Ulf, I'm afraid you've presented a false dichotomy in a couple of ways and seem to have misunderstood the problem in a couple of other.

Firstly, the alternatives are not "60 hour week or nothing". Lots of people in industries that are not as vital as medicine work significantly more hours than the hours given by Sue's last reference. I know truck drivers, machine operators, carpenters, boilermakers, accountants, small business operators, who all work much longer than that report described. The 10 hour day is a standard for many people and I can't see why medical professionals should be exempted.

Second, I see no reason why women should not work as long as their male colleagues, especially if that means they have to work a mere 4-6 hours of overtime in a week.By failing to put in the hours they are imposing on their more committed colleagues to do so. As a result the commitment of those colleagues is waning. That must be down to those "soft skills", eh?

Thirdly, many women choose general practise, then work part-time, reducing the capacity in that field and making it less likely that any given visit will see the same staff at the clinic. It is well-recognised that continuity of the doctor-patient relationship improves health outcomes. At my own GP's clinic (which opens only from 8:30 to 5:30, but patients are not seen in the first half hour) there are about 10 or a dozen medical staff listed, but there are only rooms for 4. Of those rooms I have never, except on a Saturday morning, seen any more than 3 in use, usually just 2 with a waiting room full of patients.. My own GP, who is a woman, works 2-3 days a week. If I want to see her I have to book some days in advance in order to be sure of seeing her instead of whoever happens to be there. I used to attend quite regularly with my children's various ailments and I rarely saw the same person twice.

Finally, I find it fascinating that when ever I raise this as a problem for any workforce, not just medical workforce planning, I get told to think of the "soft" skills that women bring to the job, but funnily enough that never seems to be anything properly quantifiable or even properly qualitatively defined, nor does it ever seem to have any bearing on actual productivity. It's simply a distraction.

The discussion is about ensuring the capacity of the medical workforce into the future. Women's participation in that workforce is a major factor in reducing its capacity. We need to do something about that, For a start we might look at the educational process for boys, that fails to produce enough of them qualified at sufficiently high level at school to attend medical training, or for that matter attend uni at all. 2/3 of all students at our unis are women and as women have shown they will not do the same level of work as men, this is reducing our workforce capacity in all sorts of fields and all sorts of ways. To replace a workforce of men, we need a larger workforce of women, that's the plain fact. Preferencing our least efficient workers over our most efficient ones is simply stupid, no matter how warm and fuzzy it makes you feel to talk abut :soft skills", whatever that may mean.

I also like the idea of a less laissez-faire approach to the medical training issue. Since the vast majority of such training is on the public purse, and as graduate doctors are well-remunerated there should be no trouble in compelling trainees to commit to a specific period of productive work in areas of need or indeed to commit to turning up to work on a full-time basis for some reasonable period post-graduation. Say 20 years, which would make them around mid-forties when the commitment ended, would be a good start. It might be possible to do something like rebate HECS for those who do so, while those who choose to prioritse other things would perhaps pay more. There might be other ways to achieve similar outcomes as well.

Trent, after wondering"just why the hell you wanted to do this" have you or anybody you know decided they'd be better off driving a truck for a living?

If not, what's your point?

Craig Minns - perhaps you should read more carefully.

Here is an extract from HWA "Australia’s Health Workforce Series
Doctors in focus 2012":

"Female doctors’ average weekly working hours in 2009 were 37.5 – less than the overall average of 42.2. However female doctors have experienced little change in their average weekly working hours over time, working an average of 38.4 hours in 1999. Male
doctors’ average weekly working hours fell approximately four hours between 1999 and 2009, from 48.4 to 44.9. This fall in male average hours has occurred across all age groups. Looking at male primary care practitioners, falls in average weekly working hours between 1999 and 2009 ranged from 2.4 hours for those aged 65 years and over to six hours for those aged 35 to 44."

I have witnessed this personally, Craig, as well as reading the data and having served on AMWAC committees back in the 1990's.

Your comment "It's pleasing that you seem to have finally become aware of them." shows an astounding amount of hubris.

Sue, I read very well, thanks. You are simply confirming the findings from AMWAC (women have a working life approximately 60% that of their male colleagues) and of the AHWO study ( women work approximately 80% of the hours per week that their male colleagues work).

Given that the male doctors are seeing their female colleagues work less for the same pay, it's hardly rocket science for them to work out that by working the longer hours that the job demands they are simply subsidising their female colleagues who work less. Under those conditions it's hardly surprising that the male doctors would choose to follow the lead of their less-committed female colleagues.
In other words, y employing women preferentially we have not only reduced the available workforce by the difference between the previous male average and that of the female average, we have reduced the male average as well!

Frankly Sue, I don;t think you have thought your feminist-dogmatic position through. I'm not surprised, from what I've read here there's lots of stuff you haven't thought through in preference to taking up a politically-inspired position.

For example, despite the reduction in male working hours you cite,men still outwork their female colleagues by a considerable margin. Given that women in the medical workforce have demonstrated intransigence on the subject of working hours, what is your suggested solution to the problem of providing medical resources to fill the demand?

Perhaps the AMWAC would have been better hiring a man back in the 90s?

Further to my last,from the publication: "http://www.ahwo.gov.au/documents/Publications/2003/The%20specialist%20emergency%20medical%20workforce%20in%20Australia.pdf";

"While male emergency physicians work, on average, 4.4 hours per week more than their female
counterparts, the difference in average hours worked by gender is comparable with other
specialists. Male general medicine specialists work, on average, 2.6 more hours per week than
their female counterparts, and male paediatric specialists work an average of 13.8 hours more
per week than female paediatric specialists. Overall, all male specialists in total reported
working, on average, 9.1 hours per week more than female specialists. (Table 16)."

and

"As shown in Table 17, 17.8% of the female workforce worked less than 35 hours per week, while
only 4.0% of the male workforce worked less than 35 hours per week. "

and

"Emergency Medicine Workforce – Key Characteristic Trends 1995 to 2000
The AIHW national medical labour force survey database was used to summarise the trends in
the number of emergency physicians and their key characteristics between 1995 and 2000. The
trends summarised are: total number of emergency physicians nationally; number of specialists
by jurisdiction; number of specialists per 100,000 population by jurisdiction; number of
specialists by geographic location, by age group and by average hours worked by gender."

Dr Duckett, I realise you say that the gender of the workforce is taken into account by the WHA report you cite, but given that the issue of gender doesn't appear anywhere and given that gender effects were a serious issue for workforce planners throughout the preceding 2 decades, what is being done about the gender impacts on workforce capacity?

What particular measures are being put in place to address te fact that the half of all doctors who are female are contributing significantly less to the benefit of the nation's health than the 50% who are make? Anything at all, or are we sacrificing our national health outcomes on the altar of feminist politics?

With regard to most private hospitals surviving quite happily without interns:

As Sue mentioned "But who provides the workforce for the tasks provided by interns in private hospitals? Other categories of staff - who are likely to be paid more than interns."

It's definitely only most, not all private hospitals, I agree with you on that point. However it is not all of them. I have been told that the SAN private hospital in NSW is absolutely desperate for interns because they have so much work!

Stephen, with respect, the report you linked to doen't mention the impact of gender-related changes at all. Under the heading "The Demographic Challenge" in S 2.2 it discusses aging of the workforce and population, but nothing else. Given that the female medical workforce is approximately 25% less productive (all things being equal) than their male colleagues, surely the simplest way to improve productivity to meet projected demand is to increase male participation. The report uses a "high-productivity scenario of a 5% improvement: that 5% could be achieved by simply changing the gender mix from 50:50 to 60:40 in favour of young men at the educational entry point.

Why do we persist in pursuing a feminist model that creates poorer outcomes?

Stephen, I'm pleased to see somebody suggesting some form of quid pro quo. It should be more widely adopted.

Dale, according to the chart in the link you provided, Australia in 2009 had about the same medical service as Argentina in 2004, except that we had a whole lot more nurse/midwives.

Is that a model worthy of the aspiration?

Craig Minns
The education of the so-called fee paying medical student is simply a way of getting money from the public, and paying it to university staff.

That is, money is paid by the public to a doctor, who then pays it to a university to recoup their university fees.

So the eventual transfer of money is from members of the public to university staff.

The WHO chart shows physicians per 1000 people.

Australia 2.991
Austria 4.85
Belgium 3.001
France 3.45
Japan 2.14
Finland 2.91
New Zealand 2.74
UK 2.74
US 2.42

So Australia has a doctors shortage, unless countries such as Japan, Finland, New Zealand, UK and the US etc are considered.

Dale: Australia's number of doctors is currently propped up by importing close to 3000 overseas trained doctors per year - more than any other developed nation.

Not only does this go against Australia's stated goal of health workforce self-sufficiency (as recommended by the WHO) that was adopted in 2004, it carries significant ethical issues with it.
(http://rcpsc.medical.org/publicpolicy/imwc/Medical_self_sufficiency_Australia.pdf)

One of these issues is the poaching of doctors that may be from developing nations that can ill-afford to lose their doctors. Another issue has to do with the amount of support offered to these imported doctors who then end up with significant difficulties adjusting to the system in Australia which results in more patient complaints against them.
(http://www.mjainsight.com.au/view?post=Give+IMGs+support+to+succeed&post_id=11149&cat=news-and-research)

The doctor shortage is NOT a myth. It is a fact.

Dear Blaise,

you make some valid points - is it ethical to let taxpayers from other, often poorer countries fund the expensive training of over 1/4 of the medical workforce maintaining Australian health?

Yet the study you quote to question the qualifications of overseas trained doctors mentions quite clearly that even though Australian doctors only made up 63% of the medical workforce investigated they attracted 70% of all complaints.

It goes on to differentiate its findings: 'It was not feasible in our study to examine risks of adverse findings by country of training because, with only 373 adverse findings across the study sample as a whole, the analysis was underpowered to reliably detect significant differences.'

It further highlights the possible bias that Australians might be more likely to complain about foreigners. https://www.mja.com.au/journal/2012/197/8/risks-complaints-and-adverse-disciplinary-findings-against-international-medical

What is reported in an article does not always mirror what is investigated (or proven) in a study.
Take for example that according to the study you quote women are half as likely to be involved in complaints or adverse findings than their male colleagues. Or that time in practice is directly correlated to likelihood of complaint - the 'more experience' (or the longer ago their university degree) the more complaints...

Dale Bloom - the dismal model of money exchange that you propose applies to all education - right from pre-school.

People pay to be educated - either through fees, or taxes, or both. That education then eventually contributes to their money-earning capacity, with which they repay the education fees and taxes, which pay the teachers.

Are "analysts" somehow exempted from this cycle? No other humans seem to be.