Medical practice is characterised by taking responsibility for overall clinical outcomes.
As a result, doctors are uniquely placed to take on leadership roles, including management and leadership of health services and in the wider management and leadership of the organisations that they work in. In doing so, most remain in active clinical practice.
Doctors can make a significant contribution to the effective and efficient management of public and private hospitals. Doctors can contribute to better management of health costs, while ensuring quality patient care and outcomes by being involved in decisions about resource allocation and the purchasing of services for the provision of patient care.
Involving doctors in hospital decision-making in a meaningful way is not dependent on the policy and administrative structures themselves; it depends on a genuine willingness of governments, administrators and doctors to engage and value each other’s expertise and input.
Doctors’ concern with clinical standards, outcomes, effectiveness and audit mean that their routine practice works continuously to improve the quality of healthcare.
In many cases, because of their continuity in their clinical positions and subsequent deep understanding of the needs of the local community, their hospital and their patients, doctors offer the necessary knowledge and continuity required to improve services and the care of patients.
Their role of advocacy for patients and communities who may be disenfranchised or powerless is vital in contributing to improving health and wellbeing outcomes.
If the expertise and clinical judgment of doctors is not part of hospital decision-making, it will be to the detriment of safe and quality patient care.
WA leads the way
In Western Australia, implementing the “Four Hour Rule" by taking a whole-of-hospital approach to share the responsibility for, and help solve the problem of, overcrowding in emergency departments led to better communication between emergency departments and the wards. Western Australia leads other states on performance against this target.
Doctor engagement with healthcare does not start and stop within the hospital.
It is essential that local doctors participate in and inform decisions about healthcare in their area. The demographics and healthcare needs of populations differ between areas and drive the types of hospital and other healthcare services that need to be delivered.
Governing bodies making decisions about service planning and patient care must ensure that local doctors and other allied healthcare professionals who provide healthcare in the community and in aged care residential facilities are engaged in this decision-making process.
Doctor engagement in decision-making can take the form of local general practitioners attending medical advisory group meetings for hospitals in that area; and local hospital doctors being represented on bodies overseeing the management of primary healthcare in that area.
This would ensure that care provided in hospitals is integrated with primary healthcare and aged care and that local GPs and local hospital doctors share information important to providing patients in the local area with better integration of in-hospital and out-of-hospital care.
Strong partnerships between different parts of the healthcare continuum will result in better patient care.