| You’re absolutely correct. I like to think I’m a good physician. At the very least I’m a highly trained subspecialty physician. I could never work in a small community hospital with poor standards because it drives me insane to work with apathetic clinicians (100% a real thing). Additionally, given how much I trained I need to practice in a centre that can provide complexity (largely academic centres or major metropolitan non-academic sites) This unfortunately does result in the bottom of the barrel staffing the “crappy local hospital”, but someone has to do it. It’s unrealistic to expect high quality physicians to work on a small island nation. By choosing to live on a remote island you honestly have to accept that you’re not getting the same access to healthcare as someone in a larger city. I’m not sure of any way to improve that. Edit: I wanted to add that with the additional information cameronh90 has provided, in my professional opinion I can absolutely believe that his mother may have been misdiagnosed in such a practice setting. Not uncommonly (forgive me for using this favourite word of doctors), I see egregious medical errors referred to my centre from very remote locations. The issue in this story is not that the medical profession is apathetic, careless, negligent. This is rather a good example of the issues in delivering quality care in remote locations. We can’t force people to move to islands and presumably an undesirable location for someone to migrate to so you end up with a higher percentage of incompetent physicians who can’t find jobs in better locations. Most often the only times these types of practices get a recently trained physician are if the individual originally comes from there and wants to go back, a rare occurrence in my experience. |
While I'm not a doctor, I'd imagine that if I was a good doctor, I'd rather work somewhere that I'm likely to get exposure to interesting cases, or hospital known for producing quality research, or a teaching hospital, or at least want to live somewhere that I could go to conferences and otherwise work with other smart people. Indeed, I moved to London for similar reasons in my career.
The way the local hospital tries to maintain some level of competence is by flying doctors over for a day or two a week, but even with that it's an uphill battle trying to attract anyone in the prime of their career. It's more of a place you go for an easy retirement, earning relatively good money but for boring work in poor facilities. Even then, the money isn't comparable to what a late stage career doctor could get working privately in Harley Street for example. We do know a few doctors (and nurses) working over there, and even if they start out enthusiastic, the system ultimately grinds them down until they're apathetic. Some leave, some just give into it.
I appreciate that you obviously can't have excellent doctors everywhere, but at the same time, I bet most individuals' interactions with healthcare are those local community hospitals and pre-retirement GPs with little enthusiasm for the job. I suppose that in healthcare, reaching the best physicians is usually a bad sign regarding your prognosis (or a very good sign regarding your bank balance).