Malcolm Forbes

THERE are a number of well known challenges facing our health system, including the increasing burden of chronic illness and the rising costs of health care.

To ensure there is a judicious clinical perspective on innovation, patient care, efficiency processes and resource allocation in the health system, doctor involvement in health management and leadership is vital.

Recently, we witnessed the ongoing doctors’ dispute with the Queensland Government, which threatened to affect patient care.

The government proposed changes to senior medical officer contracts that would have taken them from a collective agreement to individual agreements, challenging clinical autonomy and undermining basic workplace rights and conditions.

Although talks between the government and the doctors’ representatives appear closer to resolution, there continues to be a possibility that the dispute could evolve into a serious workforce crisis, with a number of senior doctors still expressing their intent to resign or reduce their working hours in the public system. The potential loss of experience has major implications for health care available in public hospitals and the teaching of junior doctors.

The collective and concerted action of the Queensland doctors has been a major contributor to the movement towards resolution. The level of collegiate support during this debacle has been both unprecedented and inspiring.

Many doctors without formal leadership positions demonstrated impressive leadership behaviour. Those with an aptitude for organising and mobilising shone in the workplace and in social media.

It is this collaborative leadership approach that we must harness and encourage, especially within the field of health management, to avoid further crises in the health system.

In addition to greater doctor involvement in health management and leadership, we believe that these strengths in areas outside traditional clinical practice may serve to strengthen advocacy and lobbying for the health of Queenslanders. This may also increase the mutual understanding between doctors and government officials.

The Australian Medical Council’s Good medical practice: a code of conduct for doctors outlines the principles that characterise good medical practice, including the professional obligations of doctors to safeguard patient care and act as stewards of the health care system.

For the next generation of doctors to function as effective stewards of the health care system, skill diversification will be beneficial. It is not enough for our medical leaders to focus exclusively on the mastery of highly technical clinical knowledge and skills. For health advocacy to flourish, doctors must also develop their skills in public health, and in legal, political and business leadership and management.

There is evidence to suggest that when doctors are engaged in leadership, hospitals and health services have improved performance, including quality improvement and lower rates of morbidity and mortality. In an era of increasing bureaucratisation of health care, the role of doctors is paramount.

If the medical profession is to address current and future health priorities and challenges, we must encourage and foster engagement in areas beyond clinical medicine. Promoting doctor involvement in health leadership is possible through innovation and investment in educational reforms.

Promisingly, we have witnessed positive developments in this area, with all Australian specialist medical colleges adopting the Physician Competency Framework, which recognises both clinical and non-clinical skills, including management and health advocacy competencies. A number of structured education programs also exist. However, an ongoing paradigm shift is needed to acknowledge the growing importance of workforce diversification.

We encourage our colleagues to develop and utilise their skills in health leadership beyond clinical medicine to safeguard and further enhance Australian health care.
 


Dr Malcolm Forbes is a medical registrar at The Townsville Hospital, NHMRC Postgraduate Scholar, and adjunct lecturer in the School of Medicine and Dentistry at James Cook University, Queensland. Dr Harris Eyre is a psychiatry registrar at The Townsville Hospital, a 2014˗15 Fulbright Scholar and is undertaking a PhD in preventive psychiatry at the University of Adelaide.