From the medical editor

Dr Roger Sexton

But contagious ‘group think’ that defaults to a ‘woe is us’ mentality can infect the profession. This is labelling doctors as part of the problem and not part of the solution. ‘Struggling doctors who need help’ is a really bad look.

Individual doctors give hope every day to patients. We are trained as excellent clinical problem-solvers and apply these skills to individuals, families and communities. Are we equally effective at solving the bigger problems of the health system and within tertiary hospitals, institutions, organisations and broader society? If not, why not?

It may be that we are an ‘evidencebased’ profession where we expect that clinical research will be adopted in clinical practice. We are also encouraged to be risk-avoidant with a conservative mindset. We are accountable to our regulators and indemnifiers if we choose to practise on the fringe. Unfortunately, this can slow the process of clinical and organisational improvement within the profession and the wider health system.

When it comes to trials of new ways to organise our practices and departments, we are missing in action. Trials of ‘best organisational practice’ with respect to the way we work and manage the ‘service’ aspect of health care are lacking.

care professionals in the care of patients, colleagues and emergencies

• better access to online medical information for doctors and patients

• wearable technology to help monitor and optimise aged residents’ sleep patterns

• a wearable voice prosthesis for laryngectomised patients

• genetic testing for carrier screening and counselling services.

These innovators are action-orientated individuals and organisations that solve problems through innovation, attracting significant investment from others who share their missions.

Trials and research are part of the innovation needed on an ongoing basis. I do not see enough of this in the way the medical profession delivers health care. Research is often at arm’s length from those at the centre of a problem.

How many rural doctors, for example are engaged in research? Is the medical profession looking closely enough at the creative spaces in our world that combine existing ideas into something new that will drive health system solutions and efficiency?

Have you heard that the health system is in crisis at present, with too many insoluble problems?

In a way, allowing this mantra to be re-stated paints health system leadership and the workforce as somewhat dyscopic and unable to offer a solution.

The general public is yearning for health system leadership that is realistic and optimistic, and for reassurance that it will not fall over. Feedback from the UK is that its beloved NHS is close to breaking point. Waiting times to see a GP can be as much as four months. Clapping in the streets has not sustained it.

There is a sense here in Australia that we are not far behind, with signals including our workforce deficits in rural and remote Australia, delayed access to primary care and overloaded tertiary hospitals.

But we do not have to be so constrained or risk averse.

The entrepreneurial view is that taking risks and doing something delivers solutions more quickly. While these sit at a ‘sub-system’ level, this is where successful change starts.

A list of some of Australia’s innovators in the health sector makes for an interesting read. The private sector capital these innovators can attract – basically to fund practical solutions to solve practical problems – is notable. Many solutions sit firmly in the technological space. Examples include:

• hypnosis-based apps to help manage IBS, menopausal hot flushes and smoking cessation

• an online platform to assist chronic pain sufferers

• generative AI that drives a patient simulation platform, to train health

Consider your smart phone (or equivalent) for a moment. It arose from identifying the creative space between and then combining two existing products: the computer and the telephone. It has made the telephone virtually obsolete and changed the world.

We doctors are in very close contact with our communities. We hold precious data that is underutilised and possess a unique understanding of the problems that need solving. However, there are barriers that block the application of our problem-solving skills: time, training in research and data, clinical disconnectivity with universities, and a lack of risk-taking and entrepreneurship.

It is not the time to be conservative when solving the problems of the health system. Boldness is required. Our patients seek and expect from us optimistic leadership that offers hope and better access to high-quality health care.

I hope you enjoy this edition of medicSA

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