Apparently horses can sleep standing up with their eyes open. Now here's what really aggravates me: all the other people in the hospital, who aren't doctors, but who look after the same patients as me, go home at five every day. Occupational therapists, physiotherapists, speech and language therapists, clinical nutrition specialists, ward clerks, x-ray secretaries, social workers, phlebotomists: with a few honourable exceptions, they are very careful to make a sharp exit. They plan their day around it. It wouldn't occur to them to stay, like I do, until half six, often beyond eight, until the patients are sorted.

Once they leave the building, bang on time, two things happen. Firstly, if the job they would have done is urgent, and if it is within my power, I stay behind even longer to do it myself. Alternatively, if the job wasn't urgent (for example, a home visit to assess someone for services), the likely upshot is that the patient languishes in hospital for another day or two, increasing their daily chance of catching a hospital acquired infection that will knock them for six and be resistant to antibiotics, and denying the patients who are sleeping on stretchers in the corridors of casualty a safe and comfortable bed on a ward.

Now there are many reasons why junior doctors are made to feel guilty about complaining about their long hours. The therapists who I listed above will tell me that I chose the hours when I chose the job (when I was at school aged 17, I suppose) and implicit in much of what they say is that I reap society's adulation and future financial rewards, and so I deserve to work myself into a psychiatric diagnosis. When they say this after I mention how awful I'm feeling on three hours sleep, and just as they're going home and telling me about the things they've "not been able to fit in" that day, it seems a tad insensitive, but maybe they have a point, and maybe they feel undervalued.

Consultants, who worked even more bizarre hours in their day, will tell you that doctors need to accumulate clinical experience for their professional training, and given the nature of disease this takes time. This would all be very well if I spent my time practising clinical medicine, but as I may have already mentioned, in the daytime on the wards (as opposed to when I'm on call) I am a paperwork clerk, a machine for processing forms, a robot for carrying them from A to B, a St Bernard for seeking out lost x-rays in the radiology department, and a mobster's enforcer for bullying social workers into sorting out my patients.

None of these learning opportunities will help me get my membership of the Royal College of Physicians in two years time. I love being on call, even all night. I would dearly love to work as a doctor, day in, day out, to absorb myself in the healing arts. If you took out all the parts of my job that should be done by someone else, and left me just doing the doctor stuff, on some days I'd be home by lunchtime. Then I could leave work early after a night on call. Or you could give me more patients to learn from. Either would be great.

But there is another, darker reason why we have to work such long hours. Just as the other health professionals in the hospital know that they can ultimately rely on doctors to sort out the patients if they'd rather go home on time, so do the managers of the hospital trust. Why on earth would an organisation like a hospital, run by managers, want to employ an extra ward clerk, or a phlebotomist to take the bloods, for five pounds an hour, when a doctor will stay late and do it for free? Any organisation faced with such a priceless opportunity would be obliged to rip us off.

So up and down the country this week, small conspiratorial bands of junior doctors were crouched in their squalid underground bunkers (sorry, I mean hospital accommodation) filling out their "banding questionnaires" to determine which pay scale their job will fall into. I don't know anyone who won't fall into the top one (more than 56 hours a week), although I know about plenty of hospitals that are trying to bribe and bully their doctors into lying on the form.

Doctors will continue to work their ridiculous hours, albeit on higher pay, but ultimately the positive outcome will not be an improvement in their own personal finances: it will be a restructuring of the work that junior doctors perform. Because, since the pay for each band increases exponentially in relation to the lunacy of the workload, doctors will suddenly become a more costly resource than other staff (representing also the financial burden to the country of training one). And an overworked doctor will cost more, per hour, than two happy doctors. Doctors will finally get the deal they deserve, simply because cashflow is the only language that hospital managers will understand.