Almost a quarter of senior doctors employed by district health boards intend to leave medicine or move to private practice in the next five years, a new study has found.
The study, carried out by Association of Salaried Medical Specialists principal analyst Dr Charlotte Chambers, found feelings of disillusionment, exhaustion and low morale were driving senior doctors to consider leaving New Zealand's public hospitals much earlier than they would otherwise.
Of the 2281 senior doctors who responded, 23.9 per cent of them said they were unlikely or extremely unlikely to continue with some form of district health board-based employment in the next five years.
Of respondents aged 55 or over, 44.7 per cent said they were unlikely to remain with a DHB with 38.1 per cent saying they intended to leave medicine entirely. Of those under 55, only 4.1 per cent planned to leave the profession.
More than half of all respondents said they were dissatisfied with the level of recognition they received for good work.
Age was the top reason for not wishing to continue working with DHBs, cited by 217 senior doctors.
This was followed by disillusionment with DHB management and the direction of the New Zealand public health system - 82 people; exhaustion, burnout and pressure of work - 74 people; low morale, poor job satisfaction and feeling unable to institute change - 70 people; and wanting more time for leisure or other interests - 51 people.
Of those who planned to leave DHB-based employment but stay in the profession in New Zealand, there was a strong theme of poor job satisfaction with many comments indicating feeling under-recognised, unsupported and undervalued.
One respondent said: Management are uncompromising and don't listen; my department [is] so understaffed [that] everyone [is] under pressure. I feel powerless to change this as [there is] no unity within my department. [I] find it difficult to turn work off because [I] have so much work left after every working day. I have plenty of other options in [the] private sector."
Chambers said the value of the study was that it identified the reasons doctors were leaving and what might encourage them to stay.
"We know that many senior doctors are approaching traditional retirement years," she said. "This study finds many of those older doctors would be more inclined to stay on longer if their working conditions improved, including being able to work more flexible hours, being adequately staffed to cope with the work pressures and having a greater say on how clinical services are provided."
The top five changes which could cause doctors to rethink were the provision of flexible working hours or part-time work, better management culture and less bureaucracy, better resourcing and staff levels, reduced on-call, shift work and after hours work, and more respect and greater professional freedom.
The report stated there was significant variation in intention to leave by medical specialty, whether the respondent had dependents and by how many hours they worked.
Of the larger medical specialities, nuclear medicine, paediatric palliative care, forensic pathology and developmental paediatrics were the areas where the largest proportion of senior doctors planned to leave DHB employment - either to seek work elsewhere, move overseas or leave the profession.
Of the DHBs, the largest proportion of specialists planning to leave medicine entirely was at Wairarapa, at almost 50 per cent. Southern DHB had the largest proportion of people planning to stay in the profession but leave DHB-based employment, 11.5 per cent, followed by Tairawhiti, 11.1 per cent.
Research released previously by the Medical Council of New Zealand suggested that while the absolute numbers of senior doctors were increasing year on year, in proportionate terms, the number of specialists per head of the New Zealand population remained one of the lowest in the OECD.
In addition, New Zealand had one of the highest rates of reliance on international medical graduates, who currently represented about 43 per cent of the senior medical workforce.
Other data revealed an ageing medical workforce in New Zealand. The average age of DHB-employed senior doctors was 49.9 years while 40.1 per cent of all doctors were aged 50 and over.