Are we ready for the next big thing?
Author: Derek H Meyers
Published online: 5 October 2009
To the Editor: The next challenge for medicine in Australia, in Duckett’s opinion, will be the need to provide for the “very different expectations . . . and a greater sense of entitlement” of baby boomers, as they reach old age and have more need for health services, in and out of hospital.1
They will not meekly wait for care — but how will waiting lists for appointments and elective surgery be abolished? They will not accept “cattle class” in outpatient departments — but who will pay for the replacement of wooden benches with easy chairs? They will not accept whatever is on offer — but who will provide what is not on offer at a time of need? They will expect frank discussion of choices, risks and outcomes — but which cardiac surgeon or registrar will have the time to go into the 40 different possible complications of coronary artery bypass, an operation with usually excellent results? And if nurse practitioners or podiatrists become leaders of the medical team, will they be professionally and legally responsible when outcomes are unsatisfactory or disastrous?
People with visions of the ideal medical service should keep in mind a basic principle, expressed by Enoch Powell 42 years ago.2 Even in prosperous times, limited resources (trained staff, facilities and money) will never meet unlimited demands. Duckett’s baby boomers may have expectations, but they must be measured against reality. With the unceasing growth of knowledge, technology and pharmacology, medicine is not about to become cheaper.
References
- Duckett SJ. Are we ready for the next big thing? Med J Aust 2009; 190: 687-688. 0_CBBHDEGD
- Medicine and politics. BMJ 1967; 1: 555-559. 0_i1091839