It was an average day in the emergency department. People waiting, and less than enough doctors rostered to work that day. A few sick calls later and once again the ED was a skeleton staff. Looking at the dismal roster I sighed. One of the nurse practitioners said, “wow it’s short staffed today”.

I replied, “as always”.

He then said, “you doctors need to fight more. If that happened to the nursing staff we would all cause such a fuss that they’d find a replacement the very same day”.

It made me think. He was completely right. The nurses and midwives have such a strong united front, and an amazing union. They’ve achieved so much – protected meal times, safe rostering, legal advice, improved superannuation funds and more.

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Mind blowing (for a junior doctor)

Every nurse gets a set break during their shift. They work together to ensure it’s covered and no one goes without. They band together to ensure safe rostering, with understaffing a rarity. All very mind blowing for a junior doctor in the public health system.

Most shifts you find yourself working 8-14 hours with no water break. Even going to the toilet isn’t heard of, which usually isn’t a problem given you don’t get to drink any fluids…

You stumble to your car at the end of it all, a bit shaken, tired, hungry and oh so thirsty. The idea of having a protected meal time, a novelty, a thought of “oh that sounds nice”. Getting paid for all the hours you actually work, not possible.

The most protected meal is usually you eating a sandwich in front of a computer as you hastily write discharge summaries.

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He was right – we need to stand up

That nurse practitioner was completely right. Doctors need to stand up for themselves more. If we all banded together and said – “hey we should be able to get a lunch break” or “hey it’s unsafe to have one doctor to 60+ patients” maybe it wouldn’t keep happening.

Doctors do have unions. Australia does not have a national union however for doctors, there is one in NSW that has 5000 members only. There are over 70,000 doctors in Australia (7% in the union).

A national union for nurses does exist, with about 300,000 members, with 450,000 nurses registered in Australia (66%). There is strength in numbers, and basically there aren’t many doctors coming together.

Numbers don’t lie and neither do results, it’s pretty obvious why there is a lag in doctor’s rights.

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Why aren’t doctors joining the union?

I honestly think the main reason doctors are not members of the union is fear.

There is this culture in medicine to have a stiff upper lip. Speaking up can mean you’re labelled as a ‘trouble maker’. I’ve had a friend who was sexually harassed by seniors say nothing, because she did not want to ‘rock the boat’.

Saying no to illegal hours, underpayments or bullying can make administrative staff see you as a less than desirable employee. As a student or junior doctor you must complete assessments of your work quality every 10 weeks, and you often don’t want to upset the person who will mark you.

Claiming the overtime you work is looked down on. It’s assumed that you will keep quiet about the actual hours you work, and accept payment for a lot less. If you speak up you’re not a team player, or someone suitable for a training program.

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Doctors in training are most at risk

Even higher stakes are doctors in training programs and those who are unaccredited registrars. The amount of money and time invested into becoming a specialist in medicine means that most trainees are scared of not making it to the end. Declining to work overtime will deem you ‘difficult to work with’, and could even cost you a job in the future. Everyone expects you to say ‘yes’.

Doctors put up with a lot, and do so smiling, if it means they have a protected job or spot on a training program.

So joining the union is seen as risky. Medics believe they need to ‘just get through it’ and struggle for their years as a junior doctor. It can be seen as an almost rite of passage, with the people who break the ‘weak ones’.

You can see this with Dr Yumiko Kadota, the aspiring plastic surgeon who was told she ‘didn’t have what it takes’ and lacked the ‘mental tenacity’ to finish her gruelling surgical years.

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The promise of better times

The one thing held in front of every junior doctor is the promise of better times. ‘Just get through this’ and you won’t have to deal with all this anymore. You’ll be a consultant, and consultants can choose their hours. Consultants don’t get bullied, they get paid better, and they can be more in control of their lives. Hopefully, you can have time to actually do the things you’d like to do, and spend time with your family.

This is the promise, and this is often the end goal of every doctor. Just silently put up with the hard days, and one day you can join the ranks of the staff specialists that have it better.

So why join the union? You’ll only tough it out for about 4-15 years. And if you join the union you’re putting this all at risk.

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We need to break this myth

If doctors didn’t buy into the falsehood we could have a better hope of improving our work environments. Things don’t magically become okay the moment you’re accepted into a college as a fellow. Also, what about the many years you spent ‘in the trenches’?

The present is the only thing that exists, the future is but a promise.

Why not work so that every stage of our medical careers is enjoyable? Why glorify the idea of working so hard you don’t sleep, eat, or have time with loved ones?

I believe every medic deserves a safe work environment, with basic rights of breaks, humane hours, no bullying, and proper staffing. It isn’t only for the benefit of the doctors, but for the public. A fed, well rested, happy doctor is infinitely better than an exhausted, sad and starving one.

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Joining the union

I just joined the union. Maybe you should too? Hopefully one day it is a matter of course, rather than the rare few who are members.

Feature Photo by Clay Banks on Unsplash