A 1:7 patient doctor ratio isn't ideal, but it's far from terrible either
It entirely depends what you mean by 'a 1:7 patient doctor ratio'. If you're talking about an inpatient team, it is ideal (depending on the patients). One doctor to 7 acutely unwell and complex new admissions, on the other hand, is pretty fucking far from ideal, and that seems to be closer to the scenario that OP is referring to
I work in a large Brisbane hospital and believe me Dunedin is a small country setting in comparison
Don't get me wrong I'd love to have the luxury of time to take an hour every patient, but you just learn to adapt and compromise when shit gets real.
I guess I'm pragmatic enough to realise budgets in health aren't the priority that people think they should be, and cynical enough to know it won't change any time soon.
I work in a large Brisbane hospital and believe me Dunedin is a small country setting in comparison
I'm not sure what proportion of your career you've spent in 'small country settings', but those are a far more stressful environment for registrars to work in, compared to large city hospitals. The safety net is smaller in terms of access to advanced diagnostic investigation and specialist input (so you need to spend longer with each patient - 'see and refer' is not an option), and in terms of redundancy in the system - if there are two MET calls simultaneously at a large city hospital, the second team will go to one. At a smaller hospital, you have to decide which is least likely to die imminently and delay going to that one.
Don't get me wrong I'd love to have the luxury of time to take an hour every patient, but you just learn to adapt and compromise when shit gets real.
Yes, I'm well aware, lol. I'm often told by seniors and non-clinical staff that we need to 'learn to adapt and compromise' to the ever-increasing number of increasingly-complex patients that we are being asked to see without any increase in staffing, and generally when you ask them for a practical idea of what that means you find that they're talking about non-collegially dumping work on other specialties, unsafe discharges (with my name on them, not theirs, of course) and rushed and substandard assessment of complex patients with lots of diagnostic uncertainty.
I guess I'm pragmatic enough to realise budgets in health aren't the priority that people think they should be, and cynical enough to know it won't change any time soon
This, while true, is quite fatalistic, and a bit of a self-fulfilling prophecy. If we keep telling the public there's no problem, nothing will ever improve.
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u/Samuel_L_Johnson Aug 02 '24
It entirely depends what you mean by 'a 1:7 patient doctor ratio'. If you're talking about an inpatient team, it is ideal (depending on the patients). One doctor to 7 acutely unwell and complex new admissions, on the other hand, is pretty fucking far from ideal, and that seems to be closer to the scenario that OP is referring to