I think the big difference is that as a doctor I feel more in control of my
working environment here than I did in the UK. There is no stream of
government edicts and targets, and while there are a fair number of
administrators in my hospital, I know what they all do and there don't seem
to be any 'clipboard wielders'. I've got to know many of the local GPs to
chat to on the phone, even if I rarely get to meet them. Radiology and
pathology access is excellent.
I get to diagnose and treat patients, whereas when I was in the UK all I
seemed to be was a phlebotomy service for the inpatient teams - we didn't
even get to thrombolyse because the cardiology nurses were apparently much
better at diagnosing MIs than senior ED staff. Arrests were managed by the
medics and trauma by the surgeons and I began to wonder whether my role was
simply to spend the rest of my working life managing sprains and
lacerations.
Now I run a department seeing about 24 000 a year; on trauma bypass but we
still get the odd multitrauma falling out of the back of a ute. Admission
rate is between 16-20%. I do all the admin, rostering, review all results,
run the teaching programme, teach on the RMO postgrad course, assist with
university of Tasmania exams and study days, and am starting up a part 1
teaching program for the senior RMOs who are planning an EM career. We're
having a complete rebuild next year with significant expansion, and no way
of reducing workload while this happens, which will be 'interesting'. And
we're about to get medical students too!
If this might appeal to any of your colleagues, please pass on my email.
Always looking for enthusiastic staff to join the team, either on short term
contracts or to be sponsored for residency.
And as for poisonous wildlife - I was about to rebut the slur on Tassie when
I remembered the copperhead that was sitting on my doorstep when I came home
last week. In fact, it's not so much the snakes - it's the blasted scorpions
that keep getting into the bathroom...
Fiona.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Derek Sage
Sent: Thursday, 20 November 2008 6:14 AM
To: [log in to unmask]
Subject: Re: getting out
Nothing here tries to kill you through its bite or sting. And nothing tries
to eat you.
It is easy to tell whether a snake in Tasmania is poisonous or not -They all
are!
I am surprised though that anyone stays in the UK in emergency medicine.
Australia and New Zealand are superior when it comes to working in emergency
medicine and the lifestyle!
Derek
----- Original Message -----
From: "Fiona Wallace" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, November 19, 2008 11:18 PM
Subject: getting out
> Hey - don't go there - come over here instead!
>
> 4 day working week...Mediterranean climate...5 bedroom houses for STG150
> 000...advertising shortly for consultants and staff grades...
>
> Our summer is better than their summer, too.
>
> Fiona.
>
>
> Dr Fiona Wallace MB BS MA
> Director ED
> Mersey Community Hospital
> Latrobe
> Tasmania
> Australia
>
> [log in to unmask]
> [log in to unmask]
>
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Derek Sage
> Sent: Wednesday, 22 October 2008 11:09 PM
> To: [log in to unmask]
> Subject: Re: 3hr stretch target v 4hr target
>
> Treating a backlog in the emergency department by having a time target
> only
> replaces one problem with another and destroys the specialty of emergency
> medicine.
> A patient's temperature is a marker of something being wrong and we accept
> that treating a figure (temperature/fever or time) is not the same as
> fixing
>
> the underlying problem. In fact it can be dangerous to assume that fixing
> the target is a 'healthy outcome'. It is an indicator and politicians and
> some clinicians have lost sight of this fact. If the temperature is raised
> or the time in ED is excessive look for the cause and fix it/them and do
> not
>
> assume fixing the time equates to fixing the cause.
>
> Yes it has given the ED more resources and 'power' but at what cost. The
> dumping of 'out of hours' work by GPs and the 4 hour target will suck the
> UK
>
> tax payers money up for no real health gains- only political ones. And now
> that the UK taxes are bailing out banks, the UK can ill afford it!
>
> In New Zealand we are not neurotic and it is so much better a place to
> live
> and work. All you guys in the UK should try it. Being from the UK and
> having
>
> 'jumped ships' I can say as a matter of fact.
>
> If you are interested in coming to NZ I will be happy to assist (anywhere
> here is better than damp, grey, overcrowded, violent, drunken Britain)
>
> Enjoy your winter in the UK (-Our winter was better than your summer)
>
> -Derek Sage
> 'Specialist' in Emergency Medicine
> Tauranga Hospital
> Tauranga, Bay of Plenty
> NZ
>
> ----- Original Message -----
> From: "Adrian Kerner" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Wednesday, October 22, 2008 11:52 PM
> Subject: Re: 3hr stretch target v 4hr target
>
>
> I am so pleased I do not have to deal with all this political [small p]
> stuff any
> more! I can now sort patients out; investigate and manage appropriately
> without worring about a clock!!
>
> I'm in New Zealand [3/12] and the care is pretty good. Yes, targets have
> been great to focus on what is done, but what has become of the Emergency
> Care doctor? You have become sign posts and sold out to a little 'p'.
>
> Best wishes from down under....enjoying the warmth and cosy life
> style....feel
> the air......
>
> Adrian Kerner
> 'Specialist' in Emergency Medicine
> North Shore Hospital
> Auckland
> NZ
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