‘Marshmallow-gate’ exposes ‘broader problem in our health system’

A leaked email branding junior doctors ‘clinical marshmallows’ for questioning work hours is symptomatic of deeper cultural issues impacting the future medical workforce, GPs say.
 
The fallout continues after an email was accidentally sent from a medical administrator to a junior doctor at John Hunter Hospital in New South Wales.
 
The junior doctor had reportedly been questioning a rostering decision.
 
Trending as #marshmallowgate on social media, the now viral response says, ‘I wonder if any of them realise that they are a doctor, and this is what happens’.
 
‘Oh that’s right … I forgot. Life style [sic] before career,’ it read.
 
‘God help us in the future. We are going to have a workforce of clinical marshmellows [sic]!"
 
Hunter New England Local Health District has apologised and assured the matter is being appropriately addressed.
 
‘Junior medical officers work hard and are a vital part of our health service, and we sincerely apologise for the hurt and frustration caused by a recent email that was circulated,’ a spokesperson told newsGP.
 
‘We are committed to fostering a workplace where junior medical officers (JMOs) feel valued and respected.
 
‘The email did not reflect this commitment or our values, and we have written to the relevant JMOs to apologise.’
 
But Dr Michael Bonning, a NSW GP who sits on the RACGP Expert Committee – Funding and Health System Reform, said it is the normalisation of the kind of language in the leaked email that is of concern.
 
‘This suggests there is a broader problem in our health system,’ he told newsGP.
 
‘If you are willing to put it in an email, then it must be a pretty commonly held thought, unfortunately, and something that you would generally expect others who you were sending that email to either understand or to agree with.
 
‘We’re now so desensitised in the relationship between hospitals and staff, clinical staff, that commentary like that has become potentially commonplace between other members of the hospital team.’
 
For Australian Salaried Medical Officers’ Federation (ASMOF) Councillor Dr Matthew Ingram, the problems are deeper than a single email, extending to working conditions and pay.
 
Dr Ingram was joined by around 60 of his colleagues outside the hospital on Thursday, threatening to walk off the job if changes are not made.
 
'It’s not about the email,’ he told newsGP.
 
‘It’s a symptom of a much larger problem. And it’s not a John Hunter problem – it’s a statewide problem, which really reflects a very challenging environment to be in at the moment.
 
‘We’re very seriously considering taking strike action if we have to keep working under these conditions.’
 
Dr Ingram warned failure to act could exacerbate critical understaffing and impact general practice.
 
‘Doctors are leaving NSW in droves because they can get better conditions in every other state, and generally get paid about 30% more in other states,’ he said.
 
‘GPs interact with hospitals in multiple directions on a regular basis, and when patient care is affected in the hospital setting, of course that will affect patient care in the GP setting as well.’
 
NSW Premier Chris Minns told media he hopes industrial action could be avoided but added his government needed time to consider any changes.
 
RACGP GPs in Training Chair Dr Bec Loveridge told newsGP she is not surprised to watch ‘marshmallow-gate’ unfold, saying negative interactions with hospital administrative staff can be commonplace.
 
‘The work of junior doctors often goes unrecognised by the health service and patients, which adds insult to injury,’ she said. 
 
‘When medical workforce administrators treat their junior doctors like they’re members of the same team, it makes a huge difference to doctors’ ability to cope with the challenges of hospital work.
 
‘I hope we see a culture of mutual respect unfold as a result of marshmallow-gate.’
 
Looking forward, Dr Bonning agrees, saying he hopes a more positive culture can be created in the wake of this.
 
‘This is about the socialisation of attitudes that undermine others within the health system,’ he said.
 
‘That is a bigger issue that we should talk about in general practice as well, which is this idea that we are all on the one team, and that team is the team that is there to take care of our community.’
 
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