Australasian Society of Career Medical Officers
www. ascmo.org.au

President's Letter to AMA "Work-Life Flexibility" - Dr David Tree
July 2002

Kate Kelly
Senior Policy Adviser, Workplace Policy
AMA

Dear Kate,

One last email for this series. This is a followup to our telephone discussion , covering some of my views on CMO issues- something for our members to begin arguing over to formulate our submission to your work life flexibility project. You may disseminate this as you wish. An original will go on the Presidents page of www.ascmo.org.au

Civilisation is defined by cities and division of labour. The progress of civilisation favours the big city dweller, with a higher degree of specialisation and more efficient mass production. To define CMOs as nonspecialist career doctors is therefore to imply CMOs are less civilised and inferior. The truth is that we are all specialised to varying degrees, occupy widely varying roles, and that non- metropolitan people are at a relative disadvantage. (Note Canberrans have Australia's highest life expectancy.)

The progress of civilisation (which must be said to be overall a good thing) however means most jobs are sedentary and stressful. Add long and irregular hours and shifts (courtesy of Thomas Edison's lightbulb and the industrial revolution) and job insecurity and mobility and competition for resources, and biopsychosocial problems grow. Australia is at the top of the table of long working hours internationally.(behind Korea at last count, but ahead of USA.) The pension is the preferred child support option for mothers here- its more practical. (Yes, I really am cynical.)

Medicine is no exception. Prospective medical students planning to take on the battery chicken lifestyle would be advised to study Don Quixote and read the fine print before entering into delayed gratification contracts. (I am in a bad mood today due to an occupationally acquired infection.) We now have doctors on trainee incomes and rosters at our hospital in their 30s and 40s. To retrain in order to do the job you are already doing with the current qualification also takes the best part of ten years.

Why has there been little obvious progress for CMOs in recent years? The simple answer is competition for resources- between competing medical specialist groups, other health professionals, lawyers and plaintiffs, and society's other needs. Naturally the AMA has favoured the opinions of established groups over ASCMO, a more recent group- however maybe this allows ASCMO to have the last word!

So what is the way forward? Whether a specialist or non- specialist CMO or working trainee doctor, there is some common ground. A fair slice of the pie in terms of income, sustainable working conditions, and ongoing education which is both functionally useful (targeted) (to satisfy the worker- doctor) and provides evidence of relevant skills and knowledge(to satisfy the consumer- patient or employer.) With sufficient flexibility from employers (and not just employees) we can move towards a healthier and more contented medical workforce, able to have longer more productive careers and being better role models for the health of the community. ( A good thing for our aging population ? )

Excuse me, the barbarians are at the gates again.

David Tree
President, Australasian Society of Career Medical Officers (ASCMO)
dcmgtree@iprimus.com.au