jrm and S madden seem to be having a little spat on who can really lay claim to the title doctor -it is of little consequence really.

But doctors do seem pretty precious when it comes to titles. Dont mistake a Doctor for a Mr what ever you do.

jrm is also fairly scathing of health bureaucrats - he uses an example of poor medicos hand writing and then accusing bureacrats of failing to apply a technological solution - here is another possible solution -

get the medicos to do as they are bloody well told! - there is a novel idea!

most health agencies request drug orders be written legibly using generic terminology - not the brand names of the drug company who funded the Drs last note pad, pen or trip to Vanuatu - eventually when all hospitals are kitted out with voice recognition software they will not even have to write an entry in the medical record - but until that happens courtesy would dictate they have some consideration for the poor patsy who is responsible for administering the drug. But history can attest to the fact that that is waaaay toooo much to ask

Clearly jrm has all the answers - I suspect he might be a medical practitioner - but health bureacrats do not have a mortgage on dumb decisions - medicos commit their fair share - in fact many health bureacrats are also clinicians - my take on that is jrm thinks these are failed clinicians.

Young doctors are abused because older doctors simply wish to perpetuate the same rights of passage that they were subjected to.

Steve,

Doctors can no longer set up an independant practice after intern year.

Several years ago, the Howard Govt restricted Medicare access as it was thought that there were too many doctors.

So, until a doctor attains Fellowship with one of the Colleges (becomes a consultant) they are not able to bill Medicare (and access the rebate) for seeing pts. Therefore they cannot earn an independant income.

Instead, fully registered "junior doctors" are employed by hospitals as they undergo their College training; they have numerous Medicare Provider numbers linked to the location of the hospitals/clinics where they work, which are only for the purpose of ordering diagnostic pathology and radiology tests. They do not see any money from Medicare - their income is solely from the salary the hospital pays them.

While junior doctors (and yes, i am one) have unions, the pay conditions are far from lucrative. My friends who finished engineering, IT and other professions earn far more than me, and are able to progress far more quickly up the seniority ladder.

Anyone who goes into Medicine for the money would be sadly disappointed!

Undergraduate medical training is undergoing a quiet revolution, and it is time - as Dr Ahmed points out - for post-gradute medical education to do the same.

I do not in any way mean to belittle doctors, heck they keep me alive.

My GP is the most caring person I have ever met, my rheumatologist is a wally and my heamatologist is just incredible.

I talked to my GP about this issue today, he said he had always wanted to be a heamatologist and did well in his college entry exams. He did not get in, not because of ability, but because "they" limit entry.

There are two heamatologists where I live, one has closed his books the other is bordering on incompetence. So I choose to travel to Brisbane to see a specialist in a private hospital. (Mater Private)

What other industry (forget professions, the term is now debased) can set up a new business with guaranteed payments from the Govt?

How many Docs actually work for themselves (I heard Bruce Flegg say he employed 200).

Why is the medical industry not based on talent?

As long as the medical practitioner is the sole 'gate keeper' in the medical model they will be overworked. It suits government policy though.

Many people see medical practioners for advice and treatment that could be provided by others. No, I am not including alternative health practioners but I am thinking that (say) a new mother would be better off seeing a community nurse to resolve some of her concerns than a GP.

It is true though that young doctors are overworked sources of cheap labour in hospitals. It is counterproductive because it contributes to illness and early burnout.

Want a way to make health delivery more efficient in Australia? Easy, cull those bloated health bureaucracies at federal and state level and put the money into community health centres. Why should health have to have such huge management overheads?

There is an imbalance between the number of trained people who directly deliver the services and those who are 'administering, managing and coordinating' - so often these are euphemisims for busywork for salaried fat cats.