Will internal medicine become a part of NSW?
Internal medicine is booming in NSW and the next five years could see it flourish as the most important health care sector in the state, with some $20 billion expected in investment and a potential $20.5 billion workforce.
But it’s also a lucrative industry, with about 90 per cent of doctors being unionised.
And with internal medicine as the state’s most important medical sector, there’s growing concern about the health of its members.
But is internal medicine really worth it?
In an industry where the average salary is $100,000 and the majority of nurses are unionised, is it worth the money?
And is internal health really worth the time and effort it takes to become a full-time doctor?
Read moreRead moreExternal Medicine is one of the health professions most valued and respected, but the health sector is a complex one, with so many variables and factors that go into the recruitment process and how much an employer can charge to attract the right person to the position.
For one, there are some of the most skilled workers in the profession and the demand for those doctors has been growing in recent years.
“There’s a lot of demand for people who have expertise in the health care field,” says Dr John Deakin, an internal medicine specialist and chair of the Department of Internal Medicine at the University of Sydney.
“The fact that we have this large workforce in the country means there’s lots of opportunities out there.”
In NSW, there is an emphasis on quality of care and the ability to respond to a patient’s health concerns.
There’s also the huge amount of demand from people seeking care in the intensive care unit and those who want to be involved in acute care and trauma care.
“They want to see quality and they want to know if the outcome is good or not,” says Deakin.
“It’s a bit of a gamble.
It’s a very difficult balance.”
But the health profession has to balance its desire to attract top talent and also a need to keep the health system afloat.
In NSW the demand is driven by the ageing population, the introduction of new policies like the $10 billion Health Service Levy, and the growing number of people who require urgent care.
Dr Deakin is one such person.
“I’ve been a hospital doctor for 20 years,” he says.
“At the beginning I didn’t realise how much demand there was.
Now that demand is increasing and I think there’s more and more pressure from the community to meet it.”
In some ways the government has really gone overboard.
“The demand for nurses has also been increasing in recent times, with the number of nurses in the public service reaching a record high in 2017.
It’s an industry that has been around for decades, and there’s a need for more nurses in NSW.
Dr John Deak, chief executive of the Royal Commission into the National Health Service (Rensselaer Polytechnic Institute) (Photo: Rensselau)”It was very hard for us to get people in to work in the early days of internal medicine in the 1980s,” says Professor David Crouch, a paediatrician and co-founder of the International Association of Internal Physicians.”
Now there are a lot more doctors and nurses, and it’s all very good and efficient.
“But some internal medicine specialists believe the current system is unsustainable and the industry needs to reform.”
If we’re going to keep up with the demand, we need to diversify,” says Crouch.”
We need to bring in specialists from other areas.
“For some internal health specialists, the industry is already diversifying.”
People are coming from other professions, but there’s also people coming from internal medicine,” says Prof Deakin of the Australian Medical Association.”
That’s a good thing, and if it works in other professions that’s great.
“But if it’s not working in other fields, then it’s a real problem.”
But it can be a very demanding job.
A good external medicine degree is worth $140,000, but not everyone can afford it, and for those who can, internal medicine is not the best choice.
“You can get a really good degree for about $70,000 to $80,000,” says Mark McEwen, president of the NSW Board of Internal Medical Education.
“A good internal medicine degree would be a good investment in yourself and in your career.”
The problem is not just the money but also the health conditions.
The medical school has a very high entry standard, but internal medicine requires a lot less time and expertise.
“Most people are doing their clinical experience as part of their primary education,” says McEwan.
“So they have less time to go into internal medicine.”
With the amount of time that’s required, the hours of teaching that you need to do, and you have to work very closely with the patient to get to the best outcome for them, it’s really a very draining job