I work in a hospital. Like many doctors of my generation I have spent decades participating in evening shifts, overnight on-call rosters and emergency call-backs. While I remain committed to patient care and to contributing fairly to the service, I have found that after-hours work has become progressively more taxing over the past several years.
I am conscious that emergency departments and hospitals are under increasing pressure, making roster flexibility difficult. Equally, workforce retention may depend on creating sustainable arrangements for experienced clinicians.
Should workplaces in 24/7 industries introduce age-related reductions in after-hours duties, or should roster equity require everyone to continue participating equally regardless of age unless there is a specific health exemption?
Hospital work would be demanding at the very best of times. I can only imagine how much the pressure would increase as you’re asked to work outside ‘typical’ business hours, possibly affected by disrupted sleep. “Taxing” seems like an understatement.
My first instinct after reading your email was that, yes, age must surely come into consideration for hospital administrators. But I have no experience in the area, so don’t want you to take my uneducated notions as gospel. I asked Dr Hongbo Guo, a lecturer and assistant professor in management at the University of Canberra, for his expert opinion.
His response was detailed, and I’ve sent you everything he mentioned. What I think might be most useful for a broader audience is what he told me about the two competing arguments your question raises. The first is informed by what Dr Guo describes as “formal equality logic”.
“Under this logic, fairness is sameness. All doctors should participate equally in night shifts, overnight on-call rosters, and emergency call-backs, unless they have a formal exemption,” Dr Guo explained.
“It has intuitive appeal because it appears as a neutral managerial logic, and it seemingly avoids preferential treatment. The most relevant framework is the anti-discrimination laws we have in Australia, especially the Age Discrimination Act 2004 and state/territory anti-discrimination legislation. The Age Discrimination Act makes it unlawful to treat a person unfairly because of age or age groups in areas of public life, which, of course, includes employment.”
Dr Guo said that the formal equality framework leads to an assertion that there must be no blanket age-based reductions. Why? Because a policy which makes it clear the hospitals think doctors over 50 are too old for night shifts may be unlawful stereotyping.
The second argument employs “risk equity logic”, which is more grounded in work health and safety (WHS) law, risk management and occupational health literature. It treats fairness as “safe and proportionate allocation of a known hazard”.
“Is fatigue a known WHS risk? It absolutely is. Safe Work Australia’s 2025 fatigue Code of Practice explicitly treats fatigue as a WHS risk that must be eliminated or minimised so far as reasonably practicable. Under the Work Health and Safety Act 2011, rostering is part of the system of work.”
It’s important organisations don’t assume that all older workers are less capable of taking night shifts than their younger colleagues.
If we look at your question from a risk equity perspective, Dr Guo said, we’re not talking about a mere personal preference to avoid night work. There is substantial evidence to suggest that age can indeed be relevant to sleep, recovery, health, medication, clinical performance, and even commute safety.
So your claim that night shifts are becoming more challenging is entirely reasonable, and according to Dr Guo, should be treated by management as “a fatigue risk signal, which warrants a proper risk assessment”.
Having said that, is not necessarily the experience of your colleagues, and Dr Guo said it was important that organisations didn’t assume that all older workers are less capable of taking night shifts than their younger colleagues. Apart from anything else, that doesn’t really solve the health and safety problem.
“The logic of risk equity concerns whether the organisation has actually controlled the safety hazard; by letting younger doctors do more unsafe nights, the total fatigue hazard has just been moved from one group to the other.”
Which logic wins? Dr Guo says it would be imprudent to put one ahead of the other; in fact, he suggested that both needed to be read together in cases such as yours.
“Formal equality reminds us not to stereotype by age. On the other hand, risk equity reminds us not to ignore age, not to hide behind equal treatment when the same roster burden creates unequal safety risks,” he says.
Jonathan Rivett is a writer based in Melbourne. He’s written about workplace culture and careers for more than a decade.
