THE EZFKA GUIDE TO THE UNHEALTHY

[Stewie: This isn’t my article, I’ve just uploaded it for BigDuke6 and his take on the state of our medical system]

I thought I’d get off my butt and do an article that only the true OG’s and believers will see.

To get things clear I deny I am a doctor and do not get robbed for $5000 a year to keep my subs up to the cartel known as the local college of surgeons.

This is not a guide to judge private/public outlooks to health but more perhaps stating the obvious and using common sense not to get messed up by a healthcare system that can deliver the finest care in the world right next to life changing trouble.

Chapter 1 – “Game over man, Game Over.” Corporal Hicks

We all want to choose the best surgeon for ourselves or our family.  Here are tips to put the odds of the dice roll of major surgery heavily in your favor.

If you leave things to chance and simply trust anyone simply rubber stamped by the authorities for service provision to a rising population then good luck to you.

Australias medical system is in decline but as its starting from a high ebb it may not fall to the lethality of the UK’s NHS before its recovery begins.

Many doctors from the generation above me (age 60- 80) were/are incredibly devoted to the craft and often had nothing else in their lives. Make no mistake tho – they are now past it.

This created a generation of often inspiring workaholics who were 90% men. I met one once who had done a 1 in 2 on-call for his 40 year career. To explain what that means – he would work 8am to 5pm, do the night shift resident in the hospital, then the day after continuously for 40 years i.e. have only the 5pm to 8am off every 48 hours. No doubt he stayed late too (unpaid of course) and would never have had any parental leave. Not far off being a submariner .

This was required to keep the foreign doctor horde at bay and was worth it to them due to the high respect and money (compared to RE agents, rugby league players etc) on offer.

Looking at these professionals inspired the next generation –me – now aged 45 to 60 years old – to excellence leading to my thoughts that if you know where to go you will still receive the best care in the world here. With digging around in peoples abdomens shit does happen but knowing what to look for in your care will help roll the dice in your favour.

Chapter 2 – “But the good times couldn’t last” Mark Renton.

With the arrival of the new breed of medical students (about 15 years ago), now junior doctors – hot-housed bookworm asian, 60+% female, white aboriginal Gen Yer’s – things began to hit the slide. They looked at the previous generation and instead of being inspired they were disgusted at their lack of quality of life. Instead of looking at it as an apprenticeship there were delusions of grandeur, expectations of instant gratification and the sense of entitlement now among the Australian trained juniors is breathtaking.

The point is that to reach the very high standards things depend on the machine.

My wife understands I am a well oiled machine that needs to stay well oiled.

“And when the machine breaks down, we break down” Sgt Barnes.

So now we have a generation of junior doctors who proudly call themselves marshmallows, want to be paid for every minute of overtime, have green hair, the men are mostly very effeminate and the women obese or overly thin and anxiety ridden. In most departments at least 50% of them are off sick with stress as the main factor. While being sick used to be a big no-no because it dumped your colleagues in it, now it’s unquestioned and a hug given. I realise this may the same story across the board in many skills but this is medicine goddam it!

There should be some pride.

My interviewee had spent time in the UK in the early 2000’s and had been stunned at how many foreign doctors were there to slave away for the entitled, spoiled Brits who were lied to and told how good the NHS was by their lying state propanganda service – the ABC…. Sorry BBC.

Foreign trained doctors were fairly rare in Australia around 2000, except for Brits who came for a year but then stayed and South Africans, mainly jews, who smelled the roses and deserted the place with diamonds in their shoes. Both sorts were decent quality.

But the new century brought the new laziness and with immigration spigot increasing the doors began to open to the Indian subcontinent especially in the country areas where their numbers increased exponentially to keep the shop open.

Previously if a newly qualified surgeon didn’t meet the grade in the city they would get the chat. “You don’t have the hands or the brain but there’s a job in Dubbo for you”. They would grump but go there and with the help of their colleagues in their new home improve gradually. And in the end, be a less dangerous, maybe even half decent practitioner.

But come 2010ish it then became “No! I’m not going! That’s wacist,sexist..” take your pick. So these less talented types, who would have become useful members of the medical community eventually, now hang around the cities or centres without a public appointment and scrape enough money from suckers privately to survive. If they get lucky for a few years and don’t have too many disasters they’ll get to mediocre. If they have a disaster they get kicked out of that individual private hospital and move onto the next one. We’ll get back to this point later.

All of this has led to rural hospitals having to recruit foreign doctors on masse and huge numbers of GP’s arriving to service the growingly entitled Aussie population. The demographic I’ve found who’ve always been most entitled is the male Aussie boomer. Often, but not always of course, a truly dislikeable type who thinks they’re a real estate genius for buying a couple of properties 40 years ago.

A lot of new high rise in metro suburbs and regional centres is not just for new arrivals its for health obsessed country folks getting a bit older and wanting to be near the big hospitals and away from the very random country ones. Invest accordingly.

In my experience foreign trained doctors and I’d now include the newly trained from the UK in this, are a mixed bag and fine for small things – but not for me, my family or for serious work.

Will the younger generation reach the heights we have available for now and for perhaps the next 10 years? Obviously I’m saying they will not. Exhibit A.

I went on Reddit to give my advice on a junior doctor thread which went along the lines of ..

“You lot better start showing a little backbone and stop the constant whinging. Far too many of you are now being trained up by the greedy universities. Shortages due to sickies and even strikes allow the government carte blanche to rubber stamp foreign doctors to the moon. You’re sabotaging your own future and can’t see it!” That wasn’t appreciated.

Another thread related how their Gen X boss admitted to a junior that they had lost some of the caring aspect of the job. The best rated comment was that he should have got counselling and had a good cry. I lost my shit and gave them my thoughts.

The abuse I received from the marshmallows – including a laughable threat to dox me – confirmed that things will be massively on the slide for the next 15 years until the zoomer generation take charge from them.

Chapter 3 – ““Our youth now love luxury, they have bad manners, contempt for authority; they show disrespect for elders, and they love to chatter instead of exercise.” Socrates

Obviously this is not a new feeling to have and I don’t want to be too dark. There will still be surgical quality there but it will be the exception rather than the norm. And some specialities have held things together much better than others. General surgery, cardiac and orthopaedics pretty good, bariatric surgery, obstetrics and gynaecology totally lost their shit.

The good news is that with all the young ones too scared to leave the public hospitals the service in the struggling specialities will improve slightly but not hit the heights of the Gen X busy surgeon.

The truly skilled surgeons will be less in number, bill more heavily and private health will become the domain of the wealthy rather than for those who prioritise their health as has been for the last 50 years. As in the whole world luxuries are becoming luxuries again.

A+E, cancer and most medical fields will continue to be excellent I suspect as they are protocol driven and will have the best females to choose from.

Chapter 3 – “You smoke that shit to get away from reality? I am reality” – Sgt Barnes.

I cant really describe my usual week to anyone. There is always something to stress about… if you care about people that is. That’s why there are many psychopaths are in the job.

They don’t give a shit about their patients while any normal person is sweating about that post-op crumble who obviously is sick due to a bad wound infection but the scan you did has also suggested there’s a problem inside her abdomen due to your surgery. Do you shite it and cut open her fragile form from asshole to xmas to find that its actually normal and the scan was bullshit?

Or hold steady knowing your op was solid but with that nagging doubt that there really might be a problem in there and its game over for your patient and your career if you delay. I get that level of stress – with other things too – almost constantly as I’m top 10% busy in the country.

The first time you get properly sued (rather than the more common no win no fee bullshit – “Some fat ass telling Mr Malouf I’ve lost my libido due to…blah blah”) its pretty nasty.

Nausea, dry retching, insomnia, thoughts of suicide, shouting at the kids and wife, bit of alcohol … usual boy stuff. You also get to know who your friends are and appreciate your family. Counselling in the form of telling all this to a sweet bespectacled lady doesn’t quite cut it.

I’m sure anyone who’s had a brush with lawfare realises its corrupt power and how it can take away your freedom and all you’ve worked for fairly randomly. The law is a business to allow lawyers to feed, justice is an afterthought.

So, unfortunately for excellence in surgery, the young marshmallows unashamedly say no to this.

I say “Sorry, there’s no avoiding it, you’re a goddam doctor… suck up the pressure.” Standards need to be maintained. Yeh, nah.

But like I said the sense of entitlement is off the scale.

So you can just run off and be like Dr Kerry Chant, so useless and unsuitable to be a front line doctor she hid in public health, safely away from direct patient care, where she should have been harmless instead of being so totally dreadful and out of her depth during covid.

Chapter 4 – “And that was it! Begbie’s story…” – Mark Renton.

So how to secure top quality health care for you and your loved ones? And this advice is for something serious not trivial. In the game I know who is good so I get the best, my own daughter needed major spinal surgery back in the day – I ensured it was done by someone I’d rate as the top 1% in the world of back surgeons and she’s done amazingly.

But to the unwary? Different story. I had a patient who’d had the same surgery and I asked her why she didn’t get it done by my guy, Dr Beergut. She was in agony most days and was pretty fucked for life basically.

“He was so rude! I didn’t like him so I went to Dr Jihad instead…” Oopsy..

Dr Beergut is a typical brash orthopaedic surgeon (glorified carpenter) who’s also one of the cheapest in town. Let me make this clear. How much a gap doctors charge is not according to how good they are – its related to how much money they want to make. In fact I’d say the most expensive surgeon in town is NEVER the best in my experience unless he/she is super specialised or sick of fixing up other peoples messes. And younger specialists bill more because they haven’t bought the healer vocation kool aid, have racked up debts from medicine being mainly a postgraduate degree now… and above all….they value themselves more baby!

For major surgeries I’d having a serious look at the CV which should be on the website.

Training in different hospitals and a fellowship perhaps in a big centre in Europe or the USA is a must. Surgeons who hang around the same place in their early years are often stagnant, the teachers pet and have lesser skills usually due to less exposure to different procedures or ways of doing the same one.

A public or university appointment is a reassuring sign and a must the younger they are.

Someone totally private is fine if well established and they’ve done their time and dumped the public system to keep their sanity but if under 45 years it’s a warning bell.

Google reviews are hit and miss unless over 50 of them. They need to be read too, I know a surgeon banned from every hospital in the city and full on botcher who has several 5 star reviews saying how good she is from obvious paid shills or sheer luck.

A lot of this advice doesn’t particularly apply in the centres of major cities as they are over doctored for the reasons I’ve mentioned above and the public hospitals are well audited. But the further out you go it’s the wild west out there especially in the private system where there is no audit and its incredibly hard to clip the wings of a psychopath with no insight and a large mortgage.

A lot of this is obvious really but I can barely believe people just blunder into major surgery with no research and trust the .gov to rubber stamp someone from god knows where.

Obviously the argument is the colleges need to train more specialists but unfortunately that’s easier said than done because the spots are tight for a reason. There just isn’t enough surgery going on in the public system where you’re getting through maybe 50 – 60% of what you would privately due to tea breaks, sickies and the usual inefficiencies. There’s lots going on in the private hospitals but not many training programs linked to them and so no pay for the trainee to attend, therefore buckleys of them ever turning up for free and just to learn.

I’ve offered one to one training to advanced trainees for heavy surgery for an all day list I do every week for the last 15 years and not once has anyone turned up. That’s how desperate they are to get hot shit before they become a specialist.

When I trained I did 4 times the volume they do now, did an extra 2 years in a surgical fellowship and still barely felt ready to emerge on my own two feet so churning specialists out is a dream just like building enough houses for infinity Bimalians. Very Australian!

Anyway sorry for the ranting among hopefully some nuggets of use to keep you and your family safe in the uncertain times ahead.