The World Health Organisation has outlined what it considers the top issues on the health care horizon for the next decade and beyond. As usual with any large consensus organization, the issues outlined are like spent stars – they were shining brightly once but are probably dead already. Let’s redesign, rename, revamp and reinvest. So , rather […]
Category: Workforce
To keep working healthily and in health care of course. But what doctor would want to work in any health care institution these days? Especially when at least 25% of our practicing time is spent on administrative and quality issues. Sure, some administrative activities, such as patient scheduling or staff hiring, are part of the core activities […]
The monosodium glutamate job is still around. The kind of job that satiates when you are in it …. but half an hour after leaving for the day, you feel empty and wonder, “Why I am still doing that job?” Then the next day you come back for more of the same. Most of these jobs are […]
Last month I presented two virtual sessions at the Harvard Leadership program for women in the health professions. This is a sold-out event, mainly because of the hard work of Dr. Julie Silver and her team. I have been involved for several years and every year I have found the engagement of the audience increasing. Given the […]
Hospitals are full of sick people and not all of them are patients. More and more staff in hospitals are turning up for work that they are unable to do. They are present, but not working at their best, due to the impact of COVID-19 on their health and well-being. Every week there is another […]
Hospitals are full of people sick with CoVID but not all of them are patients. More and more staff in our hospitals are turning up for work that they are unable to do. They are present, but not working at their best, either due to their own health problems, increased CoVID-related workload, or CoVID anxiety. […]
There are still not enough women in high level leadership positions in healthcare to cement change which improves the health inequalities for women. Two contradictions hold back many women who try. These are encompassed in what I call reticence. The qualities of nurturing and maintaining harmony keep women feeling comfortable in the thinking of middle […]
I was recently on a panel discussing Me Too in medicine at the Medical Women’s International Association Centenary meeting in Brooklyn. A female cardiologist who has been seeing a male patient for the past 20 years (he is now in his mid 80s) shared her predicament. Until recently he was well behaved and understood the boundaries […]
What should a clinician wear when consulting with a patient? For many years the answer was simple: a white coat. A long one, if you were qualified, and a short one if you were in training. The white coat symbolized the clinician’s authority; until authority became a non-starter for some clinicians, such as psychiatrists and […]
In an environment where at least one in every two female clinicians has experienced some kind of sexual harassment during her working life, developing educational programs to change the culture don’t and won’t work. There just isn’t enough money or time or will. Besides, too much time and money continue to be wasted in exposing […]
Creating a corpus of effective women leaders is the holy grail of health care. Everyone wants it, thinks it is a panacea, and reveres it almost as much as motherhood these days. Despite a plethora of strategies, the critical mass of women leaders required to ignite enduring change is elusive. In part, this is due […]
The UK and the USA have suffered more than their fair share of clinical crises within their health care systems. In the UK, neonates and the elderly are dying in inordinate proportions in hospitals. In the US, deadly infectious diseases are now carried out of the research labs into the wards of the most prestigious hospitals. More doctors […]
Medicine is a multinational industry no longer defined by country boundaries. Its main product is a workforce. It is time to disrupt our rigid health care so that it can bend For example, doctors now can work autonomously and remotely from their traditional locations for at least some of their work-time. Radiologists, for example, now […]
Under the surface, health care leadership is a stagnant pond filled with ever deepening chasms between the two rival schools – clinicians and managers. Clinical leadership is no longer about advocating for individual patients, especially about expensive interventions and hospital stays where there is little likelihood of these clinical decisions ever being substantiated by research. […]
Violence is endemic in our hospitals. In the US, over half of all emergency room staff are threatened by people bearing weapons at least once in their working lives. It is widely reported in the nursing literature, however mentioned much less in the medical literature. Violent thoughts and actions should be expected – they are […]
Proportionate to the numbers, few women manage break to through the glass ceiling in health care and end up having to both lead and manage from below. In the US, whilst almost half of medical school graduates are women, less one in five of these women have positions as full professors and permanent department chairs. […]
Hospitals are full of sick people and not all of them are patients. More and more staff in our hospitals are turning up for work that they are unable to do. They are present, but not working at their best, either due to health problems or other events that are distracting them or both. It […]
Support medicine based on individuals; not paper. Encourage responsive practice; based on divergent thinking with the ability to converge when necessary. Commit to genuine funding for health, that is, ten percent GDP for ten years from government and private sector. Ensure that hospitals remain places for treating sick people, not making those who treat them […]
Examining bodies is a basic skill for doctors. It is still the first stage in a diagnostic pathway. Nearly every photo we see of doctors has that platinum necklace of physical examination, the stethoscope, swinging from one neck or another. Whilst effective physical diagnosis is universally recognized as essential for good medical practice, there is […]
Health care has a love affair with teams. Everybody wants to be a good team player. Not me. I’m still struggling with the distinction between groups and teams in health care. And I think I want to be a groupie. A lot of health care requires divergent thinking with the ability to converge when we […]
The Thinker 