I am beginning to wonder if rudimentary training in economics ought to be included in medical training. I had always thought of myself as economically fairly innumerate, but some of the ideas expressed in the medical press have no contact with economic reality except in a parallel universe with free money.

The first example is doctors in training expressing concern that their income will fall as their hours of work reduce (well excuse me while I hold the front page: hadn't anyone noticed? ). This has prompted demands for a considerable increase in basic pay, coupled with a large rise in the banding supplements for work in addition to the basic 40hour week, so they can maintain their income in the face of reduced working hours.

We have moved from the average junior doctors' hours being in the order of 80-90 per week or more to 48 hours per week maximum in a few years' time. This has prompted a major expansion in junior doctors' ranks, a near doubling of staff. To maintain salary levels would add several million pounds to the expenditure of most hospitals, pushing many to bankruptcy. There can be no other group on the planet who can negotiate an approximate halving of workload while demanding pay protection.

The second example is the furore over changes to NHS pension arrangements, which seems to have angered many doctors. Many believe the changes in the consultation document take effect almost immediately, and there has been talk of a consultant walk-out. In fact, they only come into effect in 2013 and are not retrospective. Any doctor over 52 who wishes to retire at 60 will not be affected, and those who are younger only if they are not on top of the salary scale at 2013.

There will be significant effects on those who will spend much of their career accruing pension under a career average scheme after that date, but by then there will have been plenty of warning.

Appeals for the present pension arrangements to be maintained again ignore the economic realities.

Our population, including doctors, is living much longer. The ability of the state to fund pensions - maintained at today's levels - indefinitely is limited without massive tax rises. I have not seen requests from any doctors for 50 or 60 per cent tax rates.

The third example is the new consultant contract. I continue to be invited to meetings to discuss benefits realisation when what is required is damage limitation. How have we managed to provide a 15 per cent pay rise while producing so much discontent?

Doctors are generally selected on the basis of intellectual prowess, which surely includes the ability to perform simple calculations.

Money for the NHS does not come for nothing, but it seems we have failed to explain this adequately to the highest earners in the NHS.

John Coakley is medical director of Homerton University foundation trust.