How much per hour? When doctors’ wages are spotlighted, the community pays

How much per hour? When doctors’ wages are spotlighted, the community pays


Harry D’Souza
President, Western Australian Medical Students’ Society

Monday 1 July 2019

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Australia’s highest earners revealed reads the Buzzfeed-like headline of a recent ATO taxation statistics report. In it, it names surgeons, anaesthetists and internal medicine specialists as the top three.

 

With final-year students now applying for internships, many of us are beginning to seriously consider our long-term careers. We are young, green and easily influenced by the visible virtues of a profession. Work-life balance is becoming increasingly important to us, as is access to leave. Workforce trends will always be worth noting. But more than anything, I hear my friends mention pay, and occasionally status, as key reasons for aiming for a specialty pathway.

 

Higher paid specialties tend to attract more applicants. Dermatology, notoriously well compensated, may have dozens more people apply than there are training positions. Meanwhile only 1,460 of 1,500 General Practice training spots were filled nationwide in 2018.

 

Should we blame the greedy, money hungry students for setting their sights on glamorous specialties, and ignoring their Hippocratic Oath to community justice?

 

No. In fact, our goals are influenced by our surroundings. And when the only non-workforce specialty data regularly discussed by the Australian media is wage, we come to believe that this is the only factor worth thinking about. 

 

Take Google for example. If I search ‘highest paid medical professionals’, a neat, comprehensive list of local and international statistics appears.

 

If I instead write ‘happiest specialists’ or ‘doctors who would choose the same specialty again’, the information is less clear.

 

In fact, only the American website Medscape makes this information readily available, with no clear Australian data available to the average user.

 

Given this fact, my animal brain tells me that wage is the only career metric of value, and from this I infer that I will only be successful if I pursue one of the listed ‘top’ specialties.

 

Because of salary spotlighting, students may crudely and inaccurately infer a specialties merit from pay alone. This decreases demand for poorly-paid specialties such as General Practice, at the cost of the community’s health.

 

What are the dangers of this? Spotlighting without context creates a culture that one specialty is more important than another, lowering the morale and perceived value of affected doctors. Those in the profession may receive less referrals, or the public may be unwilling to see them because of this fact. It also challenges recruitment into the profession, and I worry that some students risk hurting their own wellbeing by pursuing specialties that they are not suited for, do not enjoy, or may not get into.

 

I do not advocate for drastic changes to the way most doctors are compensated. There are often reasonable and valid reasons why these wage discrepancies exist, with some notable exceptions. I do think, though, that students should have access to more statistics about a specialty than just wage. We cannot value the many virtues of a career without knowing them first.

 

One of my favourite quotes comes from The Leopard, where Giussepe Tomasi di Lampedusa writes that “if we want things to stay as they are, things will have to change”.

 

We as a generation will inevitably need to accept that our workforce is evolving. Automation is increasing and the population is ageing. If we want continued job security, we are going to have to adapt. But to do so, we need to know more about our potential careers than how they will pad our bank accounts.

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