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The Forum > Article Comments > Involving communities in their health > Comments

Involving communities in their health : Comments

By Kevin Pittman, published 22/11/2005

Kevin Pittman argues to fix our ailing health system we need to bypass the politicians.

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This is just another Baby Boomer problem as you mentioned.

All industries are the same, whilst health should be given priority over most others, it comes back the 17 and 18 year old scholars who need to be influenced more than any other group, using whatever means.

If the encouragement came by perhaps greater subsidies and incentives for those choosing medical science(to also encourage lower income and rural kids to enter the medical profession, helping to address another problem of doctors in the bush)and lowering the unversity entry mark not to effect calibre, but to attract the bright children marginalized with ineffective or isolated schools who end up good (but not outstanding) scores but have had significant disadvantage.

There should be tutorial focussed learning whilst at university moreso than lectures for these students to keep interpersonal and keep them from drifting away, and if the incentives are there, if the stigma is taken away and doctors are not looked at as workaholics with no personal time, we will get close to the numbers coming through that we need.

A marketing campaign targetted at school leavers is simple. Put some music stars on a poster and get doctors to speak at assemblies, make them more connected with the general public. That is my 2 cents anyway.
Posted by Realist, Tuesday, 22 November 2005 11:20:54 AM
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Realist,

> This is just another Baby Boomer problem as you mentioned.

Not really, lack of health care affects everyone, especially indigenous people.

There needs to be research on why "our best and brightest" aren't choosing medicine. I can mention a few ideas off the top of my head, but in the absence of a well designed survey, not one of us knows. Most of your suggestions make sense, except I don't really think there's a lot of anti-doctor stigma out there. The conditions, 80-hour weeks and 24 hour shifts, probably drive more bright people into real estate than anything else.
Posted by Moonie, Tuesday, 22 November 2005 1:36:16 PM
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Moonie,

You missed the context. The undersupply of qualified people is a baby boomer problem, the reason for this 'health' issue is that more people shortly will be leaving the workforce than entering it, especially with the proportion of doctors going to retire, and the lack of new recruits. This is a baby boomer problem.

As for surveys, they are good but just dont survey the young, i know on many surveys we did at school EVERYONE LIED and it was a source of amusement. What do you want to find? The reason the brightest and best are steering away from medicine is varied, but in the days gone by many were either doctors or lawyers, now they are across many new frontiers, IT being one of them.

Where did you get the real estate idea from? was that a shot? I missed your point
Posted by Realist, Tuesday, 22 November 2005 1:44:17 PM
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Well said Kevin. Thank you.

If medical schools followed the Newcastle Uni Med School Barrows and Tamblyn model of Problem-Based Learning, I am certain that we would have more young people entering the medical profession. Newc Uni does not rely on HSC scores alone. Prospective medical students must also engage in an intensive interview in which they are presented with a case study that they are required to solve. The thesis is that people can have a very high IQ and HSC scores, but they may not have well developed problem solving skills, which of course are essential for medical practitioners to have. Even though sophisticated problem solving skills can be taught, the prospective student does require some innate problem solving abilities. I have taught PBL at four eastern state universities. It is a brilliant way to learn. It teaches people to understand how they learn, and it teaches them an understanding of their own understandings.

I have taught nursing at hospitals and across four university nursing programs. Nurse academics have a lot to answer for. They focus on research and philosophical wanking. There are few academics who have laid hands on people called patients since 1985! Tertiary nursing programs in the main are not pragmatic. That is why I returned to the clinical field. The entry standards are generally disgraceful. Nursing has lower entry scores than most other uni programs. Far too many students gain entry to uni nursing programs (on the grounds of disadvantage) - and far too many nursing students are granted a pass level. The standards are very poor in my view. There sould be a two tier system to engage people to enter nursing, vis a vis: a hospital- based hands on system through TAFE, and a university system for those wanting an academic pathway. Bernadette Keane (renowned Vic RPN)predicted our current problems back in 1983. She was not wrong.

Cheers
Kay
Posted by kalweb, Tuesday, 22 November 2005 7:21:03 PM
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Hi Realist -

No, it wasn't a shot, just an aside :) ! A lot of my friends who could have done medicine were driven away by the conditions - either to the US, Europe, or in more than one case, to real estate.

Thanks for clarifying your point on baby boomers. The problem might not just a corollary of an aging population, but you would have to compare the number of graduating doctors with the size of their population cohort to test this. If there is a declining ratio, then it can't be explained completely by the boomer effect. My instinct is that less people are taking medicine because the conditions are rubbish, it's too hard to get into courses, and the courses are way too expensive. However, that's just my opinion and I would want to see some data of some sort to back it up.

My feeling is that Pittman has provided data that proves a shortfall, but no data to examine the causes of that shortfall. He may well have that data, but he hasn't presented it. That the problem would be solved by "less money" to hospitals and emergency departments (as well as targetted spending elsewhere) is just his personal opinion. The only evidence Pittman presents to support his opinion is the result of a community consultation exercise - and as one who has had some experience in community consultation, I donít personally find it convincing.
Posted by Moonie, Wednesday, 23 November 2005 9:47:13 AM
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I think this is a good article. The system's in decline, and the old top-down models of maintaining it are also rightly dying. The only thing left when one thinks about it is to empower those who really have a stake in making the system work. The suggestion outlined is really a form of self-organisation. (For a good description of this read Geoff Davies' book, Economia).

Without being an expert on the health system, I'd say that a self-organised model is closest to the way nature works and, as such, would have to be an improvement on the way bureaucracies operate. If people were empowered to deal with problems on a number of fronts, my guess is that the problems would be pragmatically dealt with and the current complexity in the system would eventually disappear. It is a truly revolutionary idea.
Posted by RobP, Wednesday, 23 November 2005 9:54:43 AM
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