NZ Doctors Strike: What happened to "New Zealand Doctor Utopia"?

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Birdstrike

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Burnout, pay cuts, 12-24hr ED waits and young doctors leaving the country. What's going on in New Zealand Doctor Utopia?


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Grass is never greener. US docs are better off than 95%+ of docs in the world.
 
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Grass is never greener. US docs are better off than 95%+ of docs in the world.
For all the whining you wouldn’t know it on here. Sometimes it’s just a matter of perspective. But just because it could be worse doesn’t mean you can’t work/hope to make it better.
 
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Nobody ever called it a utopia. The publically funded health services have been underinvested in for some time. As a result, physicians who mainly work in the public sector are not seeing their incomes match inflation. The population is getting older and sicker and there ain’t enough Drs to meet the need and we are overstretched. Rest assured though, if you are an orthopod in private practice, you are still making bank.

Every system has its issues, and NZ is no exception, but every system is also unique. For example Drs I’m NZ are unionized which I imagine hell would freeze over before something like that occurred in the US. At the end of the day, I have good hours, small and interest free student debt, I don’t have to do CPR on 90 yr old meemaws if I don’t think it’s appropriate nor fear lawsuits, and insurance companies don’t **** my patients.
 
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I think we have it better than many. That being said while our pay relative to the mean income is high respect is below average and so are our working conditions. Just my opinion.
 
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Every system has tradeoffs. I'm not in favor of unionization per se, because it almost always results in corruption and theft of union dues to pay for political advocacy I don't agree with. That being said, a more limited association of doctors that can strike and demand better working conditions is reasonable. When NZ doctors are making a fraction of what their Aussie counterparts are making they probably need to change something. I wish them luck and better working conditions.
 
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The situation is suboptimal. In a competitive international environment for healthcare workers, the public system salaries aren't keeping up with the international competition. The shortages become a self-reinforcing cycle of overwork, burnout, and reduction in hours. The challenges in healthcare access fall disproportionately on the most vulnerable. It's not great.

These problems are not unique to New Zealand. We do, luckily, have many healthcare worker unions, and most of them have leveraged collective action in recent times to dramatically improve their pay scales. The residents' union and the senior doctors unions, so far, have lagged behind – along with a few other groups. Government funding is a zero-sum game, unfortunately, and money for the health system naturally subtracts from an investment elsewhere – or, money for senior doctors subtracts for another aspect of health system operations. The reality, however, is New Zealand does not get to set the value of a senior doctor, particularly with Australia literally on our doorstep and virtually free movement between the two. It will inevitably be necessary to increase funding for the New Zealand system to close the gap.

We had three (mostly) performative strikes last month – although I was not directly participating, since the ED docs were part of the "life preserving care" agreements. We had two longer strikes scheduled this month that have been cancelled due to progress under facilitated bargaining. I suspect we will end up with a new deal soon enough – and, when it comes close to expiry, we will have to examine whether it was improved enough to solve the recruitment and retention issues.

A new government was elected two days ago – it will be interesting to see the actions of the new health minister once he becomes settled.

My personal situation is excellent – but that doesn't apply universally to all emergency medicine, and even less so to many specialty services, and further less so in smaller hospitals/less desirable rural locations.
 
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Shouldn’t have a problem with all those grads coming from the NHS.

Working for the public has never been a winning formula for doctors.
 
I just got a locums recruiting e-mail today for "An Exciting new position in NZ!" Pay is NZ$ 119/hour. That's $70 USD/hour! That's an absolutely criminal sum. One can work urgent care in the US for more. No wonder NZ doctor are on strike.

Hello Dr. XXXXXX

I hope you are doing well!

I wanted to see if now would be a better time to discuss an ER locum position in New Zealand next year? I'm looking for coverage starting around March 2024 for about 6 months! This is a great location on the north island! The pay is NZ$119 an hour plus house and car, roundtrip airfare and malpractice insurance! Typical hours for an ER doctor in New Zealand are 4/10 hour shifts per week!

This is a great opportunity to experience New Zealand, learn a new medical system and have a work life balance!

Let me know if you'd like to set up a time to chat about the logistics! Feel free to pass this email along to your colleagues!
 
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I just got a locums recruiting e-mail today for "An Exciting new position in NZ!" Pay is NZ$ 119/hour. That's $70 USD/hour! That's an absolutely criminal sum. One can work urgent care in the US for more. No wonder NZ doctor are on strike.

Hello Dr. XXXXXX

I hope you are doing well!

I wanted to see if now would be a better time to discuss an ER locum position in New Zealand next year? I'm looking for coverage starting around March 2024 for about 6 months! This is a great location on the north island! The pay is NZ$119 an hour plus house and car, roundtrip airfare and malpractice insurance! Typical hours for an ER doctor in New Zealand are 4/10 hour shifts per week!

This is a great opportunity to experience New Zealand, learn a new medical system and have a work life balance!

Let me know if you'd like to set up a time to chat about the logistics! Feel free to pass this email along to your colleagues!
Devil is in the details. Kind of like nurse travel contracts where your living stipend could be untaxed and so you want to jack that up and have low hourly wage for higher net comp. This doesn't seem like the most lucrative job overall for sure, but if you have housing, meals and transportation allowance then the rest is just fun money.
 
Devil is in the details. Kind of like nurse travel contracts where your living stipend could be untaxed and so you want to jack that up and have low hourly wage for higher net comp. This doesn't seem like the most lucrative job overall for sure, but if you have housing, meals and transportation allowance then the rest is just fun money.
Yeah what is a house and car worth? $5k/mo? Airfare to NZ I'll say $3k. Malpractice I would have assumed. But over 6mo that's say $35k of value, plus perhaps you can get some food/other living stipends. Certainly doesn't excuse a $70hr/job but assuming 35 clinical hour a week, and 3wk off, that's maybe... around... $40-50/hr of additional "income".
 
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Yeah what is a house and car worth? $5k/mo? Airfare to NZ I'll say $3k. Malpractice I would have assumed. But over 6mo that's say $35k of value, plus perhaps you can get some food/other living stipends. Certainly doesn't excuse a $70hr/job but assuming 35 clinical hour a week, and 3wk off, that's maybe... around... $40-50/hr of additional "income".
Well as stated above it depends on the details. Is "housing" a communal dorm, small apartment, house? It depends. The same with the car allowance. I don't care about malpractice insurance as that should be a given for any contract. They did not mention a food stipend so I doubt that's included except for hospital meals. If it's a crappy apartment, and a small car, your overall benefit is $3K/month. Also what doctor wants to fly to New Zealand in economy? At least give me business class for a 15+ hour flight. A proper business class flight is at least 8-10K round trip, and I doubt that's paid for, so extra expense as far as I'm concerned.
 
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I just got a locums recruiting e-mail today for "An Exciting new position in NZ!" Pay is NZ$ 119/hour. That's $70 USD/hour! That's an absolutely criminal sum. One can work urgent care in the US for more. No wonder NZ doctor are on strike.

Internal cover locums rates here (and most places) are NZD$200-$300/hr here, depending on shift.

I have heard around the country they do not offer particularly enticing rates in locums contracts, however – hence difficulties getting anyone to fly in and fill shifts. I have no personal knowledge of the sorts of housing and transportation allowances provided. Definitely wouldn't blame you for disapproving the arrangements you describe.

I can say 1.0 FTE here averages 3.25 clinical shifts per week. Most staff are 0.8 FTE or lower. Permanent staff benefit by having 30% of their FTE as "admin" time as standard, while also accumulating that 10-odd weeks of paid leave per year, plus other associated monetary and non-monetary perks tucked into the union contract. I suspect the locums contract may miss out on the equivalent of some of that.
 
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I just got a locums recruiting e-mail today for "An Exciting new position in NZ!" Pay is NZ$ 119/hour. That's $70 USD/hour! That's an absolutely criminal sum. One can work urgent care in the US for more. No wonder NZ doctor are on strike.

Hello Dr. XXXXXX

I hope you are doing well!

I wanted to see if now would be a better time to discuss an ER locum position in New Zealand next year? I'm looking for coverage starting around March 2024 for about 6 months! This is a great location on the north island! The pay is NZ$119 an hour plus house and car, roundtrip airfare and malpractice insurance! Typical hours for an ER doctor in New Zealand are 4/10 hour shifts per week!

This is a great opportunity to experience New Zealand, learn a new medical system and have a work life balance!

Let me know if you'd like to set up a time to chat about the logistics! Feel free to pass this email along to your colleagues!

That's gotta be a junior doctor rate.

Most places in Australia are fetching about 2,000-2,500 USD per 10 hour shift for attendings/consultants. NZ pay is worse, but I'd be shocked if it were that much worse. Either that, or the locum company is pocketing a huge amount in fees.

I love my union. COLA, regular pay rises, guaranteed non-clinical time, plenty of leave (including long-service leave), and generous retirement benefits. Very good medico-legal environment too. And I feel great about raising kids here.

It's not a Utopia, but based on what I read here, the practice environment seems much better.
 
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$70USD/hr so I can experience another medical system and work 40hrs/wk? As a bonus I get a house, car, medmal/airfare?

I would rather work in the US, make 270/hr. Work 40hrs/wk and in a month pocket an extra 32K where I can rent my own house/car and stay like a king in New Zealand for a few month not needing to worry about work.

They must be either desperate or trying to pull a fast one.
 
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It's not a Utopia, but based on what I read here, the practice environment seems much better.
Varies by department. Some EDs suffer the dysfunction of the hospital and resultant access block on far greater scale than others. Some places are quite short RMOs, and the burden falls upon the specialists.

When the department runs smoothly, however, working in the ED is fun again. There aren't any administrative "quality" games to play, nor a sense of obligation to provide unwarranted interventions, and the documentation burden is dramatically lower. It's quite satisfying work.
 
Varies by department. Some EDs suffer the dysfunction of the hospital and resultant access block on far greater scale than others. Some places are quite short RMOs, and the burden falls upon the specialists.

When the department runs smoothly, however, working in the ED is fun again. There aren't any administrative "quality" games to play, nor a sense of obligation to provide unwarranted interventions, and the documentation burden is dramatically lower. It's quite satisfying work.

Come to sunny Queensland one day!
 
Come to sunny Queensland one day!
I've been to Noosa and Brisbane. Too hot for my taste!

Brisbane, along with all the major cities in Oz, is rather amazing. It's hard to describe to folks back in the U.S. how dramatically we've missed the opportunity to make safe, high-quality, liveable cities.
 
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I've been to Noosa and Brisbane. Too hot for my taste!

Brisbane, along with all the major cities in Oz, is rather amazing. It's hard to describe to folks back in the U.S. how dramatically we've missed the opportunity to make safe, high-quality, liveable cities.

I'm sure it has something to do with the citizens and their attitudes.
 
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$70USD/hr so I can experience another medical system and work 40hrs/wk? As a bonus I get a house, car, medmal/airfare?

I would rather work in the US, make 270/hr. Work 40hrs/wk and in a month pocket an extra 32K where I can rent my own house/car and stay like a king in New Zealand for a few month not needing to worry about work.

They must be either desperate or trying to pull a fast one.

This isn't a consultant rate.

In NZ and Australia, a lot of junior doctors take time off to do locum work before getting their fellowship. It's actually quite common. $119/hour is what a resident would make (not even a training registrar).

Like anywhere in the world, life gets a lot better once you get your letters. In my part of Australia, 1 FTE is about 2.5 clinical shifts a week and ranges from 400-600K + leave + retirement + cheap healthcare + cheap university for the kids. The medico-legal framework is incomparable. It's also so much safer that it's hard to fathom. I've worked in places where nobody has seen a gunshot wound. Ever.

We're starting to see refugees from the States like we did from the NHS. The grass is always greener, and I'm sure there are many happy EPs in the US, but I really love practicing medicine here.

Glossary:
Consultant = Attending
Resident = Prelim
Registrar = Resident
Junior Doctor = Not a consultant
Letters/Fellowship/FACEM = Board certification

 
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Like anywhere in the world, life gets a lot better once you get your letters. In my part of Australia, 1 FTE is about 2.5 clinical shifts a week and ranges from 400-600K + leave + retirement + cheap healthcare + cheap university for the kids. The medico-legal framework is incomparable. It's also so much safer that it's hard to fathom. I've worked in places where nobody has seen a gunshot wound. Ever.

If you can swing Australia, go for Australia. It can be a steeper climb immigration-wise and a harder market to break into, but the pay scale is dramatically better than NZ.

I'm happy with NZ – but I also had 10 years worth of good U.S.-based income and a high-earning spouse beforehand, so the salary difference wouldn't appreciably change my lifestyle.

Oh, but NZ doesn't have any snakes. Take that for what you will (my trail-running wife is much happier here).
 
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I just got a locums recruiting e-mail today for "An Exciting new position in NZ!" Pay is NZ$ 119/hour. That's $70 USD/hour! That's an absolutely criminal sum. One can work urgent care in the US for more. No wonder NZ doctor are on strike.

Hello Dr. XXXXXX

I hope you are doing well!

I wanted to see if now would be a better time to discuss an ER locum position in New Zealand next year? I'm looking for coverage starting around March 2024 for about 6 months! This is a great location on the north island! The pay is NZ$119 an hour plus house and car, roundtrip airfare and malpractice insurance! Typical hours for an ER doctor in New Zealand are 4/10 hour shifts per week!

This is a great opportunity to experience New Zealand, learn a new medical system and have a work life balance!

Let me know if you'd like to set up a time to chat about the logistics! Feel free to pass this email along to your colleagues!
Telemed in the US pays more than this, handily. To work from home in a hoodie and pajama pants and drink your favorite coffee.

Or just get a tourist visa (good for six months) and do US-based telemedicine while on long holiday in New Zealand…
 
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