AMA Victoria - Vicdoc August/September 2019

Bullying, discrimination and low morale continue to afflict junior doctors In May 2019, AMA Victoria published the findings of the 2018 Hospital Health Check (HHC) survey. Designed to quantify issues surrounding junior doctor welfare and assess adherence to accreditation standards, the 2018 HHC successfully surveyed 674 hospital trainees across Victoria. Findings of the survey reveal that endemic issues of bullying, discrimination and low morale remain pervasive within the profession. Furthermore, it is evident that excessive workloads, poor working conditions, and unpaid overtime continue to affect a significant number of doctors-in-training (DiTs) despite advocacy efforts and negotiation of the 2018 Enterprise Agreement. Quantitative data regarding junior doctor welfare has been critical in advocating for change. A key source of Australian data has been the ‘Hospital Health Check’ (HHC). Originally developed in 2015 by the AMA WA DiT subcommittee, the HHC is a confidential, self-reported survey of DiTs that seeks to quantify issues affecting junior doctor welfare, assess hospitals’ adherence to industrial, accreditation and education standards, and guide advocacy efforts. Hospital Health Checks have since been conducted in other Australian states, including New South Wales, Queensland and Victoria. Data from the 2018 HHC continue to highlight issues of morale, unacceptable work behaviours and over work as significant areas of concern. Twenty-nine per cent of respondents rated morale among medical staff as poor. High rates of unacceptable work behaviours likely contribute to this result: 42 per cent of trainees reported being the target of bullying, discrimination or harassment. Furthermore, over half of trainees (58 per cent) reported that a fear of negative career consequences acted as a barrier to reporting such behaviours. Thirty-eight per cent of trainees perceived hospital support for mental health and wellbeing as poor. Results of the 2018 HHC highlight poor working conditions for trainees. On average, trainees reported working nine hours of unrostered overtime each week. Seventy-six per cent reported being paid for less than a quarter of these hours. Furthermore, 71 per cent of trainees reported often working through meal breaks due to excessive workload and 48 per cent of trainees reported ongoing breaches to the 2018 Enterprise Agreement. Poor working conditions have a detrimental effect on trainees: over half of trainees reported that their workload often prevents them from investing time in their physical and mental health. Furthermore, 37 per cent of trainees considered resigning from their current hospital and 31 per cent of trainees considered leaving the medical profession due to issues of workload and poor working conditions. Data from the 2018 Hospital Health Check survey continues to demonstrate poor working conditions for DiTs in Victoria. Significant rates of low morale, unacceptable work behaviours and overwork remain pervasive. Contextually, these results are sadly unsurprising. HHC surveys in other Australian states have historically painted a similar picture of junior doctor welfare, while increasing rates of physician burnout have been observed worldwide. Where to, then, from here? No magic bullet exists to address the long-standing cultural and systemic factors that perpetuate these issues: resolving these issues will require active, persistent and determined efforts to bring about meaningful change. First steps involve raising awareness about the existence and magnitude of these issues among medical staff, administrators, executives, and the public. AMA Victoria has already begun to facilitate discussions with Victorian hospitals regarding survey results and solutions for change and efforts are underway to explore broader release of HHC data to the public. Other initial steps include ensuring that the gains achieved in the 2018 Enterprise Agreement are implemented by health services. The current state of junior doctor welfare – locally, nationally, and globally – remains far from ideal. Rather than accept this as the norm, we believe that these findings should act as a rallying call-to-action for medical staff, the wider public, hospitals, and government institutions. Victoria has a proud and accomplished history of excellence in medical care, education and training. The vision statements of various Victorian health services document their commitment to excellence and it is clear that these organisations possess the drive, talent and determination to achieve great things. Through active engagement, determination and genuine commitment, we believe that Victoria and its health services have the opportunity to set a world-leading example in caring for its junior doctors. Most importantly, we again call upon all doctors, both junior and senior, to use this information to raise awareness about the endemic issues that affect our profession. It is our responsibility to actively engage with these issues, stand in solidarity with our peers and advocate for real, meaningful change. We hope the publication of the 2018 Victorian Hospital Health Check will empower you to challenge the norm, raise awareness about these issues and encourage you to engage with local advocacy efforts to address them. Dr Chris Lim DiT subdivision Hospital Medical Officer Royal Melbourne Hospital skyenergysystems.com.au Call us now on 1300 787 488 Power your life. u Save money, whilst you save lives. Start saving with a smart solar and battery system. Surgically installed by the in-house team at Sky Energy. Act now and receive Free System Monitoring. August / September 2019 Vicdoc | 21 The full findings of the 2018 AMA Victoria Hospital Health Check are available at amavic.com.au in the ‘Assistance for Doctors’ section. DiT subcommittee meetings are held monthly. All AMA Victoria members are welcome to attend. Please email Grant Forsyth at [email protected] for more information.