By John Ryan
The nature of medicine together with the issues that go with funding and running a public health system means that doctors often experience excessive workloads.
However, being faced with an excessive workload does not mean you have to accept it or simply find a way to cope. In fact, taking on more work than can be safely managed can put both you and your patients at risk and can be potentially unlawful.
What constitutes an ‘excessive’ workload can also depend on perspective. The person allocating the work may believe their request is reasonable. The doctor expected to complete it may have a very different view based on their existing workload, competing priorities and what can realistically be achieved safely.
This is important at every career stage, but particularly during internship. Interns can feel pressure to keep saying yes, work faster or somehow manage everything that is asked of them.
Ignoring an excessive workload or pretending you can cope is not the answer. If your workload becomes unsafe, patients may be placed at risk and mistakes are more likely to occur. Importantly, being overloaded does not necessarily protect you from responsibility if something goes wrong.
Recognising when your workload has become unsafe and knowing how to raise concerns, escalate appropriately and ask for support are important professional skills for every intern.
How to manage excessive workloads – Clause 41 Workload Management and Review of the Doctors in Training (DiT) Agreement
All health services and all clinical supervisors and clinical managers (including Senior Registrars, Specialists and Departmental Heads) have an ongoing obligation to monitor the workload of doctors.
Three key parts of clause 41 Workload Management and Review in the DiT Agreement require that:
41.2 Safe Workload
(a) The Health Service is obliged by the OHS Act to provide a safe workplace. This includes ensuring that workloads are not unreasonable (including from unrostered overtime).
41.3 Assignment of Work
(a) The Health Service will ensure that the type and volume of work assigned to the Doctor is reasonable with regard to the Doctor’s skills, abilities, capacity and availability to perform.41.4 Consultation
(a) The Health Service and Doctor shall consult regularly regarding the Doctor’s workload.
(b) The Health Service shall review workloads of Doctors and particular units.
Health services and supervisors/managers have an ongoing responsibility to monitor and review doctors’ workloads. It is not a ‘set and forget’ situation.
Unfortunately, supervisors may themselves be managing excessive workloads and significant workplace pressures. This can flow down the line, with supervisors feeling they have little choice but to pass additional work on to more junior doctors. The fact that your supervisor is under pressure, however, does not make an unsafe or excessive workload reasonable or acceptable.
Even with the requirement for ongoing workload review under clause 41.4, clause 41.5(b) provides an important additional protection: you can request a review of your workload at any time.
Under clause 41.5(a), the review must be conducted by someone who is appropriately experienced and familiar with the unit and the duties involved.
The process starts with consultation between you and the health service about your current workload. Your workload is then reviewed with the aim of reaching agreement on a workload that is reasonable and manageable.
At any stage of a workload review, AMA Victoria/ASMOF members can seek advice, support and representation.
Don’t put your health, your career or your patients at risk by simply accepting an excessive workload.
You have rights. Know them and use them.
Click here to learn more about your DiT EA,.
And if needed, we are here to support you – email us at [email protected]
John Ryan is a Senior Workplace Relations Advisor at AMA Victoria and Victoria Industrial Officer at Australian Salaried Medical Officers Federation (ASMOF) Victoria.