There is no shortage of doctors in Australia and never has been - the problem is one of mal-distribution.
The numbers speak for themselves - 3.3 doctors per 1000 head of population in Australia compared to an average in the developed world of somewhere between 2-3 doctors per head of population.
So what gives with the massive increase in the number of doctors graduating from Australian medical schools at the moment? Surely the architects of this policy have, either some cunning plan that we are not privy to, or have grossly miscalculated.
Either way we have a problem.
Whilst there has been much discussion in the press about what will happen with the immediate crisis there appears to be little consideration given to the long term consequences (intended or not) of doctors pouring out of medical school, like a cars approaching a motorway pile-up.
So indulge me, if you will, in a little bit of good old-fashioned speculation.
I have tried to imagine what the future holds for this surplus workforce as the years roll by, so here goes.
Some will leave the profession - disillusioned by their investment in a highly specialised education they cannot use and cannot easily transfer to another career.
Some will go overseas - and there is plenty of interest from other countries with genuine shortages. Some will return, but most will not be able to, given the oversupply.
The specialist colleges will close ranks, displaying more of the defensive behaviour that has drawn the attention of the ACCC in recent years.
Doctors will have to accept lower incomes, particularly in urban practice, based on simple supply and demand pressures.
Expect more unnecessary services being provided (and cost to Medicare) as doctors over-service smaller numbers of patients to keep themselves busy.
More part-time work and job sharing - a trend already gathering pace due to the feminisation of workforce.
More corporatized medicine - it will be a buyers market and doctors will find their bargaining power eroded.
More doctors will choose to do full-time locum work as they find their urban job prospects becoming limited and unattractive.
Ultimately ... even more saturation of doctors in the cities, more cost to the country and the same old problems in rural areas.
I don’t mean to sound dystopic. People, especially smart people, have a way of working things out for themselves over time and I am sure that no-one is going to starve. However, thwarted career ambitions and healthcare cost blow-outs are not desirable and they do seem inevitable to some degree.
I, therefore, back the call for urgent review of current policy. Much like the climate change debate, it is easy to dismiss speculation as alarmist, until the water is lapping at the foundations of your waterfront property.
Of course the real issue here (as it has always been) is what to do about the mal-distribution. This problem has not gone away. Perhaps a topic for another blog.
If you can think of any other unintended consequences, feel free to comment below.
Dr John Bethell, Director
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