David Oliver: How hospital doctors’ own pressures affect GPs

Abstract Background Since the 2008 recession, Ireland has experienced large-scale doctor emigration. This paper seeks to ascertain whether (and how) the COVID-19 pandemic might disrupt or reinforce existing patterns of doctor emigration. Method This paper draws on qualitative interviews with 31 hospital doctors in Ireland, undertaken in June–July 2020. As the researchers were subject to a government mandated work-from-home order at that time, they utilised Twitter™ to contact potential respondents (snowball sampling); and conducted interviews via Zoom™ or telephone. Findings Two cohorts of doctors were identified; COVID Returners (N = 12) and COVID Would-be Emigrants (N = 19). COVID Returners are Irish-trained emigrant doctors who returned to Ireland in March 2020, just as global travel ground to a halt. They returned to be closer to home and in response to a pandemic-related recruitment call issued by the Irish government. COVID Would-be Emigrants are hospital doctors considering emigration. Some had experienced pandemic-related disruptions to their emigration plans as a result of travel restrictions and border closures. However, most of the drivers of emigration mentioned by respondents related to underlying problems in the Irish health system rather than to the pandemic, i.e. a culture of medical emigration, poor working conditions and the limited availability of posts in the Irish health system. Discussion/conclusion This paper illustrates how the pandemic intensified and reinforced, rather than radically altered, the dynamics of doctor emigration from Ireland. Ireland must begin to prioritise doctor retention and return by developing a coherent policy response to the underlying drivers of doctor emigration.

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Outflow management of health professionals in Serbia: survey results from a tertiary-level hospital

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.530 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Šantrić Milićević ◽

N Vasilijevic ◽

V Vasic

Keyword(s):

Health Workforce ◽

Organizational Support ◽

Health Workers ◽

Work Conditions ◽

Medical Doctors ◽

Policy And Practice ◽

Retention Factors ◽

Hospital Doctors ◽

Almost All ◽

Doctors And Nurses

Abstract Background Some rich countries are actively recruiting labour from abroad for lack of health workforce. A high-level tendency for emigration among health care personnel in Serbia has attracted the attention of policymakers. In the search for evidence that can support the interventions to manage the outflow of the health workforce, the objective of the study was to obtain the opinion of medical doctors and nurses about retention factors. Methods A 65-item questionnaire was distributed to 384 hospital physicians and nurses to explore their views on fourteen aspects for labour outflow management (recruitment, training, job, salary, benefits, managers' behaviour, career development, relationships, work conditions, institutional image, organizational support, and three types of organizational commitment). Any difference between physicians and nurses and their responses' scores was assessed with Pearson Chi-Square (p < 0.05) and Independent Samples t-test (p < 0.05). Results Few nurses (17.8%) and physicians (13.6%) are familiar with measures taken in the country to manage the migration of healthcare workers, but most would work abroad if given such opportunities (56.8% and 63.0%, respectively). The responses of physicians and nurses differ for many aspects of management; the best scored were managers' behaviour (11.9 v 10.4, respectively, p < 0.001) and organizational support (15.3 v 13.4, respectively, p < 0.001), while the least scored were job benefits (4.1 v 4.0, respectively p = 0.531), salary (5.9 v 5.8, respectively p = 0.459), relationships (5.3 v 5.3, respectively p = 0.911) and performance assessment (5.3 v 4.9, respectively p = 0.008). Conclusions The study has identified success and failure factors for the outflow management of health workers in Serbia. Hospital doctors scored higher than nurses almost all retention factors. There is a space to strengthen the policy and practice to retain hospital doctors and nurses in the country. Key messages Hospital nurses are in a worse position than hospital doctors in regard to almost all aspects of outflow management. Stakeholders should invest in retaining medical doctors and nurses in the hospital.

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379 The Critical Care Experience of Irish Surgical Non-Consultant Hospital Doctors, Are We Equipped to Assist During the Covid-19 Outbreak and Beyond?

British Journal of Surgery ◽

10.1093/bjs/znab134.135 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

E Burke ◽

P Balfe

Keyword(s):

Critical Care ◽

Intensive Care ◽

Healthcare Systems ◽

Care Environment ◽

Care Experience ◽

Electronic Survey ◽

Surgical Trainees ◽

Hospital Doctors ◽

Basic Course ◽

Further Development

Abstract Introduction The ongoing COVID-19 pandemic has presented unforeseen threats and stresses to healthcare systems around the world, most notably in the ability to provide critical care. Aim To assess surgical NCHD experience in providing critical care and working in an intensive care environment. Method An electronic survey was distributed amongst surgical trainees and then amongst individual surgical departments. Ten questions were included in the survey assessing the NCHD’s experience with aspects of critical care. Results 39 respondents including 16 specialist registrars, 3 senior registrars, 11 registrars and 9 senior house officers. 18% of respondents had previous experience in anaesthetics or intensive care. 23% self-reported being competent in performing endotracheal intubation. 15% self-reported being competent in the use of CPAP and BiPaP, 5% did not know what these were. 20% self-reported being competent in the use of AIRVO. 15% self-reported being competent in placing central and arterial lines. 15% self-reported being competent in starting and adjusting inotropes/vasopressors. 49% reported completing a CCRISP or BASIC course. 85% felt that a rotation in anaesthesia should be a routine part of surgical training. Conclusions Whilst there is critical care experience amongst the surgical NCHD cohort there remains room for further development.

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Questionnaire survey assessing the leisure-time physical activity of hospital doctors and awareness of UK physical activity recommendations

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2019-000534 ◽

2019 ◽

Vol 5 (1) ◽

pp. e000534 ◽

Cited By ~ 3

Author(s):

Jennifer A Cuthill ◽

Martin Shaw

Keyword(s):

Physical Activity ◽

Leisure Time Physical Activity ◽

Teaching Hospitals ◽

Muscle Strengthening ◽

Scottish Population ◽

Physical Activity Recommendations ◽

Hospital Doctors ◽

Type Of Exercise ◽

The Uk ◽

Activity Recommendations

ObjectiveThe UK Government Physical Activity Recommendations suggest that adults should aim for 150 min of physical activity each week to maintain health. We assessed the total volume, frequency, intensity and type of exercise taken by hospital doctors in association with their specialty, age and knowledge of the specific components of the recommendations.MethodsAn anonymous paper-based questionnaire was distributed to doctors working in the two largest teaching hospitals in Glasgow. 332 questionnaires were analysed with a response rate of 60.3%.Results239 (72%) doctors felt they exercised regularly with 212 (63.9%) meeting the recommended volume of cardiovascular activity, similar to an age and sex-matched cohort of the general Scottish population. Only 78 (23.5%) doctors achieved the recommended muscle-strengthening activities. 108 (35.5%) doctors were aware recommendations for activity existed but only 45 (13.6%) were able to state the recommended duration of activity per week. Doctors who were aware of the recommendations were more likely to personally achieve them (OR 1.802, 95% CI 1.104 to 2.941) although other additional factors may contribute.ConclusionAlthough this was a small study in two hospitals, our results suggest that hospital doctors are as active as the general public in the UK of a similar age. Eight years after implementation, knowledge of specific components of the current physical activity recommendations remains poor. Efforts to improve this prior to graduation, combined with improving confidence and competence in counselling practices and enhancing the opportunities for doctors to exercise, could translate into improved healthcare promotion.

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