What has been described as the biggest underpayment class motion in Australian legal history has been resolved. Who was allegedly underpaid? Thousands of young doctors who, with court approval, are expected to share back wages amounting to almost 1 / 4 of a billion dollars.
Amireh Fakhouri, who brought the claim on behalf of junior doctors in New South Wales, alleged that after they worked in the state health system from December 2014 to December 2020, NSW Health didn’t pay her overtime and weekend breaks. for meals. her colleagues owed money.
More than 20,000 plaintiffs will now be entitled to a share of the settlement value almost A$230 million.
But repayment was never the primary goal of the class motion. Fakhouri who’s now training as a general practitioner in Victoria, said she hoped it could as a substitute change the culture of work in medicine.
A rite of passage?
Our healthcare system routinely relied on the work of junior doctors. They include interns (individuals who have accomplished medical studies at a university and are of their first 12 months of practicing medicine), residents (who’ve accomplished an internship and have general registration) and registrars (training specialists).
Junior doctors often provide the bulk of the staff on night and weekend shifts and perform burdensome administrative tasks for consultants (senior doctors).
Overwork of young doctors has been a standard phenomenon for many years. We see it in books (e.g House of God AND This is Gonna Hurt: The Secret Diaries of a Junior Doctor) and TV programs (e.g House AND Peels).
This is a security issue. Doctor fatigue does significant effects on patient safety as a consequence of potential medical errors, low quality of patient care, longer patient recovery period, less doctor empathy and impact on the doctor-patient relationship.
AND 2020 study found that when doctors reported even moderate fatigue, the risk of medical error increased by 53%.
Put simply, stretched, demoralized, and drained physicians will do harm. Eventually it is going to affect you.
It’s not only long working hours
Expecting long hours is just part of the culture of medicine.
Our research AND global evidence to introduce “teaching by humiliation” and other forms verbal abuse have also been normalized.
AND 2018 study trainees and New South Wales residents said greater than 50% had experienced abuse. About 16–19% (mostly women) experienced sexual harassment.
Some of the young doctors who fell victim to mistreatment later grow to be so-called perpetratorsperpetuating this harmful culture.
Young doctors suffer
Research, including ours, clearly shows the impact of long working hours on junior doctors and the harassment they experience. Young doctors have a significantly high level depression, anxiety AND thoughts of suicide.
As now we have been saying for nearly a decade, there may be a desperate need for higher work-life balance for young doctors and a profound cultural change in our healthcare system.
However, young doctors are sometimes shown little sympathy. In 2022, one hospital threatened to be removed comfortable lounges to forestall juniors from napping during quiet night shifts. Just last week we heard about an analogous case involving junior doctors at one other hospital who it was said “sleeping is not part of your job.”
Culture of silence
This class motion lawsuit was needed because junior doctors often do not complain.
They internalize suffering as a failure (by not being tough enough) and fear that a diagnosis of depression or anxiety will lead to patients and colleagues avoiding them.
They do not report mistreatment or deny overwork because they are sometimes monitored by senior doctors profession progression.
This is significant because, contrary to the perception of doctors as a wealthy elite, our tests shows that it is usually difficult for young doctors to make progress, discover a job in the city of their selection or discover a full-time job. There is increasing pressure on young doctors to “make it” in an increasingly competitive environment. Such profession problems reinforce a culture of not complaining for fear of rejection.
Most of those that take motion report ineffective or personally harmful consequences of reporting to senior colleagues. This ends the vicious circle of silence when young doctors get sick, but this doesn’t occur Seek help.
We wanted to interrupt the silence
We used theater to lift the culture of silence about health care employees’ stress brought on by workplace pressures.
We carried it out interviews with junior and senior doctors about their experiences and used their literal stories to create the play’s script Grace under pressure.
The goal of this “literal theater” is to facilitate conversations and activities that promote positive cultural change.
What must be done?
Bold public legal motion like this lawsuit is usually needed to speed up culture change – to get hospitals to forestall junior doctors from working double shifts, to guard day without work for private lives, to offer meal breaks and to offer a way of rest for influential senior doctors who must take this under consideration.
Changing culture is difficult, slow and requires multi-pronged strategies. We need a protected way for young doctors to lift concerns, and training in order that they know what their options are reacting to mistreatment. We need senior doctors and hospital managers to be trained to encourage complaints and respond constructively to complaints.
Our research shows that when this happens, culture changes possible.
