Flexibility is essential in fighting doctor burnout and workforce shortages in Australian public hospitals

Hospitals ought to invest in technology that enables flexible workplace offerings, or risk the hyper-casualisation of their workforce

Josh Case Jan 30th, 2023 · 4 min read

Public hospital staff are bending over backwards to stay afloat post-pandemic.

Over the last several years as a doctor working in the public hospital system in Australia, I’ve come to realise that the single most important factor driving clinician burnout is lack of flexibility.

Doctors are at the mercy of hospitals administrations and specialist colleges, who conspire to dictate when, where and how they work.

Hospital rosters are often published in 3 month chunks a mere 10 days before they are due to start, if you’re lucky. And with a chaotic mix of evenings and weekends, and inflexible roster swapping systems, getting to your cousin’s wedding depends far more on miraculous fortune than good planning.

Heaven forbid you want to socialise with someone subject to the same restrictive workplace conditions - that’s wishful thinking.

Rotational jobs mean that administrators determine which specialty you work in and when, often using your favourite specialty as an incentive to pucker up and take some ward-call nights. But don’t worry, I’m sure that anaesthetics term will also become ward-call by the time September comes around.

With annual employment contracts the industry norm until very late in medical careers, it’s common to be told to move cities every year or two. And for those in a specialist training program, this is likely the only way to progress with your clinical training. You’re left with a Sophie’s Choice between career progression and lifestyle stability.

And I know your family is going to Greece to celebrate Dad’s 70th in June, but you won’t be going. You’ve been instructed that your annual leave block is in November.

Doctors blindly serve a system that is controlling and inflexible, and one that would not be tolerated in any other industry.

Not knowing when you’re working or where you’ll be at a given time is just the norm. Planning your life any more than 10 weeks in advance is fraught with danger.

But it will all be worth it once you become a consultant, won’t it?

Just kidding - it will take 10 years of misery to get there, and even then you’ll have to move cities to find a job that remotely reflects your level of experience.

It’s no wonder career dissatisfaction is on the rise, and resignations are flowing en masse. The cracks in the system are beginning to show.

The solution

It’s up to hospitals to provide a flexible workforce experience that considers natural human desires for autonomy in their employment offerings. Otherwise, they risk haemorrhaging staff burnt-out from the pandemic and rigid rostering conditions.

And ironically, these staff will find their flexibility one way or another, gladly re-employing themselves in the same jobs in a locum capacity, for 4x the wages.

Existing solutions to provide flexibility to doctors include part-time appointments and job-sharing arrangements, however these are the exception and not the rule, and are often restricted to a constrained set of specialties or roles.

Not to mention the generalised stigma of part-time clinicians not taking their job as seriously as their full-time colleagues.

In my personal experience, there is also often a large gap between a given hospital’s stated willingness to be flexible, and their actual capacity to do so.

This likely reflects administrators’ desire to provide flexible workplaces, but the lack of infrastructure and tooling to actually achieve it. Hospitals are nowhere near capable of entertaining these fluid workforce arrangements at scale.

So consider this a call-to-arms for entrepreneurs and hospital policy makers alike: Can you work together to build a workplace experience that meets the needs of the modern doctor?

The future of our public hospital system depends on it.

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