you just moan about the long wait for your diagnosis. Sometimes patients are a mystery to us & we don't have all the answers at the drop of a hat. We're human, get over it or pay to go private.

The above is what I do all the time at the expense of seeing my partner & kids so forgive me if I want some fucking renumeration and some proper safeguards (for myself & the patients) for this level of responsibility.

That's so upsetting to read. I think another strain on mh services are the robbing off of cheap easily treated physical health conditions. Vitamin deficiencies for example, I had to change GP practice to get my bloods checked, even had a history of low levels. Are blood tests, vitamin D tablets, Folic acid tablets and vitamin b12 injections that £££? Are sleep studies and a CPAP that £££. My old GP wanted to label me mentally ill instead of rule out physical things. Oddly when I did see a psychiatrist they said I was depressed. Guess what the symptoms of my physical health conditions are? The practice of lazy medicine is adding extra burdens on mh services in my experience.

Sometimes patients are a mystery to us & we don't have all the answers at the drop of a hat. We're human, get over it or pay to go private. yes I did after I worked out what was wrong and found a specialist. I spent thousands and it was half my annual income, because I am ill and unable to work not just because of my physical stuff, because I care for children with the same issues. I am also v depressed and anxious because I can't "get over" losing everything due to some like you not having the answers so calling me mentally ill. I lost my friends, family, home and future fighting off a munchousens and munchousens by proxy false accusation because of misdiagnosis by someone with an attitude like you.

Eat this

I never labelled you mentally ill & I was merely trying to point out the complexities of patients & the fact that we make mistakes & get it wrong sometimes & the waiting time is exacerbated in the NHS because of the lack of doctors! We aren't superhuman. You probably have no idea what goes on behind closed doors for many doctors. I meant, 'get over,' the fact that we're not robots.

I don't like chocolate.

I know you didn't, I didn't say you did. I am referring to your comments about the go private and get over it comments, if a patient hasn't got a run of the mill condition. A professor for my main condition, labelled people behaving like you as practicing lazy medicine.

Thanks. I'd love you to come and see how lazy I am at work. I'm sure your Professor would be enthralled.

So you believe JD shouldnt strike because you were mis diagnosed?

Sorry, was that the private professor that you gave half your annual salary to that suggested NHS junior doctors were lazy

OP, YABU.