Doctors/consultants Hours

[in a mo]

So the government are pressing ahead with Hospital Consultants and Doctors 7 days a week ,obviously this does not mean they must work 7 days it just means that the hospital /wards must be covered for this time ,It is unbelievable that if you are in a Hospital over a weekend there are very few doctors working also apart from Emergencies Theatres are usually closed over the weekend what a complete waste of money having all the equipment letf idol some of which is on Hire.
Remember many NHS Consultants also take on Private work also working out of the very Hospital that employs then on a so called full time basis.

[RATTER15]

Why so unreasonable? they dont work 7 days a week, they just work shifts like any other company. I work every weekend and if I am lucky I get one day off a week, and if cover is needed on that day then I will go in to work.
I know I dont have a God like position like consultants but at the end of the day, these are ordinary people looking after people that need looking after, maybe they need to consider that!

[pixie374]

Exactly ratter. So, more people die at weekends due to....arrogance?

[RATTER15]

The problem with many consultants is they are so far "up themselves" they forget what is actually important here, it is actually people, not holidays and bank balances and behaving like some kind demi god!!

[bednobs]

sqad, just so i can be clear. in your day consultants did their normal working week, AND provided on call cover nights/weekends? or was theri week made up of say four days work in work, then 1 day/night covering?
if the first scenario, providing a 24/7 service will benefit them - no more on calls to do, because a colleague will be on site doing that stuff.

[pixie374]

Maybe cut their pay in half, so they only do it for the right reasons and then hire twice as many? :-D

[RATTER15]

Good idea Pixie!

[Sqad]

RATTER....I will ignore your post as it is born out of ignorance.

Bednobs....Many Consultants had Senior Registrars who were waiting for a Consultant post and they plus the Consultant provided 24/7 Consultant cover. After an operating session, even though the consultant team was not "on call" it was an unwritten law that they provided post operative cover. Weekends were always covered by a Consultant and registrar.

[bednobs]

i don't think we need to demonise consultants - they study hard (at great personal expense these days!) and train for a very long time, plus it's your life in their hands. The workman os worthy of his hire, and personally i don't think they get paid "too much" more like "not enough"
also, All of my own , "personal" consultants have been lovely

[bednobs]

but i still don't know - was that on top of their normal hours? If so, this is going to be a great deal forthem

[ummmm]

I don't think they get paid too much either but they do get paid enough to cover weekends.

[RATTER15]

I agree bednobs, but they need to be doing the job for the right reasons! I have also had dealings with some excellent consultants, some however are just *** holes!!!

[Ellipsis]

> it's been well known for a while that statistically, if you are admitted at a weekend, you are likely to have a poorer outcome

I think this is the nub of it. Resources are limited, so the way this could work is for outcomes from Monday to Friday get a bit worse, freeing up resources so that outcomes at the weekend improve. The average outcome across the week then stays roughly the same, but patients wouldn't be disadvantaged by being admitted at weekends versus weekdays.

Average outcomes could be improved by improving productivity (where productivity is defined as successful outcomes per pound spent) or by providing additional money/resources, but I don't see the proposals mentioning either of these options, simply re-allocating money/resources to provide better outcomes at weekends. Therefore this must be at the cost of weekday outcomes.

[Peter Pedant]

// > it's been well known for a while that statistically, if you are admitted at a weekend, you are likely to have a poorer outcome //

yes I agree if you are admitted Sat/Sun then you have a greater chance of dying at the end of your hospital stay on whatever day that is

and NOT if you are admitted on a saturday you have a greater chance of dying on that very day.

does anyone have a ref ? said to be J of the Royal Socty of Medicine

[Peter Pedant]

// Why so unreasonable? they dont work 7 days a week, they just work shifts like any other company.//

not really - they have fixed lists or session or outpatients - 9-12.30 and 1400-`7.30, and no they arent shifts and you dont just walk out of hospital if the operation is half done, or the junior has been slow or whatever

then there is on call - 17.30 - 09.00
and it differs whether you are called in or not during that

now 21.00 to 03.00 - is another six hours not unreasonable for a renal transplant for example and you the reader really want to be thinking - christ do I want him then to do two more fixed sessions the next day on mysick child who has an acute appendix ?

In 2003 the sessions were fixed because the then health secretary said the doctors were skiving - all of them - didnt matter who. Lazy idle and fiddling
A contract was imposed where their bottoms were nailed to various chairs at fixed times - in the working week
and now of course having done that for week days because it leads to much greater productivity

they say Oh ! Oh ! there is no provision for week ends and emergencies !
Oh Bad doctors ! oh very bad doctors - it is all THEIR fault !

As the BMA president said - an anaesthetist actually
he is already going in for emergencies during nights and the week end already

[DTCwordfan]

Wherever, whenever, whatever, whoever, just remember the surgeons' first maxim, "If in doubt, rip it out."