A quarter of SMOs intend to leave in next five years

Significant number of senior doctors intending to leave in next five years, survey finds

17 November 2016 • Media Release - ASMS

A quarter of all senior doctors and dentists who took part in a survey by the Association of Salaried Medical Specialists (ASMS) intend to leave either medicine or their district health board in the next five years.

ASMS has surveyed DHB-employed members about their work intentions over the next five years with a view to better understanding the factors influencing their decisions as well as the link with demographic factors such as age, gender, medical specialty and levels of job satisfaction.

ASMS Executive Director Ian Powell says the survey findings should be of great concern to DHB chief executives and senior managers, as they point to a looming exodus of public hospital specialists.

“This research follows on from our earlier surveys which found high levels of presenteeism and burnout in New Zealand’s senior medical workforce,” he says.

“Senior doctors, along with other health professionals, are under intense and sustained pressure to keep the public health sector functioning effectively, in the absence of ongoing resourcing and longstanding shortages that have yet to be properly addressed.

“What we’re seeing now, though, is that the pressure these doctors are under is taking a toll on their wellbeing and their job satisfaction. Hospital specialists are going to work even when they’re sick or experiencing symptoms of burnout, and many of them are starting to look for the exit doors.

“The last thing we need now is more talk from the Government and its agencies – what senior doctors and others on the front line of public health need is urgent action to address this situation. If it’s not fixed, then patient care will suffer.”

ASMS Principal Analyst Dr Charlotte Chambers, who carried out the research, says 2424 ASMS members employed by DHBs took part in the survey, a response rate of 63%.

They were asked how likely they were to leave medicine entirely, remain in DHB-based employment, or leave New Zealand permanently to go overseas. Those who indicated they planned to stay put were then asked how they would like to change the number of hours they worked (their full-time equivalent or FTE status), or their on-call work.

The survey’s main findings include:

· 572 survey respondents (24%) plan to leave either medicine or the DHB they work for in the next five years.

· Of those who intend to stay, 40% might look at reducing the hours they work, 30% would like to decrease their on-call and/or shift work, and 8% would like to stop doing on-call work altogether.

· Survey respondents cited age, poor job satisfaction, culture, remuneration and workloads as some of the factors influencing their future work intentions. The top three factors that would encourage them to reconsider leaving were flexible working hours, ability to take leave, better remuneration and more opportunities, and improvements in DHB culture.

· In medical specialties where more than 25 senior doctors responded to the survey, considerable variation was noted in five-year intentions. For example, a third of rheumatologists and endocrinologists who answered the ASMS survey plan to leave medicine entirely in the next five years, with smaller but still considerable numbers planning to do the same in obstetrics and gynaecology, public health medicine, otolaryngology, and geriatric medicine.

· There were also variations by DHB, with smaller and mid-sized DHBs facing a potentially bigger exodus of senior doctors than some of the larger DHBs. For example, more than half of all hospital specialists at Wairarapa DHB who took part in the ASMS survey plan to leave either medicine or their DHB in the next five years.

Comments provided by survey respondents included:

· “Feel under-valued, being bullied, passive violence at workplace. Cost-cutting putting clinicians at risk.”

· “Little appreciation from managers for the skills older practitioners bring to the job. Some members of department view ‘old fogies’ as inferior.”

· Why stick it out when I can earn more and work less in private practice? My only concern is I will truly miss working in a team and teaching medical students, junior doctors and allied staff.”

· “I am fed up with targets and chronic understaffing and lack of resources.”

The initial survey findings were presented to delegates at the ASMS Annual Conference in Wellington today, and Ian Powell says the results will be taken up with individual DHBs to encourage greater workforce planning. More details are available at http://www.asms.org.nz/wp-content/uploads/2016/11/5.-Age-frustration-and-call_166957.pptx

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