Where Have All the Doctors Gone?

It’s the week before Christmas and Dr Clare Skinner, an emergency medicine registrar, has been on her feet for hours. She’s one of eight doctors on duty to treat up to 180 patients during her shift in the emergency department at a busy Sydney hospital. Tonight, there should have been ten doctors on duty but, as usual, they’re operating without the full complement of staff.

Steering a course through the irate patients who have waited too long, the psychiatric patient who is trying to kick and bite her, and the intoxicated young woman who is vomiting on the floor, Dr Skinner is terrified of what might come through the door next. "It’s just chaos," she says. "I don’t think the general public realise we’re working on the brink of what we are capable of all the time, and things can easily tip over the edge."

Beyond the Emergency Doors

Inside the emergency department, harried and burnt-out staff are trying to manage the workload. But it’s hard when you lack enough trained staff.

A major problem is emergency wards being staffed by juniors, who need constant supervision. "It means that what I do is fragmented. I’m constantly interrupted," says Dr Sue Ieraci, an emergency medicine specialist at Sydney’s Royal North Shore Hospital.

It’s not just inexperienced young doctors who are the problem. Many of our doctors come from different countries – anywhere from Ireland to Nigeria, brought in by public health departments desperate to boost staff numbers. While most have adequate clinical skills, their lack of knowledge of the local system causes problems. "After a year or so they’re fantastic, but you really have to nurture them through that," says Dr Ieraci.