WA News Doctor Polls
Poll Results
Training, Dr Image, Bad Eggs, Consumer Say - October 2016

GPs (42%) and Other Specialists (52%) responded within 10 days. Questions were aimed at adding to the Doctors Drum meeting in September. Gender breakup was predominantly Male (67%) especially as Specialists (82%).

Do you think the Medical Profession currently has an image problem because of the bad behaviours of a minority?

50%     No          

35%     Yes

15%     Uncertain

ED. Interestingly, ‘Other Specialists’ were more likely to choose the ‘Yes’ option but without significant gender differences, although female doctors, overall, were a little more uncertain.

Generally speaking, is it going to improve how we tackle community health problems if consumers determine more what doctors do?

65%         No

20%         Yes

15%         Uncertain

ED. Consumers do not know best when it comes to tackling community health problems, according to 65% of doctor respondents. Interestingly, GPs felt this stronger than ‘Other Specialists’ (81% vs 51%) with nearly three times more of the latter being ‘Uncertain’ of their position. There were no significant gender differences.

Overall, are new medical graduates adequately trained to work in our community?

41%         No

33%         Yes

27%         Uncertain

Should we ask the community about the performance of new medical graduates?

42%         No

37%         Yes

21%         Uncertain

While you were studying at medical school did another student, in your view, need either serious counselling or ‘weeding out’ because of their beliefs or behaviour?

50%         Yes

44%         No

6%           Uncertain

ED. Both sexes gave similar answers. A minority of doctors (37%) thought they should ask the community about new medical graduates while a third (33%) of respondents felt new graduate doctors were inadequately trained to meet community needs. Maybe doctors have the answers already as exactly a half (50%) said they knew of someone during their training at medical school, who they thought should be weeded out. This latter view was held more strongly by ‘Other Specialists’ (58% vs 36% of GPs).

Would it surprise you to learn that some teachers of trainees (medical students or specialist trainees) are wary of failing students because of legal consequences, student expectations, or student appeals?

72%         No

26%         Yes

2%           Uncertain

ED. A sizeable majority of doctors were not surprised by our revelation about teachers being reticent to fail students. The next question might be, ‘Is this going to impact doctors adversely?’

Do some overseas trained doctors seem to repeatedly underperform, for whatever reasons, when doctoring in some locations?

65%         Yes

26%         Uncertain

9%           No

ED. A high proportion (26%) were ‘Uncertain’, so perhaps someone needs to look into this. Compared with GPs, Other Specialists held this view more strongly (69% vs 58%) and GPs were more uncertain of their position (31% vs 24%), perhaps reflecting their differing experiences. Interestingly, more female doctors answered ‘Yes’ than males (75% vs 62%).

Do you think the profession will be increasingly faced with a lack of quality training positions?

69%         Yes

21%         No

10%         Uncertain

During your undergraduate training do you recall a teacher who harassed or bullied students in ways you found detrimental to learning?

51%         Yes

47%         No          

2%           Uncertain

During your time studying medicine do you remember a teacher whom you regarded as 'very poor' in getting across practical or theoretical teaching?

71%         Yes

26%         No

3%           Uncertain

ED. The issue of poor quality training positions concerns most doctors (69%), particularly male non-GPs. But maybe a closer look at teachers are required with harassment of bullying by teachers that was detrimental to their training mentioned by a half of doctors, particularly GPs over Other Specialists (61% vs 47%) and females over males (58% vs 45%). Furthermore, 71% of doctors said they were exposed to ‘very poor’ teachers.

A question of student attitude?

‘Dud’ says that we recognise that the doctor in question is not up the task required. It is often a question of insight, and understanding, rather than knowledge. In some cases it is cultural.

Attitude is important. We have all seen trainees who perform when observed by teachers/superiors, but completely change their behaviour, and performance, when on their own.

Dud Doctors have a common fault which is lack of ethics and respect for patients. This needs to be part of their training and if failure to comply with ethical behaviour, they need their registration cancelled.

A need to do it differently?

I teach in a med school and am increasingly concerned about how scared the uni is of student appeals and legal challenges. It is almost impossible to prevent unsuitable or underperforming students from graduating eventually and then when they do they almost immediately cause problems in their workplace but by then it is too late.

The idea of training is to bring these people up to a standard, which I think is done reasonably well at every level. I do get concerned that universities are letting people past the barriers (exams) when they are ‘borderline’, and have experienced this as a sixth-year examiner.

The biggest problem is there is no objective metric to measure and identify problems with insight, enthusiasm and attitude. We (as teachers/trainers) recognise a problem when we see it. If you dare to comment today, you are likely to be labelled and harassed by HR as a bully.

I had asked my mentors and teachers how they decided who got onto the training programme. The answer was simple. “Pick the people you like. Pick the person you would be happy to marry your child.” While this seems almost blasphemous today, I am starting to think, upon reflection, they may have been right. If you like them, they are likely to have a similar set of values and mindset, a decent work ethic, and are likely to get on with others (which is becoming increasingly important).

Doubling the number of students junked the degree…The cream is undoubtedly still there but very significantly diluted by inadequate performers…[who] will not be practising medical practitioners in 20 years. The universities are the problem and adding a new problem in Perth is an insane waste of taxpayers’ money. The public need protecting from duds. The medical colleges/AMC will do that as they are responsible for training and quality control. The universities will not as they are responsible for turning a profit. They are a disgrace. The undergraduates are poorly trained on emergence from university such that specialist primary examination pass rates have plummeted from high 80% to under 50% in a mere five years resulting in the termination of specialist training of increasing numbers because they are unable to pass the examinations. Personally, I had to terminate the specialist training of two people this week. They now need to find a different career. One is unlikely to work again. The Australian taxpayer has been ripped off again by the university that ‘trained’ that person.

The current framework that inhibits us from failing a student when we feel appropriate and the fear of reprisals from the students let us pass far too many students who should not be let out in the community.

The dud trainers and the dud students are a tiny minority.

Present deficit of training positions, which will be exacerbated by the creation of yet another Medical School (Curtin). An insane decision by the previous Minister of Health.

Honest talk and more?

My pathway to specialty was difficult and, in the end, I had to work it out for myself. I still resent that someone had not pulled me aside earlier, sat me down and said ‘this is not good enough’ and then perhaps pointed me in the right direction. I walked several paths until I stumbled on the right one. Some do this sooner than others. This ability can't be measured, but is clearly identifiable when you see it in a prospective trainee…Perhaps if they do not reach the standard, we need to be stricter in allowing them to proceed.

It is time to not be afraid to protect the public and our professional reputation.

Medical Board tolerates too many underperforming doctors. This is dangerous to the public and is detrimental to the profession’s image. We need to be less tolerant of people who are under performing (incompetent, personality disorders, criminal behaviour, drug/alcohol dependence, etc.).

I personally witnessed overseas trained doctors negligently killing patients and I know that bringing it up formally will mean I'm victimised by the profession as a whole.

If the practice embraces accreditation properly and it is done well you address some of the issues and can implement behavioural change.

 

Patients with chronic diseases are encouraged to self-manage more – problems like asthma, diabetes, arthritis, etc.

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Serving the Community – Risk vs Reward - April 2017

On the eve of our first Doctors Drum meeting of 2017, we wanted to poll readers to bring some of their views to the table. We received 135 responses from GPs and Specialists within the three-day window. Thanks to those who took part. Many of them made comments and gave some great insight into what life is like in modern day medicine. We will be publishing their comments in full in the May edition along with a full report of March 23’s Doctors Drum meeting.

Do you believe the political persuasion of the Health Minister has more influence than his/her personal abilities?

Yes    54%

Uncertain    26%

No    20%

ED. It appears most doctors believe politics will be put ahead of personal ability in addressing health issues. Given that hospital funding is the big ticket item for states, Roger Cook may have some decisions ahead of him around rationing of services (see next response) that most doctors will be sceptical of.

How much do you identify with this statement: "One of the biggest problems facing the Health Minister is that growing health demands will outstrip supply."

I agree strongly    46%

I agree    39%

No opinion either way    6%

I disagree        7%

I disagree strongly    2%

Are doctors prone to burnout, more so than many other professions?

Yes    65%

No    18%

Uncertain    17%

ED. What is it about doctoring that fosters burnout these days? Or is it the type of doctor?

How important is the doctor's work-life balance in determining how much they can serve the community?

Very important    54%

Important    40%

Uncertain    2%

Unimportant    4%

Very unimportant    0%

ED. The vast majority of responses seem to say, anyone who devotes 100% of their efforts to work cannot serve the community well.

Should medical education rely less on hospital training?

No    54%

Yes    33%

Uncertain    13%

Are new doctors adequately trained to tackle today's problems in the community?

No    55%

Uncertain    27%

Yes    17%

ED. It would be interesting to see community views on this! But choice of careers for doctors is one area the community should not have a say, according to most of our respondent doctors (see next question).

Should the community have more say in what areas junior doctors focus their career?

No    64%

Yes    22%

Uncertain    14%

Is the profession attracting people, more than it should, who are less resilient under pressure?

No    36%

Uncertain    34%

Yes    30%

In your experience, do gender differences explain whether people feel either put at risk or rewarded by their work?

No    59%

Uncertain    27%

Yes    14%

In general terms, what place should medical research take in health funding?

Third    39%

Second    25%

Uncertain    14%

Less than third    9%

No priority    8%

First    7%

ED. Most respondents gave medical research 3rd or 2nd place for funding allocation, and we cannot give the Specialist-GP split on responses, which would interest us all, sorry.

Have you heard of a smartphone ‘app’ that you think improves patient care in some way?

No    46%

Yes    43%

Uncertain    11%

ED. What proportion of doctors who actually use an app in patient care would be less, we guess. We hope to review some of them in future editions.

How you made contact

The vast majority of respondents to the epoll, in about equal proportions, used Safari, Chrome and Internet Explorer as their browser, with just over half using Windows as their operating system and just over a quarter using their mobile device to respond. The average time taken to answer the questions was about five minutes.

 

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Patients with chronic diseases are encouraged to self-manage more – problems like asthma, diabetes, arthritis, etc.

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Curtin Med School, Testosterone, Parenting etc – July 2015

GPs (nearly two thirds male) responded within a week.

Q. From what you know so far, will the new Curtin Medical School in WA be good for general practice?

64%    No
18%    Yes
18%    Uncertain   

Close on two thirds of GPs do not share the view that the new Curtin Medical School will boost general practice, so proponents have some convincing to do. Unfavourable comments were along the lines:
•    Money better spent on expanding junior doctor training places.
•    Curtin will dumb down medical education, accepting those who do not qualify for UWA or Notre Dame etc – their brochure says so.
•    More medical students will not equate to more rural GPs – instead, what about a rural GP training college or a mandatory 12 months in rural practice for early graduates, specialist trainees included.
•    We need post graduate training places in general practice not more medical schools.
•    It is highly unlikely that very young urban graduates will work in the country – instead, spend the money on supporting the IMGs who have very little support.
•    Whose votes are being bought by Curtin Medical School? Will GPs be expected to take up the slack of teaching placements? If they are spending so much on this, why are they cutting back in so many other areas of primary care? Am I going to be shut out of admitting to Midland Hospital because it will be tertiary and GP skills not wanted?

 

Q. What do you believe is the main purpose for recently changing PBS criteria for testosterone prescribing?

41%    To prevent potentially harmful overprescribing.   
41%    To reduce costs to government.   
16%    Uncertain
2%    To improve benefits from testosterone use.

ED. Twice as many women think (60% of females vs 31% of males) that men are overprescribed testosterone, as think recent PBS changes are designed to save government money (34% females vs 45% males). Men think the reverse!

Q. In your work, how often do you see parenting that you consider too restrictive and detrimental to the child involved?

3%    Never        
25%    Rarely        
42%    Occasionally        
19%    Often            
3%    Very often    
2%    Uncertain    
5%    Doesn't apply    

Interestingly perhaps, there were no significant gender difference in responses to this question – one in five GPs think kids should be allowed to ‘harden up’.


Q. Doctors are asked to declare any competing interests when presenting on an aspect of health care. Does the number of competing interests declared affect how much you take at ‘face value’ any comments the doctor makes?

31%    Maybe   
29%    Yes   
19%    No   
9%    Uncertain   
12%    Doesn’t apply   

About 60% GPs, especially females, are wary of the competing interests of speakers. Something for Medicines Australia and the ACCC to consider?
 

Q. Do you believe the Medical Board and AHPRA use their income from doctors’ registration fees wisely?

6%    Yes   
47%    No   
46%    Uncertain   

 

Q. How important is it to know what use AGPAL puts the accreditation fees it collects from general practices to?

66%    Very important.   
15%    Slightly important.   
5%    Take it or leave it.   
3%    Hardly important.   
4%    Not important at all.   
6%    Uncertain.    

Patients with chronic diseases are encouraged to self-manage more – problems like asthma, diabetes, arthritis, etc.

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FSH, Politics & Impartiality - May 2015

195 doctors responded to our e-Poll within the six-day time frame. Around 63% of respondents were male and 54% were financial members of AMA WA (8% preferred not to say).

Q In your experience, what are main reasons why smart people make bad decisions (up to 3 choices)?

 22% Self-interest    
15% Poor self-awareness    
13% Think they can get away with it    
13% Blinded by success    
13% Surrounded by ‘yes men’    
10% Abuse of power    
 6%   Confusion    
 5%   Other    
 3%   Cannot say    

ED. “Self interest”, “Think they can get away with it”, and “Surrounded by ‘yes men’” were responses significantly favoured by AMA members, compared to non-members. “Poor self-awareness”, “Surrounded by ‘yes men” and “Confusion” were responses significantly favoured by female doctors.

Are the problems at Fiona Stanley Hospital, including those reported by the media, beyond what you might expect from start-up ‘teething problems’?

54% Yes   
32% No   
14% Uncertain 

  
Is your perception that the Minister for Health in WA can be easily influenced by medical factions that lobby him?

27% Yes   
27% No   
46% Uncertain

Is the impartiality shown by AHPRA or the Medical Board in processing a complaint about a doctor, wherever it comes from, usually acceptable to you?

25% Yes   
36% No   
39% Uncertain   

ED. There were no significant effects from gender or AMA membership on these responses.

You answered ‘No’ to the previous question. Are you concerned that unfairness will be seriously damaging to someone?

94% Yes   
4%   No   
2%   Uncertain   

Do you believe that some doctors asked by AHPRA or the Medical Board to sit on Medical Assessment Panels to judge the performance or health of another doctor, could lack impartiality to a serious extent?

42% Yes   
15% No   
43% Uncertain

Patients with chronic diseases are encouraged to self-manage more – problems like asthma, diabetes, arthritis, etc.

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