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Episode 7 - The Pitt and the Logjam in our Public Hospitals w/ Dr Sarah Whitelaw
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In this episode of The Waiting Room Emergency Physician Dr Sarah Whitelaw joins Dr Omar Khorshid and Dr Chris Moy to discuss the Logjam in our hospitals, similarities to the TV drama The Pitt, and how to fix the crises in our hospital system.
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Transcript
Introduction to 'The Waiting Room' Podcast
00:00:00
Speaker
Welcome back to The Waiting Room, where we explore the stories behind the headlines in healthcare. I'm Dr Omar Khorshid. And I'm Dr Chris Moy. You're listening to The Waiting Room, a podcast by Australian Medical Association, with your hosts, Dr Omar Khorshid and Dr Chris Moy.
Dr. Whitelaw on 'The Pit' and Real Medicine
00:00:25
Speaker
Today we're joined by Federal Council member, Dr. Sarah Whitelaw, who is a real emergency physician, to talk about the show that's hit a little too close to home across many, many countries, the Emmy award-winning hospital drama, The Pit.
00:00:40
Speaker
Now, for many doctors who've been watching that show, it's not just a medical drama, it's a mirror. And for Sarah, watching it was hard, really hard. Sarah recently wrote a powerful column on The Pit and how it mirrored her own years spent working as an emergency physician And that article really seemed to connect with the peers who read it. Sarah, I suspect I know why because a long time ago I was in an emergency department, but I suspect it's a lot worse now. But, you know, for for those listeners who haven't seen the show, um why do you think it's affected you so personally and that hit you quite so hard? I think it's one of the most accurate reflections of lots of different parts of working as um an emergency medicine physician. that I have ever seen. and And previously I would have said shows like Scrubs, unbelievably accurate ah ER is what a lot of emergency physicians of my generation grew up with, um some of whom were prompted to go into emergency medicine by that show. ah um yeah a lot of people watch medical shows and many, many of them just don't feel, they feel really enjoyable to watch but not really like our workplace, whereas the pit manages not only to show the clinical aspects of our job um and the joys of our job, are because most of us dearly love and appreciate working in emergency medicine,
00:02:08
Speaker
But it also shows some of the system pressures in a way that I have never seen.
Challenges of Emergency Medicine
00:02:13
Speaker
So not just the challenges of working with individual patients and delivering emergency care, which can be dramatic and it can be really um you know very challenging in the moment.
00:02:28
Speaker
but also issues like what it's like to be a patient and what it's like to be a doctor when the waiting room is full, what it's like to deal with um a department full of patients, many of whom have been there for hours and hours and hours waiting to go to beds upstairs, what it's like to have a waiting room full of patients who you don't know which ones are incredibly sick and about to deteriorate and which ones aren't because you can't get out there to see those patients because you are constrained in dealing with the the patients inside. What it's like to be a patient who sits in that waiting room ah for many hours when you feel sick, when you're uncomfortable, when you're tired, when you're really worried and how that frustration comes out. in different ways and how a lot of our job is well beyond our clinical expertise in emergency medicine. It's also dealing with people who are often you know having one of the worst days of their lives.
00:03:32
Speaker
ah So I haven't seen the pit and in fact I really try and avoid medical dramas as much as possible but I ah do remember watching er back in the day and I think it's quite ironic that you've got the same actor leading the pit as as one of the key characters in ER but yeah ER always seemed a bit a bit American. it It just didn't, it was so dramatic, so much was going on and it was in this place where there's just so much more violence than we get. It was it was somewhere else.
00:03:56
Speaker
But is the pit like that or or or are we actually, so our are our EDs like what you're saying on the pit? I think that's such a great question and so many of my non-medical friends have said to me when they've watched it, they've really enjoyed it, but they felt that they were watching um something that was taking place in another country and it's been really interesting to have that conversation and say, no no no no, that is happening all day every day in emergency departments around this country, in your city, in your emergency department. All of those issues are playing out for us and it is unfortunate that no longer are some of those issues in terms of overcrowding, in terms of um you know patients sitting in the waiting room for far too long, in terms of that stress coming out in the form of abuse and violence. No longer is that an American problem and that's something that we are very much grappling with. So I think you're right Chris, I remember watching yeah ER growing up and thinking oh you know that that's
00:05:05
Speaker
that's terrific and it's fascinating but it's probably not what it's going to be like to work in emergency medicine and now when I watch the pit it feels like watching watching my workplace, which in a way, I,
00:05:23
Speaker
and yeah you know, that that the power of storytelling really interests me because I also don't like watching medical shows that remind me too much of work and I didn't think I was going to enjoy watching The Pit for that reason. and I think maybe that's one of the reasons why I found it tough to watch because it it put me back immediately into that um emotional zone of being at work. and And Noah Wiley, the lead actor who was a junior doctor in ER, who's now transitioned to being the the senior consultant, um has a ah great way of describing it and an in-depth understanding that I don't quite know how he's achieved about how it's important for us all
00:06:06
Speaker
ah As doctors and nurses and healthcare team members, ah we often distance ourselves from what it might be like to be a patient. We are the care deliverers. and We very rarely and often actively avoid thinking about what it's like be a to have that emotional experience of being in that situation and and watching the pig, can't avoid that. I've got to say that leads very nicely onto to the the issue of burnout. And i think I think the show does a great job of actually, you know, and explaining what happens to people when they're under fire for so long with the, you know, trying to balance their...
00:06:43
Speaker
the the you know, their ethical and and and job job priorities while under the garden in terms of time and stress and lack of resources.
Burnout and Moral Injury in Healthcare
00:06:54
Speaker
um I mean, and in terms of how you've felt, I mean, do you see many of your colleagues, you know, suffer from this sort of not just burnout, but um just really ah suffering and changing because of of of what's happened to them over the the times they've had to work in these these situations? Unfortunately, i do. and And again, that's borne out by almost every single research report and and poll with regards to healthcare specialties.
00:07:27
Speaker
Emergency medicine is right there at the top of burnout. And um you know burnout, we know one of the huge drivers is moral injury. And and the description of moral injury being ah what you know you could be and should be delivering in terms of care, but being unable to deliver that care and seeing patients suffer as a result of that, seeing your team members suffer as a result of system problems.
00:07:51
Speaker
ah It's not that the work is too hard, it's not that the hours are too long, even though you know the physical demands are ah challenging and the intellectual demands are challenging, it's that difference between what you want to be able to deliver and what you are able to deliver and the harm that comes in that gap that unfortunately for emergency physicians, is getting more pervasive and is such a huge driver of stress and burnout. And again, it's beautifully described on the show where you've got these passionate, um skilled clinicians that really struggle with the fact that they can't deliver the care to their patients that they
00:08:37
Speaker
know they should be able to. I've got to say that, you know, for many people watching this show, though, who haven't been there, i think they're they're taking a, you know, a Disney ride. but they're They're fascinated in seeing this because they're seeing the stretching of emotions and and the stresses.
00:08:52
Speaker
And obviously they're seeing it from the outside. But I think... I think for for people inside there, they they're actually responsible for the patients. And I don't think people really understand what that means, but being responsible for people and having to deal with so many inputs, ah which are not just medical, they're often social, really affects people. i really And really, and I think the show really optimises how people are numb after a while. Their emotional responses are numb. And that's actually one of the really sad things that happens to your colleagues. And, and, and I,
00:09:25
Speaker
I've seen that myself in in in in the people I've worked with emergency, but I mean, in your in your experience, have you found that people ah go through different stages coping with with this over a long period of time under the gun?
00:09:39
Speaker
A hundred percent. And why don't they seek help for that? Why um do we find that really difficult to talk about? And I think it's also because we find it difficult to compare the stress that we're under compared to what our patients are going through. And it always seems to us that we never want to minimise the experience that our patients are having because whatever we're feeling, surely our patients, um you know, are suffering more than we do. And there's ah there's a real barrier, I think, in us discussing our, you know, the negative impacts of our job
Systemic vs Clinical Challenges
00:10:16
Speaker
because we don't want to ever feel like we're diminishing, you know, who is most important to us, which is our patients.
00:10:24
Speaker
um I, yeah ah you know, i think I think that is key, Chris, and one of the ways I deal with that is to separate my frustrations and my potential moral injury and my burnout from the work that I do day to day, but make sure that I'm able to channel that into something else. And for me, that's the AMA. It's advocacy. It's fixing the system because I don't think I could work as a clinician without the avenue that I have in terms of trying to to fix those system issues.
00:10:55
Speaker
And can I just point, just explain to people that, I mean, I think the the world out there says, look, you know, when you're under stress, look after yourself and take time off and have balance.
00:11:08
Speaker
I think for you, when you you're in that situation there, and I think that's the thing that people do need to look into the show, you haven't got the choice. It's life or death at that point in time. and And I think that's the terrible situation that many of your colleagues are trapped in over and over again.
00:11:23
Speaker
We do love it though ah in terms of ah you know that that um some of the challenges that are ah depicted in the show um in terms of the acuity and the state of flow when you are in a resuscitation or in your in a mass casualty incident. um For us, time often slows down and that's what we train for. That's what we do. They are not the most stressful parts of our job. The most stressful parts of our job are not being able to get patients in so that we can care for them. not being able to get patients out of the emergency department, seeing them sit in plastic chairs in the waiting room ah you know for for many hours too long, um seeing them in pain, seeing them um ah not being able to get the the inpatient specialty care team that they need because there is no bed available.
00:12:15
Speaker
For us as emergency physicians, that is much more stressful than actually that point of care when you've got someone that is seconds to minutes away from death and what your decision making and your skill involves is is absolutely going to potentially you know impact their life, um ah whether whether they live or die, whether they have a good outcome or not. It's interesting if you talk to emergency physicians, it's not that part of the job that is driving their burnout. That's not what they find stressful. it ease
Impact of Storytelling on Healthcare Awareness
00:12:51
Speaker
those other system challenges. So I think that the other um aspect of watching the pit and similar programs is is the the personal stories, the the ability of a TV show to give people a window into what is actually happening that you do not get from the horrific statistics we see in the newspaper, you thousands of hours of ambulance ramping, like in Western Australia at the moment where I am.
00:13:16
Speaker
um you know, stats on on um overcrowding in hospitals, they're they're all a bit meaningless and I think we're all ah immune. You know, we look at what's going on in in Ukraine, in Gaza and all these places around the world, we're immune to bad news stories. We're sick of them and we turn off.
00:13:31
Speaker
But the the stories in the pit and the stories that we see occasionally told through the media of people's individual experiences are so much more powerful. They resonate so much and they actually cause governments to act.
00:13:43
Speaker
So I guess ah my question is, where's the lesson there for us as advocates wanting to change the system and make it better? How do we tell these stories? I think that's um i think that's spot on, Omar. It's not just about telling the story for patients. um What has really struck a lot of people with the pit is um the resonance of seeing their story depicted on the screen and the therapeutic benefit for and for staff, for emergency clinicians um and nursing staff and allied health staff. For us to watch that, there's been this strange outpouring across the world um of emergency physicians thinking, oh my gosh, the value, again, Omar, of not seeing it written down and seeing the statistics of our burnout, but actually watching the stories of these of the cast ah as well as the patient stories. is incredibly beneficial beyond the advocacy potential. Noah Wiley has um been able to use the platform and the impact generated by the pit to actually go to US Congress and advocate for change in that way. I think there's huge lessons for us in terms of how we translate the statistics into something that people actually understand the impact of. That's been a real problem for us
00:15:09
Speaker
um in healthcare for a long time and it's a real problem. and It was a huge problem in COVID when we couldn't show people what was going on. We could tell them, we could tell them the numbers, um we could describe it, but we couldn't show them because we couldn't bring film crews into hospitals to actually show um you know what what was happening there. And yes, we have to balance patient privacy. Yes, we have to balance dignity. But sometimes patients want their stories told as well and they understand the impact of that. So how do we use that? One of my colleagues that some people might know, Jonathan Patson, who's known as J-PAP, who is ah is a key figure on The other show that ah you know we have at Royal Melbourne Hospital Emergency, which is called Emergency on Channel 9, he is doing a sabbatical on exactly that. How do we tell the stories of things that we need to change in a way that resonates with people that mirrors their experience? Because I think um the pit mirrored my day-to-day, but surely for patients and their families watching it,
00:16:16
Speaker
they must see their experiences reflected in you know the drama that happens on the pit as well. And it might not be us, but all of us know somebody who has had a difficult experience now, I think, going through an emergency department. Hopefully we manage to make their lives better and their outcome better, but oh my gosh, you know many, many of us now in our community know how stressful that can be as well.
00:16:46
Speaker
Sarah, you mentioned the pandemic and and of course EDs were the site of, I guess, some of the most horrific patient experiences around the world, but but also in in particular in Melbourne compared with the rest of Australia.
00:17:00
Speaker
it It was during the pandemic that you and I were the faces, I guess, of the launch of the AMA's Clear the Hospital Logjam campaign, fighting for more resources for public hospitals, in particular looking at the funding model.
00:17:15
Speaker
um But A fair bit of water has gone on the bridge since the pandemic. What's what's changed? how ah Do you feel our hospitals, both pre-pandemic, during and after, have they changed and and what's their patient experience like?
Pandemic's Impact on Systemic Change
00:17:29
Speaker
It is really difficult to have to say that I don't think um you know we have learned nearly enough from the pandemic experience. And and if you look at our um trajectories in terms of the increased number of patients year on year that are needing to come through our emergency departments and and use our public hospital systems, they're continuing to grow at the same rate they were before the pandemic. So COVID was a ah blip, but unfortunately we've just gone straight back to that that those those graph lines that we were on before COVID. So all of the stresses on the system that were getting steadily worse are continuing to get worse and are in fact um unfortunately worse again five years on from the pandemic. So we still have increasing numbers of presentations um of people to the emergency department. We have increasing numbers of ambulance presentations. We have increasing acuity and ah
00:18:33
Speaker
ah increasing complexity of our patients. We have increasing numbers of people needing to be admitted to ah hospital and unfortunately, ah you know, when we look at our numbers and and it mirrors the experience that we're having in emergency departments as as team members. You know, we are seeing people waiting longer. we are seeing people waiting longer in our emergency departments. And for those really vulnerable groups in terms of, you know, particularly our aged care patients and our ah patients with mental health problems, um they are waiting even longer and longer again in our emergency departments than they were in 2022 and certainly before the the pandemic. So I really um hate to have to describe it in that way. And ah it um you know it feels like you and I and Chris often, it feels like we're saying the same thing over and over and over again. and and how do we maybe try and tell those stories in a different way? because we aren't getting the action that we need to address those issues.
00:19:45
Speaker
um you know We've had some impact at ah at a federal level absolutely and I have high hopes for the national reform agreement ah but there is no doubt that every state and territory in Australia and the federal government you know, need to come together in a much more engaged way to work out how we grapple these issues because we don't have enough funding, we don't have enough um longevity and guarantee of funding, we don't have the strategy and the funding settings right to be able to deal with our demand now, let alone what we're predicting into the future. I wish I could i could tell you a different story there, Omar, but unfortunately I can't.
Advocating for Systemic Improvements
00:20:32
Speaker
Sarah, straight out, do you feel yourself day to day that things are getting worse? And is it getting is this scaring colleagues away from working in emergency departments? It is. um we We have just grappled with this issue in the last week.
00:20:47
Speaker
Unfortunately, again, Chris, I would have to say overwhelmingly, yes, it is very different to when I started emergency medicine recently. Is it worse? It's worse for our patients.
00:21:00
Speaker
ah And um that, as we discussed, you know drives the moral injury of the staff. So it is worse. We are seeing people... Waiting longer, we are seeing people um staying longer in the emergency departments. We are seeing more and in the way of overcrowding. There are ah still enormous joys about being in emergency medicine. In general, we are able to you know make people's lives better at one of the most crucial crisis times of their lives. We are able to um ah you know influence their outcome in a positive way. And how do we make sure we don't scare off people from emergency medicine? um ah Last night we were discussing, i am hand on heart able to say, i think emergency medicine specialists trained in Australia and New Zealand are the best in the world. I would i would go toe to toe with Noah Wiley on that one. And clinicians, emergency medicine clinicians around the world are incredibly highly skilled. What we can do for our patients now is getting better.
00:22:10
Speaker
um it's it's It's making sure that the system allows us to do what we're trained to do. um And most of us are here because of the sheer love of the job. The the team environment, yes, it's chaotic, but bringing order to chaos is incredibly satisfying.
00:22:29
Speaker
ah Yes, it requires intense focus and and crucial, you know, second-long decision-making. But if you train for that and we we have an excellent training system in Australia and New Zealand, um then then you love putting that into practice. So ah the the joy that we get from our work is still enormous um and I would not hesitate to ah describe how grateful I am. I had this conversation with our AMSA president at at National Conference. as a medical student, not wanting to give her anything other than the impression that we are so lucky to do what we do. And yeah I think you get that in the pit too. I think you get there um their joy in their skill and their pride in their team and their love of their work, but you get the stress that they're under as well. They definitely have good of job as orthopaedic surgeons though.
00:23:31
Speaker
Oh, I don't know. I don't know. Again, I'd probably go toe to toe on you to with you on that. i my But um I accept that you orthopaedic surgeons love their work probably almost as much as ah emergency medical physicians.
00:23:47
Speaker
i you know I think the cast of the pit have got so deeply embedded in what it's like to be an emergency medicine physician. JPAP told me last night that being on set of the pit, he found out that Noah can suture and they've taught him how to intubate. And they are so, ah you know, the fidelity and accuracy is so important to them and they have such extra excellent ah medical advisors, including our own Australian, Mel Herbert, um that that attention to detail has really led the cast to kind of have a very deep understanding of actually what it's like to
Role of Administration and Training in Healthcare
00:24:27
Speaker
do our role. And um and that means that they've been able to advocate, you know, for the same things that that we are,
00:24:36
Speaker
advocating for in terms of benefiting our patient care and improving our system in the States and how how fantastic if we could do that here as well. While you're having your non-specialist love in, I will just say that general practice can go toe to toe with you guys on one area which is admin.
00:24:53
Speaker
um I think one aspect of the show that fails really to sort emphasise the importance of is is the the the non-clinical side of things, and that's you know administration and leadership, but also things like training and research.
00:25:10
Speaker
And and i I think for to many people, that they ah could could could I just ask you to explain to them why this matters? Yeah. ah So I think there are a few things for all that it depicts accurately.
00:25:24
Speaker
um You know, some things are very difficult to dramatise and all of the time that we spend making sure that we have accurate patient records in communicating with so many other teams within the hospital, but also the behind the scenes stuff, um the quality improvement, the real focus on how do we make sure that we're setting up our teams and being able to train our junior doctors and our junior nurses and our medical students to actually be emergency medicine specialists and senior emergency medicine nurses because that takes years of training. So on top of your six years of medical school and your now two years of internship, you're looking at you you know a minimum of another five years in specialist training, a lot of that study and that teaching goes on behind the scenes. Some of it goes on on the floor, as we call it, as you see in the pit, but a lot of that um is is all done Often in unpaid time, and I think that's a ah key area for our health system in Australia, we need to work out how to fund that because that is what drives quality. That's what drives improvement. That's what drives excellence in patient care. We cannot um do the work that we do without investment in teaching, training, supervision, all of the quality work. that you need to do, that that patients don't see ah and is not at the moment funded within our system. And until we change the way that we fund ah the system, we fund primary care, we fund ah
00:27:12
Speaker
public hospitals, we are we are going to continue to miss out on ah you know that really important aspect of our work that that we all do in every single different specialty. So Sarah, I was really pleased to hear ah the positive way that you're talking about your profession, about the care that is delivered in in emergency departments despite all these pressures.
00:27:38
Speaker
But you did also mention that you probably wouldn't be able to cope if it wasn't for the time you're able to spend as an AMA representative fighting for change and representing your your patients and your colleagues.
00:27:51
Speaker
um so so So I guess going forwards, looking at solutions, what needs to be done and and how do we get from where we are to some some future state? and and And before we get to solutions, even understanding the problem is is something that I'm not sure there's really...
00:28:10
Speaker
are understood by politicians or the people who who pay for our system, you know, in terms of the the changing complexity that seems to be happening, not not just due to the ageing population and numbers, but the but medical care of people who who are living with cancers that used to kill you and now chronic diseases, yeah all the immunotherapy issues.
00:28:30
Speaker
Drugs that are fantastic, but they lead to other infections or other complications and conditions that we never used to manage. And now patients haven't got two or three problems. They've got five or seven problems. um So, you know do do you have any ideas as how do you quantify what you see day to day and then...
00:28:48
Speaker
where's the action? What do we need to do as a profession, as ah as a community, as an AMA to
Complexity of Australia's Healthcare System
00:28:55
Speaker
drive change? I think um our system, our health system is incredibly complex. It's federated in Australia. It covers so many different areas from, you know, socio-economic determinants determinants of health and and then primary care and community care.
00:29:12
Speaker
We've got our public hospital systems, we've got our private specialists and then we've got our private healthcare care system, you know, which again, um um really needs its own fit for purpose regulation system around it and then you've got of course all of the things that we refer to as exit determinants so all of those issues around the NDIS and aged care and supports for people being able to then live with chronic disease and live safely when they are discharged from hospital. So how do we bring all those
00:29:50
Speaker
aspects together, particularly when you've got different governments responsible for different aspects of those things in terms of their performance and their outcome, but also their funding. I think that's a uniquely Australian challenge. I think we are incredibly well-placed and unique within the AMA to bring all of those different medical parts of the system together. And I think we all have our own views this um on how we see the changing demands of our health system and the changing needs of our patients.
00:30:23
Speaker
you know, over a period of time and it's about making sure that we are using all of that information, using all of that expertise from our clinicians on the ground to help describe the problem and and not assuming that any one of us has the answer in isolation. From our perspective, I think it's about, um you know, the community I think our biggest strength is the fact that we always put our patients first and our advocacy and our policy is usually driven by how can we deliver better patient care. and so one of our biggest
00:31:08
Speaker
leave, as if you like, is is that trust that we have with the community and then the community advocating on our behalf to their levels of government to say this is really important to us. um You know, this is something that influences how we vote.
00:31:25
Speaker
you need to get in the same room and you need to sort this out. and And as a patient, I don't want to be told that, oh, well, that's not my problem. That's the other part of the government's problem. ah i you know You need to divide your problems into state and federal. And we we need to really tackle this as a combined Australian responsibility and stop dividing these problems into state and federal. How do we do that practically? You know, I think that's a ah challenge that we grapple with every day.
00:32:04
Speaker
We see so many emergency medicine colleagues involved in advocacy, involved in trying to change the system. And I think that's because at the nexus of the system, you know, we see how all these different complex parts of our health system interact and the impact on um our patients. So it is something that we will never stop trying to improve as emergency medicine physicians. But we're so aware that we're It's about understanding all of the system and not just trying to fix it in in in little bits and being able to describe the importance of that and the cost of that if we don't. I think that's the other piece that's often missing is the health economics analysis and saying it feels like a huge amount of money. It feels like It's not going to pay off um before the end of the, you know, before the next election cycle ends.
00:33:03
Speaker
But, oh my gosh, if we don't, you know, invest more in our health system, then it is going to cost us so much more later on for all of the reasons that you described, Omar, in terms of, you know, understanding how much more we can do, but also how much that's going to cost us in the future.
00:33:22
Speaker
so It's been really interesting in South Australia where the current ah state government won an election almost purely on the fact that they would solve ramping. And they came in pretty, you know, ah pretty confident that we're going to do that. And numbers have just gone up. And and and to be frank,
00:33:39
Speaker
They've had to divert to a different tactic of saying, we're just putting in more beds now. um and But it has been interesting because I think one of the main focuses has been really copping out by looking at the blame game, which has really been and in general practice, my lot, having really been targeted for a long time, but also aged care and NDIS.
00:34:02
Speaker
I mean, is this really the problem? They're parts of the problem, there is no doubt. But ignoring the fact that we are also in desperate need of increased capacity within our public hospital system is just putting a blindfold on.
00:34:19
Speaker
ah Yes, we need to improve all aspects of our system in terms of primary care, in terms of aged care, in terms of NDIS, but saying that's all we have to do and that will mean that we don't have to invest in our public hospital system um is is really it just doomed to fail, Chris. So the answer is yes, but it's not only they're not the only parts of the problem. And if we don't appreciate all of the different aspects and where we need to invest, um then just trying to fix those problems in isolation is just not going to work. And I think um all of us probably feel that frustration and and that's absolutely you know something that has driven the Clear the Logjam campaign, which came out of us getting together as a group and realising that for every single state and territory in Australia, you know this issue was in their top three ah in terms of ambulance ramping, in terms of public hospital bed capacity and public hospital funding. And we realised that it is a national issue and we cannot stop. keep saying that, oh, that's a state government issue. We don't have to do any work on this you know at ah at a federal level. So it's really tackling it as as a whole system, not just trying to fix things in isolation.
Need for Hospital Funding and Strategy
00:35:43
Speaker
Patients don't come in those boxes.
00:35:45
Speaker
At the end of the day, the system needs more money, doesn't it? mean, we've said ah you know many, many billions of additional expenditure from the the federal government. That's what we fought for in the in the campaign. And to some extent, we understand that's kind of been agreed and it might might actually happen with the next round of agreements.
00:36:03
Speaker
But the states need to stump up too, again, similar amounts of money, tens of billions, in order to just keep your head above the water. It won't transform our system, but it it it will just allow us to keep up and not get worse and worse and worse.
00:36:18
Speaker
And it's an investment in the health of our population. It is an investment in the future. I believe, Omar, that it's not just a sunk cost, that it will pay off for us and it will...
00:36:30
Speaker
equivalently cost us enormously more if we don't put in that in investment now. But it's not just about the amount of money, it's how that funding is delivered and what it's delivered for and what are our our funding drivers and what are our our performance outcomes that we want. That's also something that we need to look at. um I think we will need to come back to some of the details about how to fix our system because, as you pointed out, it's such a complex system and so interdependent, more than we can do in and one podcast.
00:37:07
Speaker
But I think it it probably is worth worth finishing on ah on a positive note and and you mentioned that, you know, your enthusiasm for your profession, definitely not as good as orthopaedic surgery but, but you know, up there and I i can understand that.
00:37:22
Speaker
You guys do actually save some lives, unlike us who who merely improve people's lives. But um the the you rented your article um that we that we read and that was so impactful for many doctors who read it with a quote from from Dr Robbie. This place will break your heart.
00:37:41
Speaker
but it's also full of miracles. Absolutely. And Omar, get back to me when you have an Emmy Award winning show about orthopaedic surgery. i yeah I'm looking forward to watching that one. You know, i think that is such a ah beautiful description of how most of us feel about our workplace and health.
Rewards of Emergency Medicine Despite Challenges
00:38:05
Speaker
It is it it is a ah place that we're incredibly grateful to work. People thank us all day, every day. We are able to have such a huge impact on people's lives. um ah
00:38:19
Speaker
Our patients have heartbreaking experiences, but being able to make that better for them, being able to improve their outcome in some way, even if it's delivering excellent palliative care, is such a gift. and And I am so proud of my specialty and I still absolutely love going to work. It is the system that frustrates me, but the work that we get to do is an an incredible privilege. And i i have no problem saying that hand to heart and I want our junior doctors and the community to to know that as well.
00:38:59
Speaker
So for listeners out there, this is the real Sarah Whitelaw, having known her, and and and for the advocacy and the the sad stories she's told us over so many times, I think we are seeing the best of us in in Sarah. So I think despite all the the the hardness that you see in the pit, ah she represents the best of the profession.
00:39:22
Speaker
Thank you very much, Sarah, for joining us. Thank you, Chris. Thank you, listeners. We will be back again soon with the next episode of The Waiting Room. Thanks for listening to The Waiting Room.
00:39:32
Speaker
Learn more about the AMA, including how to become a member, at ama.com.au.