Orthopedic surgeon DR SINDY VRANCIC resigned from Canberra Health Services after an intractable dispute over new working conditions being forced on doctors. Here she reflects on 15 years at the department she loved… 

Resigning from Canberra Health Services (CHS) was not something I thought I would ever do.

My plan was to continue to be active in the orthopedics department and to mentor the new team of surgeons we hoped to recruit over the next few years.

That plan has now dissolved and the unit has publicly disintegrated, with three of the department resigning in frustration, and the remaining surgeons evaluating whether they will stay once their current contracts expire over the next two years.

One of my regrets in resigning is leaving behind more than 75 ​​ patients on my elective waitlist, and many patients who are yet to be seen in my upper-limb outpatient clinic. 

What’s more, as I was the most senior trauma upper-limb surgeon, I wonder what will happen to the existing trainees and fellows now that my teaching capacity has evaporated.

I regularly took on patients from Wagga, Goulburn, Cooma and Bega on direct referral from other orthopedic surgeons unable to offer care based on their location and skill set.

CHS is now actively blocking these referrals, I’m told – wanting CHS to only see ACT patients. 

Now those remote surgeons will need to decide where in NSW they will send their uninsured complex shoulder patients.

I am disappointed that my contribution to CHS has been downplayed to being minimal by Health Minister Rachel Stephen-Smith in media interviews.

Since 2009, I have signed five three-year contracts as a visiting medical officer (VMO) fee-for-service orthopaedic surgeon with ACT Health. 

I have been a very active surgeon in the field of training and education.

As one of the five per cent of female orthopedic surgeons in Australia (it was less than three per cent when I started), and one of the few who continued to work in the public system doing general orthopedic trauma, my role was to also be an example to junior female doctors to show that you can be a female surgeon, even in orthopedics.

I championed the room in theatres that met the breastfeeding guidelines for our doctors.

I was instrumental in implementing the ortho roster to meet national safe working hours guidelines, and regularly juggled to ensure all the needs of our trainees and fellows were being met – all of this non-surgical work was done out of hours.

The whole health system has been subjected to massive hurdles, from covid to the Calvary fires to the digital health records.

As if these weren’t enough, then there was the move to the new hospital building. To experience first-hand the poorly efficient new operating theatres was embarrassing. 

The lack of equipment, the lack of space and staff to manage the simplest of actions such as sterilising trays and equipment, and the significant time delays just trying to get a patient to the theatre complex from the ward was taxing. But, we all tried to continue to push for efficiency in the best interest of the patients.

As an active surgeon faced with these challenges, to then be told our contracts wouldn’t be renewed, and that we would only be offered sessional rates or salaried positions… this was one step too far for me. It’s not about the money; it’s about being valued and appreciated for what we do.

I will miss caring for my patients. There has been sadness with poor outcomes, and happiness with good outcomes.

I have cried with families after the death of their loved ones, and I have happily cared for multiple family members over the years. I am grateful for the trust that patients put in me.

What I won’t miss is the continual and ever-increasing interference by executive in my capacity to offer timely care for my patients. 

If I assess a patient and believe that they should be offered elective surgery within three months, then that is their category. That is my role as the surgeon – don’t change the category because the name of the operation doesn’t fit the national guidelines. I treat all patients as individuals.

My resignation was not an easy choice. I am not retiring, despite what has been incorrectly stated in the media. I am at the peak of my surgical expertise, but that skill is now only available to those able to access the private system.

The loss is being felt by those currently in the public system and those waiting to see an upper-limb orthopaedic surgeon to manage their disabilities.

The sharp change in direction at CHS will forever change the orthopedic department, and all other departments who still have VMOs. 

Our departmental mix of all VMOs was unique. We were one of the most cohesive and synergistic groups of like-minded surgeons.

But the VMO will soon be an extinct breed, with irreversible loss to the most important people in CHS – the patients.

So, goodbye to my friends and colleagues at CHS, I will miss all of you.

To Rachel Stephen-Smith I offer the words of Joni Mitchell: “Don’t it always seem to go, that you don’t know what you’ve got ’til it’s gone.”

This is an edited version of the column first published in The Canberra Doctor.