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Emergency physicians are planning to leave the profession in overwhelming numbers after years of patient overcrowding and excessive stress, raising serious concerns about the future of Australia’s already short-staffed emergency departments.
A new report by the Australasian College of Emergency Medicine (ACEM) found close to two in five emergency doctors plan to leave in the next 10 years, including younger doctors decades away from retirement.
One in five respondents aged under 50 said they were “likely” or “very likely” to quit – a rate that has doubled in less than 10 years, according to the report released on Wednesday.
Unsustainable workplace conditions were the most common reason for those considering leaving, while almost three in four emergency physicians planned to cut down their hours.
ACEM president Dr Peter Allely said a shrinking emergency physician workforce was a “very real threat” and staff shortages would worsen as the number of emergency department presentations rises.
“We’re seeing people in corridors, in chairs, in the [ambulance] bay,” Allely said. “It’s the moral injury that we face day-to-day of not being able to give the best possible care because we don’t have the space.”
Allely said the rising tide of overcrowding had become so normalised that its impact on staff burnout and patient care wasn’t being properly addressed.
A major cause of overcrowding is bed block, in which emergency departments become multi-day holding rooms for people waiting to be admitted to a ward, where beds are occupied by patients who are medically cleared for discharge yet are left waiting months for community aged care or disability accommodation.
Dr Rachael Gill, ACEM NSW branch chair, said bed block was “emotionally draining and distressing” for staff “literally begging for a bed” for acutely unwell patients.
The report found of the 906 emergency doctors surveyed, 60 per cent of them said the demands of work interfered with their home and family life, and more than half reported work-related burnout.
Gill said many senior clinicians were taking administration roles or early retirement, and attracting junior staff to the specialty was challenging.
“We need to keep emergency medicine as a vibrant, exciting place to work, so that we have the next generation of clinicians,” she said.
The survey found instances of discrimination, bullying, harassment and sexual harassment perpetrated by a colleague had more than halved since 2019, but two in five clinicians still reported experiencing verbal abuse or physical aggression from a patient or carer in the past year.
One junior doctor working in a NSW emergency department – who is not authorised to speak publicly – said she experienced verbal abuse “almost every shift”.
She has decided the specialty is not for her after seeing the overcrowding, burnout and intense hours involved.
“When I speak to junior doctors, it’s really rare to hear that somebody wants to go into emergency,” she said.
Allely said governments needed to invest more in aged care and primary care facilities to ease pressure on EDs, and in security officers, who are not present in all emergency departments, to better protect staff and patients.
“The success story of medicine is that people are living longer lives, but the impact is that we have an ageing, complex and sicker population attending emergency departments,” he said. “Things are going to get worse unless there’s some significant changes.”
NSW Health Minister Ryan Park said in a statement that his government is recruiting more health workers and hospital security staff, and investing in pay rises for doctors and more hospital beds.
But Park said patients awaiting aged care or NDIS beds, both of which are funded by the federal government, meant state governments were “effectively subsidising” a Commonwealth responsibility.
In a statement, federal Health Minister Mark Butler pointed to January’s $25 billion hospital funding deal with state and territory governments, a joint taskforce into bed block, and a $3.7 billion investment in aged care.
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