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Doctors are leaving Ireland and heading for Australia in droves – here’s why

Ireland has a long history of doctor emigration, but something needs to be done to encourage doctor retention and return

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3 months ago

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In 2022, 442 Irish doctors were issued with temporary work visas for Australia. This is a significant number of doctors compared with the total that Ireland trains each year (725 graduated in 2021).

Ireland has a long history of doctor emigration. UK research estimated that 71% of Ireland’s medical graduates of 1950-66 had emigrated by 1969. There was little interest in measuring doctor emigration back then, and little has changed in the past half a century.

Disinterest in doctor emigration stems from the belief that emigrant doctors will return and that doctor emigration will benefit Ireland.

Although emigrant doctors who returned with skills and experience obtained abroad have greatly enhanced Ireland’s medical training capacity, it is also important to acknowledge that doctor emigration without return has drained medical talent from the Irish health system.

Ireland has focused on the positive effect of doctor emigration and this has led to the development of a culture of medical migration. Although not unique to Ireland, such a culture accepts international training as inherently superior and requires doctors to complete additional training abroad (in the form of a fellowship) to further their careers. This means that in many specialities in Ireland, emigration is essential rather than optional.

When Ireland entered recession in 2008-09, the rate of doctor emigration increased, Australia emerged as a key destination, and doctors also began to emigrate earlier in their careers.

To better understand doctor emigration from Ireland, I began to study it.

In a survey of 307 emigrant doctors in 2014, I found that many had emigrated to escape difficult working conditions in the Irish health system. Emigrant doctors were enjoying the opportunity to work abroad in better-resourced health systems with superior working conditions. This both vindicated their emigration decisions and complicated their plans for return. As one doctor put it: “It’s awful to feel exiled from your country because of the expectations and work conditions of your job.”

Among those doctors surveyed, only one in four intended to return to Ireland. And the decision to return was for personal rather than professional reasons – for instance, to be closer to family and friends.

In 2018, I interviewed 40 Irish hospital doctors who had moved to Australia in the previous decade to find out why they had emigrated and whether they planned to return.

Unsustainable ways of working in Ireland also led them to decide to emigrate. They described Irish hospitals as understaffed and overstretched workplaces within which extreme ways of working had become normal.

In contrast, they enjoyed working in the Australian health system, describing well-staffed hospitals in which they were supported in their roles. Many had rediscovered their love of medicine while working in an efficient, well-resourced health system in Australia.

Once again, only a minority of those interviewed (one in three) planned to return to Ireland, indicating the risk of non-return inherent in all emigration decisions.

And then came COVID

However, this research was undertaken before COVID. Perhaps the pandemic changed the dynamics of doctor emigration.

Initially, the pandemic seemed to change everything when hundreds of Irish emigrant doctors returned to Ireland at short notice in March 2020 in response to a government recruitment campaign.

However, interviews with 31 hospital doctors later that year revealed that the pandemic had not radically altered patterns of doctor emigration because the underlying reasons for emigration remained unchanged – that is, a culture of medical migration, poor working conditions, and a lack of employment opportunities for those who had completed postgraduate medical training.

The graph below shows that the rate of doctor emigration from Ireland to Australia increased throughout the pandemic.

Irish doctors issued with temporary work visas for Australia, 2008-22

Graph showing Irish doctors issued with temporary work visas for Australia 2008-22
Australian Department of Home Affairs

Doctor emigration on this scale has implications for the Irish health system.

Ireland continues to rely heavily on migrant doctors to deliver healthcare – 43% of doctors on the Irish medical register are internationally trained. While this migration greatly benefits the Irish health system, it is out of sync with the WHO Global Code, a voluntary code that encourages member states to reduce their reliance on international recruitment by training and retaining enough health workers.

Ireland also has a significant number of vacancies at consultant level, perhaps indicating that traditional patterns of emigration followed by a return into a consultant post have changed in recent years.

To strengthen its health system after the pandemic and implement planned healthcare reforms, Ireland needs to strengthen its medical workforce. It is hard to see how largescale doctor emigration will contribute to this goal.

The Irish health system needs to better understand the dynamics of doctor emigration. This requires up-to-date data on the dynamics of doctor emigration and return. While policymakers have begun to analyse data on doctor return, more remains to be done. (New Zealand’s medical retention data is the gold standard in this regard.)

We also need to listen to doctors to understand why they are emigrating and what might encourage or discourage their return. When doctors voice their concerns, particularly about their working conditions, the onus is on the Irish health system to listen and respond.

Only when the dynamics of doctor emigration are understood will it be possible to develop solutions to promote doctor retention and encourage the return of those doctors who have already left.

Niamh Humphries receives funding from the Health Research Board.

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Watch Yield Curve For When Stocks Begin To Price Recession Risk

Watch Yield Curve For When Stocks Begin To Price Recession Risk

Authored by Simon White, Bloomberg macro strategist,

US large-cap indices…

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17 mins ago

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May 31, 2023

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Watch Yield Curve For When Stocks Begin To Price Recession Risk

Authored by Simon White, Bloomberg macro strategist,

US large-cap indices are currently diverging from recessionary leading economic data. However, a decisive steepening in the yield curve leaves growth stocks and therefore the overall index facing lower prices.

Leading economic data has been signalling a recession for several months. Typically stocks closely follow the ratio between leading and coincident economic data.

As the chart below shows, equities have recently emphatically diverged from the ratio, indicating they are supremely indifferent to very high US recession risk.

What gives? Much of the recent outperformance of the S&P has been driven by a tiny number of tech stocks. The top five S&P stocks’ mean return this year is over 60% versus 0% for the average return of the remaining 498 stocks.

The belief that generative AI is imminently about to radically change the economy and that Nvidia especially is positioned to benefit from this has been behind much of this narrow leadership.

Regardless on your views whether this is overdone or not, it has re-established growth’s dominance over value. Energy had been spearheading the value trade up until around March, but since then tech –- the vessel for many of the largest growth stocks –- has been leading the S&P higher.

The yield curve’s behaviour will be key to watch for a reversion of this trend, and therefore a heightened risk of S&P 500 underperformance. Growth stocks tend to outperform value stocks when the curve flattens. This is because growth companies often have a relative advantage over typically smaller value firms by being able to borrow for longer terms. And vice-versa when the curve steepens, growth firms lose this relative advantage and tend to underperform.

The chart below shows the relationship, which was disrupted through the pandemic. Nonetheless, if it re-establishes itself then the curve beginning to durably re-steepen would be a sign growth stocks will start to underperform again, taking the index lower in the process.

Equivalently, a re-acceleration in US inflation (whose timing depends on China’s halting recovery) is more likely to put steepening pressure on the curve as the Fed has to balance economic growth more with inflation risks. Given the growth segment’s outperformance is an indication of the market’s intensely relaxed attitude to inflation, its resurgence would be a high risk for sending growth stocks lower.

Tyler Durden Wed, 05/31/2023 - 13:20

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COVID-19 lockdowns linked to less accurate recollection of event timing

Participants in a survey study made a relatively high number of errors when asked to recollect the timing of major events that took place in 2021, providing…

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May 31, 2023

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Participants in a survey study made a relatively high number of errors when asked to recollect the timing of major events that took place in 2021, providing new insights into how COVID-19 lockdowns impacted perception of time. Daria Pawlak and Arash Sahraie of the University of Aberdeen, UK, present these findings in the open-access journal PLOS ONE on May 31, 2023.

Credit: Arianna Sahraie Photography, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Participants in a survey study made a relatively high number of errors when asked to recollect the timing of major events that took place in 2021, providing new insights into how COVID-19 lockdowns impacted perception of time. Daria Pawlak and Arash Sahraie of the University of Aberdeen, UK, present these findings in the open-access journal PLOS ONE on May 31, 2023.

Remembering when past events occurred becomes more difficult as more time passes. In addition, people’s activities and emotions can influence their perception of the passage of time. The social isolation resulting from COVID-19 lockdowns significantly impacted people’s activities and emotions, and prior research has shown that the pandemic triggered distortions in people’s perception of time.

Inspired by that earlier research and clinical reports that patients have become less able to report accurate timelines of their medical conditions, Pawlak and Sahraie set out to deepen understanding of the pandemic’s impact on time perception.

In May 2022, the researchers conducted an online survey in which they asked 277 participants to give the year in which several notable recent events occurred, such as when Brexit was finalized or when Meghan Markle joined the British royal family. Participants also completed standard evaluations for factors related to mental health, including levels of boredom, depression, and resilience.

As expected, participants’ recollection of events that occurred further in the past was less accurate. However, their perception of the timing of events that occurred in 2021—one year prior to the survey—was just an inaccurate as for events that occurred three to four years earlier. In other words, many participants had difficulty recalling the timing of events coinciding with COVID-19 lockdowns.

Additionally, participants who made more errors in event timing were also more likely to show greater levels of depression, anxiety, and physical mental demands during the pandemic, but had less resilience. Boredom was not significantly associated with timeline accuracy.

These findings are similar to those previously reported for prison inmates. The authors suggest that accurate recollection of event timing requires “anchoring” life events, such as birthday celebrations and vacations, which were lacking during COVID-19 lockdowns.

The authors add: “Our paper reports on altered timescapes during the pandemic. In a landscape, if features are not clearly discernible, it is harder to place objects/yourself in relation to other features. Restrictions imposed during the pandemic have impoverished our timescape, affecting the perception of event timelines. We can recall that events happened, we just don’t remember when.

#####

In your coverage please use this URL to provide access to the freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0278250

Citation: Pawlak DA, Sahraie A (2023) Lost time: Perception of events timeline affected by the COVID pandemic. PLoS ONE 18(5): e0278250. https://doi.org/10.1371/journal.pone.0278250

Author Countries: UK

Funding: The authors received no specific funding for this work.

Journal

PLoS ONE

DOI

10.1371/journal.pone.0278250

Method of Research

Survey

Subject of Research

Not applicable

Article Title

Lost time: Perception of events timeline affected by the COVID pandemic

Article Publication Date

31-May-2023

COI Statement

The authors have declared that no competing interests exist.

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Hyro secures $20M for its AI-powered, healthcare-focused conversational platform

Israel Krush and Rom Cohen first met in an AI course at Cornell Tech, where they bonded over a shared desire to apply AI voice technologies to the healthcare…

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2 hours ago

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May 31, 2023

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Israel Krush and Rom Cohen first met in an AI course at Cornell Tech, where they bonded over a shared desire to apply AI voice technologies to the healthcare sector. Specifically, they sought to automate the routine messages and calls that often lead to administrative burnout, like calls about scheduling, prescription refills and searching through physician directories.

Several years after graduating, Krush and Cohen productized their ideas with Hyro, which uses AI to facilitate text and voice conversations across the web, call centers and apps between healthcare organizations and their clients. Hyro today announced that it raised $20 million in a Series B round led by Liberty Mutual, Macquarie Capital and Black Opal, bringing the startup’s total raised to $35 million.

Krush says that the new cash will be put toward expanding Hyro’s go-to-market teams and R&D.

“When we searched for a domain that would benefit from transforming these technologies most, we discovered and validated that healthcare, with staffing shortages and antiquated processes, had the greatest need and pain points, and have continued to focus on this particular vertical,” Krush told TechCrunch in an email interview.

To Krush’s point, the healthcare industry faces a major staffing shortfall, exacerbated by the logistical complications that arose during the pandemic. In a recent interview with Keona Health, Halee Fischer-Wright, CEO of Medical Group Management Association (MGMA), said that MGMA’s heard that 88% of medical practices have had difficulties recruiting front-of-office staff over the last year. By another estimates, the healthcare field has lost 20% of its workforce.

Hyro doesn’t attempt to replace staffers. But it does inject automation into the equation. The platform is essentially a drop-in replacement for traditional IVR systems, handling calls and texts automatically using conversational AI.

Hyro can answer common questions and handle tasks like booking or rescheduling an appointment, providing engagement and conversion metrics on the backend as it does so.

Plenty of platforms do — or at least claim to. See RedRoute, a voice-based conversational AI startup that delivers an “Alexa-like” customer service experience over the phone. Elsewhere, there’s Omilia, which provides a conversational solution that works on all platforms (e.g. phone, web chat, social networks, SMS and more) and integrates with existing customer support systems.

But Krush claims that Hyro is differentiated. For one, he says, it offers an AI-powered search feature that scrapes up-to-date information from a customer’s website — ostensibly preventing wrong answers to questions (a notorious problem with text-generating AI). Hyro also boasts “smart routing,” which enables it to “intelligently” decide whether to complete a task automatically, send a link to self-serve via SMS or route a request to the right department.

A bot created using Hyro’s development tools. Image Credits: Hyro

“Our AI assistants have been used by tens of millions of patients, automating conversations on various channels,” Krush said. “Hyro creates a feedback loop by identifying missing knowledge gaps, basically mimicking the operations of a call center agent. It also shows within a conversation exactly how the AI assistant deduced the correct response to a patient or customer query, meaning that if incorrect answers were given, an enterprise can understand exactly which piece of content or dataset is labeled incorrectly and fix accordingly.”

Of course, no technology’s perfect, and Hyro’s likely isn’t an exception to the rule. But the startup’s sales pitch was enough to win over dozens of healthcare networks, providers and hospitals as clients, including Weill Cornell Medicine. Annual recurring revenue has doubled since Hyro went to market in 2019, Krush claims.

Hyro’s future plans entail expanding to industries adjacent to healthcare, including real estate and the public sector, as well as rounding out the platform with more customization options, business optimization recommendations and “variety” in the AI skills that Hyro supports.

“The pandemic expedited digital transformation for healthcare and made the problems we’re solving very clear and obvious (e.g. the spike in calls surrounding information, access to testing, etc.),” Krush said. “We were one of the first to offer a COVID-19 virtual assistant that deployed in under 48 hours based on trusted information from the health system and trusted resources such as the CDC and World Health Organization …. Hyro is well funded, with good growth and momentum, and we’ve always managed a responsible budget, so we’re actually looking to expand and gather more market share while competitors are slowing down.”

Hyro secures $20M for its AI-powered, healthcare-focused conversational platform by Kyle Wiggers originally published on TechCrunch

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