Dear colleagues and supporters,
We are nearing the end of May so if you haven’t already contributed this year, I hope you will consider doing so soon. Please recall the initial concept was donating a day’s pay or part thereof sometime in May in lieu of physically going to work in the developing world for a period.
So what is the actual good that can be achieved in donating? What is the actual bang for your buck? It is in fact more, and probably much more, than most of us (in the Western world) would like to believe.
It has been estimated that the average doctor averts about 4-5 DALYs (Disability adjusted life years) per year through their medical work. We should be justly proud of this. This estimate is likely to be pretty close to the mark on the following reasoning:
- In developed countries we pay an average of about $70,000 (between $21,509 and $168,720) to avert a DALY.
- A full-time salaried doctor might get $250k p.a. The doctor’s entire medical training might cost $500k and she might work for about 30 years full time equivalent so the amortised cost of training is about $15k per year of work life. So the total cost to the community is $265,000 pa. This lines up very well with the cost of averting 4 DALYs (4x $70k = $280,000)
In other words, doctors paid at this level are probably worth what they are paid in terms of helping the community avoid disability. If the estimates of what doctors achieve was greatly underestimated then it would be totally remiss of medical economic decision makers to not train and pay a lot more doctors rather than, say, build more hospitals with the available funds. But that is not happening… because it is not worth doing…. because doctors probably do avert about 4-5 DALYS per year on average and not a lot more.
So, if that doctor on $250k pa gave 1 day’s salary….about $1000 and it was donated for use in highly effective medical programs in the developing world, what would that achieve?
An extensive analysis in 2014 determined that cataract surgery in Africa averts a DALY for an average of $US50 (not $70,000). Elective inguinal hernia repair $12-$78. Emergency caesarean section – as low as $18 per DALY averted. It is not difficult to understand that saving a mother’s and a baby’s life (an estimated total of about 60 DALYs) with an emergency caesarean can be this cost effective. An earlier study indicated $17 for tarsal surgery for trachoma in Ethiopia . Preventing blindness with simple surgery is incredibly cost effective. Assuming these cost figures have doubled since (which they haven’t)… the $1000 donation (just less than 1/2% of our doctor’s annual salary can avert 5 DALYs (at least). There is a lot of “low hanging fruit” in terms of possible medical interventions in the developing world.
So what can be achieved? ….DOUBLING the total DALYs your medical efforts have averted in a year. In other words, doubling of your direct medical impact for patients on this planet. You can be “twice the doctor”.
Therefore to be “twice the doctor” you can either work twice as many hours in a week all year or you can donate about half of 1% of your annual income … tax deductible… once a year.
So, on those few days when not everything is going 100% right and a patient may not be 100% happy and let you know it…how would it feel to recall that you have (virtually, yet very effectively) also been working in the developing world that very same day and helping some of the most medically under-resourced patients in the world… who are incredibly appreciative of your efforts?
We are nearing the $1million total donated since inception. Be part of the milestone.
Regards to all
Rob Baume
On behalf of the directors of the Twice the Doctor Foundation