Medical Matters: Desperate times as GPs cut losses and head for better jobs abroad

Even though I have a steady, if increasingly stressful, job as a general practitioner, I still read the “Doctor wanted” ads in the classified section of the medical papers. It may be an indication of how general practice has been undermined that there seem to be an awful lot more of these ads than there used to be.

I am not sure why I read them. Maybe it is the same phenomenon that makes an old horse charge wildly around his field when he hears the hunter's horn. After all, when I was looking for GP jobs about 20 years ago those ads were vital signposts on the journey through life. They were the call to don the beguiling smile and the black suit and career about the country with the CV. I knew one young doctor, well qualified, well connected and charming as bejasus who endured 43 interviews before he landed a modest rural practice. He was glad to get it. By the time he got a job he, like me, knew how to read the ad. Like politics, it is all in what is not said.

Drudge
The ads in Irish medical papers tend to be coy about the who, where and how much and the identity of the advertiser is cloaked in a box number. Here is a quick guide to them.

“Assistant wanted” means poorly paid drudge. You will never get a permanent job here if you work until you’re 100. The job is being kept for a nephew in the College of Surgeons who will come on stream in about five years’ time and you will be shown the door. “Definite view for a suitable candidate.” Yeah. Right. “View” should mean a permanent job offer but can often mean a glimpse of Aranmore through the rain.

“Prospective partner.” Now you’re talking. The old boy has obviously had enough and the wife has put the ad in behind his back.

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“An interest in women’s health is essential.” That means don’t even apply lads. They don’t want you. I saw “Female doctor wanted” recently which is a bit blatant. You could be a qualified gynaecologist, sincere, diligent and brilliant but you will have to play second fiddle to some young wan whatever her qualifications so don’t even bother applying.

“A knowledge of eastern European languages desirable.” This is a recent one in the charts. I am so glad I knocked off those night classes in Moldovan and Romanian in third med.

Maybe the “busy” will frighten off the dossers. Remember that they only want you to keep the job warm for little Breffni in Surgeons so there’s no need to exert yourself.

“Close to an urban centre.” Limerick. “Close to Galway.” Kinnegad. “Close to Dublin.” Kinnegad.

"Busy computerised mixed practice with full practice staff and excellent prospects for the right candidate." We are desperate.

Cut income
I think a lot of these ads are a bit desperate, actually. The life of the GP is not what it was. On the one hand, we are told that we are the mainstay of the health service, doing most of the work for a pittance of the budget. On the other hand, practice income has been cut by about 40 per cent. At every GP meeting we hear tales of staff being let go and practices going broke. When substantial principal GP jobs are advertised now, they are lucky to attract one candidate. If you want an indication of the way general practice has been damaged remember that these jobs would get dozens of applicants a few years ago.

The new GPs, and several established GPs, are cutting their losses and heading for Australia, Canada and New Zealand where they will have a better lifestyle and some appreciation for all they do.

I have not dared let my imagination run farther than Ireland. The ads for Australia are much more professional. They tell you where the job is, how much you’ll get, what the locality and the schools are like and what the long-term prospects are.

And if I am reading them you can be sure little Breffni, who has been destined to take over uncle’s practice since he was a lad, is reading it too. Does he want to be the only one left , as he watches general practice teeter over the edge? Maybe his uncle should join him and place an ad: “Doctor to replace practice principal. Gender irrelevant. A knowledge of English, a driving licence or any kind of a clue at all not necessary. I’m off abroad and don’t care any more.”

Dr Pat Harrold is a GP in Nenagh, Co Tipperary