Editor:  Mellissa Naidoo

What is medical administration?

The first question I am usually asked when I try to describe my job is “What do you actually do in Medical Administration?”

Medical Administration involves the management of a health service or organisation by medical professionals. It is a variable and at times, challenging role that provides an opportunity for doctors to be involved at the executive level. It is a recognised medical specialty with a formal training pathway through the Royal Australasian College of Medical Administrators (RACMA), where for most of us working in the field – no day is ever the same.

One of the nice things about my job is flexibility. I start work most mornings at 8:30am. Having flexible hours is not something you usually get as a junior doctor and I feel particularly appreciative of this today, having got home late from an interstate flight last night. I head across to my little cubicle. It is nice to have somewhere to call home, having previously been used to using any surface to write notes or pleading with colleagues for access to the sparse computers. My boss is the Director of Medical Services at the hospital and won’t be in till 9am (though he is likely to be in till late in the evening), so I’ve got a bit of time to wrap my head around the rest of the day’s activities.

Emails – a daily part of life as a medical administration registrar

I check my emails. My working life now revolves around them. Something I previously quite enjoyed doing in my clinical job (as a 5-minute mundane break), has now become a mountain of work. Keeping track of them requires exceptional organisational skills. I can’t complain though… while I usually clear mine each day, my boss sits on about 600 emails daily. I quickly realise why he needs a personal assistant!

I can also access my emails on my phone, which is both a blessing and a curse. Colleagues can send and subsequently expect responses at all hours and sometimes it can be hard to completely switch off at home – as you perhaps would from clinical shift work.

Why I chose a career as a medical administration registrar

So why Medical Administration? I get asked this on an almost daily basis. I saw this role as an opportunity for change, and an opportunity to make things better for junior doctors and the hospital overall. I came into a role that no one had ever done before. It was a whole new world. My boss has been great and has given me the ability to focus on issues I genuinely care about: junior doctors and medical education.

Dealing with doctors in difficulty

Part of my role involves closely working with the Postgraduate Medical Education unit to deal with doctors in difficulty, identifying them early on, discussing ways we can help them and encouraging them to access resources available. About 95% of doctors going through the system will have no issues, but about 5% may need assistance. These doctors usually have precipitating factors to their issues.

I think the important thing for them to remember is that we’re here to help and not hinder their career progression and that we are all working towards the same goals of optimising patient care. The difficulty can be when the doctor in question lacks insight into their own issues and so we must be careful on how we broach the topic. I find the conversations we have with them fascinating, though sometimes challenging; as I can relate to their experiences as a junior doctor on a personal level.

The issues can be so varied. For example, one day I could be dealing with a complaint, another day focuses on issues with AHPRA (the health professional regulatory body) around a doctors’ requirements for registration and the next, trying to resolve conflict between a junior doctor and other staff members when and if they occur.

Roster issues

Another aspect of my role is dealing with rosters, which continue to be a point of contention for junior staff. Luckily the hospital I work at gives that role to consultants who have worked in junior roles before. Unfortunately, junior doctors often feel unable to directly confront their seniors about issues in the roster, so I often act as the negotiator. I meet up with some Medical Registrars to discuss their rosters. The night and after-hours roster are particularly problematic at present and there are plans to change it for the next group of registrars. After discussions with registrars and consultants, back and forward, it appears we finally reach agreement on how to fix it for everyone’s benefit – to minimise the amount of sick calls, burnout and fatigue.

Consultation

In my role, consultation is so important. Everyone has their own preconceived ideas about how things should work, but reality can be so different. Making sure you ask all relevant parties how a change could impact them is vital if you want them to actively embrace the change. Unfortunately, this can take time and often holds up implementation of innovative ideas. It has taught me patience is a virtue and persistence is key.

Achievements as a medical administration registrar

You can see small but tangible changes that make your work satisfying and it has made me appreciate there is a lot of work that goes on ‘behind the scenes’ to enable hospitals to function.

During my time as a Medical Administration Registrar, I have helped to form a Junior Medical Officer Society, facilitate a training agreement between my hospital and a GP training provider; and run a Research Skills Workshop. I have helped put together a new Orientation plan for junior doctors, to ensure they feel adequately prepared coming into a new hospital environment. Other days I have spent visiting hospital sites and talking with junior doctors to determine if their hospitals met state accreditation requirements and offer recommendations on how things could be improved to enhance the experience, supervision and education at that site.

The career path for medical administration registrars

I am lucky to be in a position which encourages innovative ideas and provides the opportunity to make them happen. The career trajectory for someone in my position is dependent upon the interest of area but can go on to a whole variety of positions including Director of Medical or Clinical Services, Medical Advisor to a health insurance company (e.g. Medibank Private) or Chief Executive Officer of a hospital or large health network. As someone who is fascinated by business opportunities as well as clinical opportunities medicine has to offer, it is an exciting career path and one to consider for all those looking to make changes to the system as a whole.