Donning the legendary white coat, rushing to revive the cardiac arrest in a single bound, curing the incurable and saving the world one patient at a time, are heroic pursuits that most doctors dream about when they graduate from medical school. I know I certainly did!
But sadly, as with most superhero fantasies, one wakes up to find that reality does not care for idealistic notions, that healthcare challenges are very real and we as medical practitioners are often powerless to alter the course of disease and death. And the reality also plays out in a health system that is still very much less than ideal, often with inefficient systems and processes that may not always allow doctors to achieve the ultimate aim – provide the best possible care for patients.
These are frustrations that are frequently felt across the medical industry and certainly no different to what I faced, even as an intern. This conundrum of wanting to provide the highest quality of patient care but being constrained within limitations in systems or processes is what may prompt many young doctors to consider specialising in a somewhat novel field of medicine – medical administration.
It is here that we first encounter the crux of what medical administration and medical leadership is really about. Medical administration and medical leadership links the provision of high quality clinical care with that which ‘enables’ the provision of high quality clinical care. It is the planning, the coordinating, the directing and the managing of systems that are then actually conducive to providing the highest possible level of patient care.
It is the capacity to impact patient care on much larger and broader scales that can go well beyond the treating of individual patients.
More broadly, medical management is a specialisation pathway for those of us who see ‘the wood for the trees’ and see how efficiencies in systems and processes can be achieved, specifically where the greatest cost-benefits may be realised, and gaps in clinical outcomes can be bridged. It is for the truly visionary leaders among us — those who are not afraid to constantly challenge the status quo and those who may passionately (or secretly) yearn to steer the direction of the proverbial ‘ship in stormy seas’.
These were certainly reflections that influenced me in pursuing a career in medical management. The Royal Australasian College of Medical Administrators (RACMA), as well as an abundance of literature, avidly espouse that the medical and clinical knowledge, skill and judgement of medical practitioners are absolutely essential and beneficial in administering/managing a hospital or a health service. This knowledge, skill and judgement are essential in developing health operational policy, planning, purchasing and strategising for the delivery of health services.
Strong clinical management is necessary to handle emerging healthcare challenges, ensure that we have a safe and equitable health system and above all, to sustain the future viability of Australia’s health system itself. I absolutely agree with each and every one of these sentiments. They are the foundational beliefs upon which I entered this new and intriguing field of medical specialisation.
More often than not, one may enter this profession with the false expectation that it will be ‘a cruisy job’; that they can escape waiting rooms filled with patients; be expected to only work regular office hours; and that pressures of clinical accountability will be a thing of the past. This is most definitely not the reality of medical administration.
The day to day life of a medical manager is in fact not much different at all from those of our solely-clinician counterparts. In fact, the pressures faced by a medical manager can at times be substantial, owing to the large cohort of patients and doctors for whom we are responsible.
As a medical manager, you are required to be on-call 24 hours a day in dread of potential catastrophic hospital system failures; be accountable for the actions of thousands of senior and junior doctors; oversee multimillion dollar budgets; and continually liaise with, negotiate and quell dissention among multiple stakeholders (often those who have competing vested interests).
Consequently, in addition to clinical knowledge, a great deal of maturity, emotional intelligence, adaptability and problem solving skills are essential for succeeding in this field.
So, despite the fact that a career in medical management can very much be termed a career in ‘chaos management’ or that many of my own clinical colleagues continue to perceive it as a transition to the ‘dark side’, intelligent medical management can actually revolutionise the future of how healthcare is delivered. It has the capacity to impact the health and safety of patients on greater and grander scales and enable the realisation of visionary leadership. It could possibly even be our best chance of really saving the world, not just one patient, but one policy at a time.
Dr Singithi (Sidney) Chandrasiri