Monday, 28 March 2011

Vote Mick!!!

Don't vote Pedro, Vote Mick.

This post is a shameless plug for my friend Mick Molly, who's running for the Seanate in Ireland. Mick is the kind of guy we need in politics.

He's a doctor, who's worked in A+E for a long time, so he's knows all about Ireland and the problems facing our crumbling health system. He's been the president of the Irish Medical Organisation, and has been on the board of a regional health authority, so he also knows how health WORKS. he's been working in Harvard over the last 2 years or so, and has served on a pan-European body, representing the interests of junior doctors, so he knows how to navigate the global health environment.

As a person, he is incredibly helpful, incredible bright, and incredibly dedicated.

The Senate will hopefully start up Mick's career in politics, specifically in area of health politics.

For years, clueless politicians have run healthcare in Ireland.
This can change. Make sure that you check out Mick's site and make sure you give him your number one.

This is my 100th post, and I'm glad to use it to endorse Mick for the position of Senator, representing my family and I. Voting is now open, so go and vote :D

Dr. Thunder

Sunday, 13 February 2011

The downside of being down under.

This blog, and many others are full of the joys involved in a move to Australia and New Zealand. A region where work/life balance is (usually) possible, and where we don't have to routinely watch patients die while they wait for outpatient appointments, or operating theatre slots.

The weather is decent, there's lots to do, and our political masters don't seem to exist purely to screw up our education. Most doctors who come here never regret it.

But there must be a downside, right? Of course, and many of them. So, here is the Dr Thunder MD official "Downside of being down under" list:

1) Trying to get here: NIGHTMARE to get registered as a doctor. Very slow process, and they've outsourced the verification of medical qualifications to the USA!! This, of course, only prolongs the process.

2) Patient expectation is higher: In my opinion (and I've been disagreed with on this topic on the blog before) Australian patients are more aggressively demanding than those in Ireland or the UK, often to the point of being unrealistic. Having said that, I think it's because they're used to a health service of a high standard. Whereas in Ireland, especially, we accept that we'll wait in A+E for 16 hours before seeing a doctor.

3) Residents often rotate every 4 months: As opposed to 6 months in the European model. I don't think they get a good grasp of some of the specialties in 4 months. In fact, 6 months often isn't long enough for these junior doctors to get enough experience.

4) Cost of living: In my experience, it's higher than in most places in Ireland and the UK. Though I found New Zealand much more reasonable. There will obviously be some regional variation here.

5) It's a long way from home: Don't underestimate that side of it, especially if you're not used to living away, or if you're coming out for a long time. One of my grandparents passed away not so long ago, and I didn't get to say goodbye or go to the funeral.

6) There's a craziness about cross-recognition of exams: We have a lot of very highly qualified paediatric doctors who come to Oz, and they have to re-sit all their specialist exams, because Australia won't recognise the UK/Irish ones (and vice versa), which is madness. We're all developed countries, and someone who has their postgraduate paediatric exams in the UK should be given exemption from those exams in Australia (and, again, vice versa).

7) The place is full of GAMSAT course students: We won't go into this, as it's been covered to death on this blog, but we probably need to make the medicine course longer, not shorter, and I personally think that's reflected in the quality of many of the medical students. Though this is almost as much of an issue in Ireland too, as of recent years.

8) Primary care: In contrast to the UK, primary care here is basically a business model. GPs can (and usually do) charge more for a consultation than the government pays. They also usually insist on patients paying cash up front and then reclaiming the money themselves. I'm not having a go at GPs. Anyone who reads this blog will know I have much love for GPs. But they are forced into becoming business people, and the financial realities of that inevitably mean that our poorer patients often can't afford to see their doctor, and get poorer follow up. It also means paediatric A+E is like a GP surgery, with a huge amount of "primary care types" of problems showing up. This will come as a bit of a shock to UK doctors in particular, who are used to a free-at-the-point-of-care NHS.

9) Patients?: Not over here. Seems every second person is now referring to them as "clients". I heard some psych person call a patient a "consumer" the other day. I don't know why, but it boils my piss.

10) The bloody chocolate: it's DISGUSTING!

So, leave your comments below for the benefit of the hordes of UK and Irish docs fleeing their jobs. Remember, no positives. We've done them to death. This is all about the misery :D

Dr T

Thursday, 6 January 2011

the family doctor Vs the FAMILY doctor

I hate being the only doctor in the family. Aunts, grannies, nieces and friends of theirs all seem too keen to show me their bumps and bruises at any opportunity, in the hope of getting a quick diagnosis. I even had a relative show me his penis recently!

I hate this. Not because I don't understand their frustration at being stuck on a waiting list, or having to pay to see a GP. I hate it because I'm worried I'll get something wrong.

There's a meddling lady who lives near our family home, who brought her child around to my house when I was a 1st year medical student, and asked me to look at her injured shoulder. She'd fallen off a trampoline and landed on it. I'd never seen a broken shoulder before, and told her that.

"But what do you THINK might be wrong?"

I buckled and told her it didn't LOOK broken to me. But I told her I didn't know for sur, and that she should get it checked out in the emergency department.

IN her head that became "this shoulder is most definitely NOT broken, and there is no need to seek medical care for this child". Obviously, the pain persisted for a few days, and she got an x-ray....diagnosis = "broken" shoulder.

To this day she tells everyone who'll listen that it's a crime for me to be doing paediatric emergency medicine, as I can't even diagnose a broken shoulder.

So, today when my gran rang me to say she's getting "funny turns" I told her to see a doctor and she seemed disappointed that I wasn't offering a diagnosis. I don't want want to be that guy who can't even diagnose granny with x, y or z.

So, to the families of doctors out there, I ask you, on their behalf, to treat them like the clueless mucker you grew up with, and not as the professor of brain surgery that they actually are.

Happy new year to you all.

Dr. T