What junior doctors’ unpaid overtime tells us about the toxic side of medicine | Claire Hooker, Alex Broom, Karen Scott, and Louise Nash

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What’s been described as the largest underpayment class action in Australian legal history has just been settled. Thousands of junior doctors, subject to court approval, are set to share back-pay of more than a quarter of a million dollars.

“There is a desperate need for better work-life balance for junior doctors and deep culture change in the health-care system,” write the authors, who are academicians at the University of Sydney in Australia.

Amireh Fakhouri, who brought the claim on behalf of junior doctors in New South Wales, alleged that when they worked in the state’s public health system from December 2014 to December 2020, NSW Health had failed to pay the overtime and weekend meal break entitlements she and her colleagues were owed. More than 20,000 claimants are now set to be eligible for a share in the nearly A$230 million settlement.

This is a safety issue. Doctor fatigue has considerable effects on patient safety through potential medical errors, poor quality patient care, longer patient recovery, reduced physician empathy and impacts on the doctor-patient relationship. A 2018 study of NSW interns and residents found more than 50 percent experienced bullying. Some 16-19 percent experienced sexual harassment. Some of the junior doctors who are victims of mistreatment later become the perpetrators, perpetuating this harmful culture.The impact of long hours on junior doctors and of the abuse they are subjected to is vividly evident through research, including ours. Junior doctors have significantly high levels of depression, anxiety and thoughts of suicide.

 

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