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Medicine in the UK is moving away from being a profession to becoming
a business with business ethics. Targets are set and increasingly doctors
are being conditioned to practise solely to meet such targets. This
leads to payment by results and as Fiona Godlee puts it “more money for
less and less autonomy”(1).
Dr Buckman states that “without adequate pay there is no morale”.
The morale of individuals working in a profession depends on their knowing
that they have performed to the best of their ability and that they are
continuing to learn to do better next time. In the early days of the NHS
junior doctors worked very long hours on a pay scale relatively
considerably less than that of today – yet there was little talk of low
morale. Most doctors were proud to be part of building the National Health
Service.
And Dr Buckman continues “……….demanding and receiving proper pay and
conditions is a right, not self-interest. Self-interested doctors would go
and work elsewhere.” Exactly where?
An article in the concurrent issue of the New England Journal of
Medicine describes health improvement in Ghana at a standstill and
attributes this, at least in part, to the exodus of doctors and nurses
from the developing world to the USA and the UK. Ghana has 13 physicians
and 92 nurses per 100,000 population, just 5% and 10% respectively of
human resources in the USA. Yet 25% Ghanaian-trained physicians are
practising in the USA, the UK or Canada (2).
The earnings of doctors in the countries of Western Europe (3) pale
into insignificance compared with the pay of Ghanaian doctors even though
this is better than in most African countries “A trained physician can
make more in London in two months than in a year in Ghana”(2)
If the medical profession in the UK were prepared to address the
problems of providing global health care, and regain the moral high
ground, perhaps British doctors might consider increasing their commitment
to the developing countries. Would that not be a more satisfying way of
improving morale than proudly heading the league table of doctors’
earnings in Europe?
Godlee F How much should doctors earn? BMJ 2007;334:214.
Mullan F Doctors and soccer players – African professionals on the
move. NEJM 2007;356:440-3.
Day M. So how much do doctors really earn? BMJ 2007;334: 236-7.
How much are doctors worth? - the future of medical practice
Medicine in the UK is moving away from being a profession to becoming
a business with business ethics. Targets are set and increasingly doctors
are being conditioned to practise solely to meet such targets. This
leads to payment by results and as Fiona Godlee puts it “more money for
less and less autonomy”(1).
Dr Buckman states that “without adequate pay there is no morale”.
The morale of individuals working in a profession depends on their knowing
that they have performed to the best of their ability and that they are
continuing to learn to do better next time. In the early days of the NHS
junior doctors worked very long hours on a pay scale relatively
considerably less than that of today – yet there was little talk of low
morale. Most doctors were proud to be part of building the National Health
Service.
And Dr Buckman continues “……….demanding and receiving proper pay and
conditions is a right, not self-interest. Self-interested doctors would go
and work elsewhere.” Exactly where?
An article in the concurrent issue of the New England Journal of
Medicine describes health improvement in Ghana at a standstill and
attributes this, at least in part, to the exodus of doctors and nurses
from the developing world to the USA and the UK. Ghana has 13 physicians
and 92 nurses per 100,000 population, just 5% and 10% respectively of
human resources in the USA. Yet 25% Ghanaian-trained physicians are
practising in the USA, the UK or Canada (2).
The earnings of doctors in the countries of Western Europe (3) pale
into insignificance compared with the pay of Ghanaian doctors even though
this is better than in most African countries “A trained physician can
make more in London in two months than in a year in Ghana”(2)
If the medical profession in the UK were prepared to address the
problems of providing global health care, and regain the moral high
ground, perhaps British doctors might consider increasing their commitment
to the developing countries. Would that not be a more satisfying way of
improving morale than proudly heading the league table of doctors’
earnings in Europe?
Godlee F How much should doctors earn? BMJ 2007;334:214.
Mullan F Doctors and soccer players – African professionals on the
move. NEJM 2007;356:440-3.
Day M. So how much do doctors really earn? BMJ 2007;334: 236-7.
Competing interests:
None declared
Competing interests: No competing interests