I know that this is going to get me a lot of criticism from my peers, but I don’t think that my “value” is determined by the amount of my salary.
I know this is an unpopular view because over the past 48 hours I’ve been told that I am sanctimonious and have poor self-esteem for saying that money is not what determines my self-worth.
Why does it matter how doctors measure their self-worth? Why does it matter if we feel valued at work?
It matters because a sense of value is related to burnout; burnout is related to patient care. And whatever comes up about salaries, most healthcare workers do care about their work.
It’s a self-perpetuating cycle:
- Don’t value your workforce
- Increase burnout in your staff
- Diminish the care given to patients
- Reduce staff self-worth and increase burnout…
- Repeat. Again. And again. And again…
As I’ve said before, what junior doctors are contracted to do and what we deliver in practice differs quite a lot.
When that extra isn’t recognised, then yes, I feel unvalued. Sometimes, it’s as simple as being part of my team. A phone call from the administrator or consultant to ask if I can work the extra shift? An agreement with my consultant that I will come in to cover during my leave, but that she will make sure that I can get to that conference I really need to get to?
The problem is that the money makes things easier (obviously). My worry is that the salary was used to replace the other ways that a responsible employer would value their staff.
Junior doctors can rotate between different hospital Trusts every 4 – 6 months: we are supposed to get 6 weeks notice of this. In my area, that can mean that in July you work in Leicester city centre and in August you work in Boston. These hospitals are 70 miles apart: a 90 minute commute if you drive, or 3 1/2 hours by public transport. What do you do? Uproot your home every 6 months at a few weeks notice? Try and find somewhere to stay after a 12 hour shift? Rent somewhere else for that six months, and hope that you’re closer for the 6 months after that?
When do you see your partner or family? Especially if you’ve been allocated to different areas (the choice is usually between accepting a post in the speciality that you want for 8 years – and whatever part of the country – or not having a job.) You can apply for a transfer between different Deaneries, but only if you fit certain criteria and only if Deaneries agree. Colleagues with young babies live at opposite ends of the country to their families because their requests for transfer were refused. Having the money to travel to see your partner? Kind of important for your wellbeing.
We’re supposed to get a rota for that six months. Again, this is supposed to be 6 weeks in advance. How do you arrange childcare at that notice? (Bear in mind, this could be in a completely different city) How do you get night cover, or cover for a shift that can finish at 10pm or midnight or 2am? In practice of course, we often get our rota a few days before the rotation starts: family trips? time with your partner?*
We pay for most of our own training courses – last year, I spent £7000 on training. I get a study budget of £600. Some of the money I spend includes mandatory training (fairly important stuff like life support), but it’s not provided in house. The courses get booked up months in advance… which is a problem if you don’t have a rota…because you can only use certain days. So, you book a course that’s further away (but on a date that you can make). You take the extra financial hit of accommodation and transport as a result.
My value is not just about my salary. But there’s precious little else to show us that we are valued.
* My ex-partner was a junior doctor as well. We lived in different parts of the country. Every July and every January turned into a waiting game for our rotas to be published. Once we knew what we were working for the next 6 months, it would take hours on the phone trying to work out when we could see each other; if we could combine a weekend together with seeing friends as well; how tired we would be (invariably, one of us was always post-nights and so would turn up having not slept for 24 hours +). It doesn’t make for great quality time together; it really doesn’t help your relationship