Abrahim Mohammed
Division of Emergency Medicine, Department of Family Medicine, McMaster University, Hamilton, CAN.
Cureus. 2023 Jul 14;15(7):e41891. doi: 10.7759/cureus.41891. eCollection 2023 Jul.
Conventional wisdom suggests that in almost every profession, the most experienced and educated employees are remunerated at a higher rate than the less experienced ones. For example, new-graduate hires most commonly start at the bottom of the pay scale. No profession could reflect the importance of experience and the need for mastery of skills more than emergency medicine (EM), where a split-second decision could mean the difference between life and death. In Canada, however, EM physicians are remunerated as per a common pay scale that does not consider the length of their education, training, or years of practice. Such an unfair experience-remuneration mismatch (E-R mismatch) could lead to job dissatisfaction, burnout, and switching to other specialties. Given the current EM physician shortage in Canada, the E-R mismatch among such physicians could negatively impact patient care and the health system as a whole and prolong the already long wait times. The aim of this editorial is to shed light on this flaw in the Canadian healthcare system and lead to change toward a fair pay system. The creation of a professional and experience-based hierarchy among Canadian EM physicians should be considered a matter of urgency for those developing health-related legislation.
传统观念认为，几乎在每个行业中，经验最丰富、受教育程度最高的员工比经验较少的员工薪酬更高。例如，新入职的毕业生通常从薪资等级的最低层开始。没有哪个行业比急诊医学（EM）更能体现经验的重要性和掌握技能的必要性了，在急诊医学领域，瞬间的决策可能意味着生死之差。然而，在加拿大，急诊医学医生是按照统一的薪资标准支付薪酬的，该标准不考虑他们的教育时长、培训情况或从业年限。这种不公平的经验与薪酬不匹配（E-R不匹配）可能会导致工作不满、职业倦怠，并促使他们转向其他专科领域。鉴于加拿大目前急诊医学医生短缺的情况，此类医生之间的E-R不匹配可能会对患者护理和整个医疗系统产生负面影响，并延长本就漫长的等待时间。这篇社论的目的是揭示加拿大医疗系统中的这一缺陷，并推动向公平薪酬体系的转变。对于那些制定与健康相关立法的人来说，在加拿大急诊医学医生中建立基于专业和经验的等级制度应被视为当务之急。
