Medical Leaders

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Medical leaders

Dr David Rankin
Senior Advisor Child, Youth and Family

Medical leaders are an integral and vital part of an effective health service. While mainly engaged within health service delivery organisations, they are also critical to the formulation of effective health policy, governance of clinical practice, health service purchasing and the monitoring and reporting of health outcomes.
While not directly involved in the diagnosis and treatment of patients, it is the clinical skills and knowledge inherent in medical training that separate medical administrators from health service executives. In making day to day decisions

in health service management, the medical leader is applying their clinical knowledge to assess the impact, risk and clinical outcome of decisions. It is the role of the medical leader to apply clinical medicine to the development of policy, strategy, service design, behaviour change and determining effective clinical outcomes. The focus, orientation and language of the clinician are very divergent from that of the health service manager or executive. Yet for a health service to function effectively and efficiently, these two groups must work collaboratively. It is the role of the medical leader to bridge this gap in orientation and interpret the impact of change across the divide.
December 2011

CliniCian
Patient Focus Clinical Outcomes Patient Safety Clinician Performance Risk of Harm to patient Patient Need Evidence Based Practice New Technology Patient Satisfaction

HealtH exeCutive
Service Orientation Fiscal Outcomes Organisational Risk and Assurance

MediCal leader

Organisational Performance Media and Reputational Risk Ministerial Priorities High performing, peer organisations Facility maintenance Data collection and reporting

To be an effective clinical leader a doctor must possess a range of skills and competencies that are not taught at medical school. This body of knowledge should include an understanding of health law, health economics, health care financing, health care organisation, human resource management and the management of change in a complex organisation. Unless a clinician is fluent in the language of executive management they face a very real risk of frustration and marginalisation from strategic decision making. The Bristol Royal Infirmary enquiry reinforced the principal that practitioners working outside direct patient care still have a duty of care to the patients within their health service, and that they must ensure the effective and competent delivery of health services by clinical staff for whom they are responsible or associated.

In Australian and New Zealand it is the Royal Australasian College of Medical Administrators (RACMA) which is the recognised body that defines competence in medical leadership, providing training and offering ongoing professional development to medical practitioners who have moved into clinical leadership as their chosen medical specialty. There are a plethora of didactic learning opportunities that are available to assist the clinician gain knowledge in the science of leadership, however the attainment of competencies in clinical leadership requires practical workplace based problem focused learning accompanied by a structured mentoring programme. It is this practical supervised experiential programme that RACMA provides. The College expects the competent medical leader to be able to: Articulate a clear vision Lead teams to drive improvement in service quality and safety

December 2011

Engage constructively and effectively with management and planning functions Maintain a contemporary knowledge of health and management issues Manage a high quality clinical service in an environment of limited resources Maintain strong professional and ethical standards Encourage and assist with the education and research activities in health Fellowship with RACMA offers specialist registration in medical administration with the Medical Board of Australia and the Medical Council of New Zealand.

To be an effective clinical leader a doctor must possess a range of skills and competencies that are not taught at medical school. This body of knowledge should include an understanding of health law, health economics, health care financing, health care organisation, human resource management and the management of change in a complex organisation.

December 2011

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