Penance

Hi Ian, Blaming individual doctors for the health system’s woes is a little like blaming young people for binge drinking or individuals for eating junk food. When societal structures encourage and promote this sort of behaviour, it seems more than a little unfair to heap all the blame on people who are responding to environmental and societal cues. Similarly the health system (if there is such a ‘thing’) often encourages doctors to work in areas and ways that may not be for the greater public good. So I’m not trying to put the blame on individual doctors acrss the board. I know many individuals who work very well with other health professionals or choose to work in relatively under-rewarded and difficult areas such as mental health or rural health. On the other hand, the AMA and other professional organisations (and not just in the medical sphere) are too often major barriers to us progressing towards a system that is truely based around the community and patient needs.

There is clearly a need for very broad scrutiny of professional roles and how best to fund and deliver the services the community needs. The incentives and disincentives for health professionals to work in areas of need also need scrutiny. As an aside, at least some of the physician assistant roles now being tested in Australia are in the surgical area. I know of at least one surgeon in Adelaide who has been pushing to have physician assistants working alongside surgeons.