Leadership, medical engagement and junior doctors Essay Example

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2.2.The importance of medical engagement and leadership skills

Rapid change in the healthcare environment provide many challenges and complexities, in which has prompted current health systems, organization, health professionals, and educational bodies to explain more intelligently what are the necessary skills to be a fully competent physician. Therefore, to tackle such difficulties, it is important to escalate the clinical leadership trainings throughout medical professions (Clark & Armit, 2010).

Medical leadership is a vital part of the current health reform in various countries. It plays an important role in improving health care delivery including quality, safety and value, in which rely on physician active engagement (Clark, 2012). According to Hamilton et al., (2008); engagement refers to doctors being actively involved in the management of health services; this may include planning, development, distribution and revolution of services (cited in Greening, 2012).

Baker and Dennis (2011) also proposed similar point of view:

[…] Transforming health care organizations to improve performance requires effective strategies for engaging doctors and developing medical leadership. Most efforts in the US and UK to develop medical leadership have focused on structural changes that integrate doctors into administrative structures, but these have limited impact. Recognizing the distributed and collective nature of effective leadership, some health care organizations are attempting to create greater alignment between clinical and managerial goals, focusing on improving quality of care (Baker & Denis, 2011 p.355).

Supporting this argument, Bohmer (2012) has described the importance of leadership skills and behaviours amongst practicing physicians to improve overall health system performances; he argues that since the processes and micro-systems are largely controlled by physicians, without these leadership skills, their intelligence alone is inadequate to produce good patient outcomes (Bohmer, 2012).

One approach of improving leadership skills in junior doctors is engagement them in training forums such as workshops to be trained on non-clinical skills like resource management, communication, conflict resolution as well as decision- making. This can help junior doctors to have the necessary leadership skills and emotional intelligence to even make complex decisions amidst limited information and stressful situations (Chadwick, 2013). Ongoing learning is one form of approach that can impact leadership skills on junior doctors. Junior doctors can be encouraged to keep journals of their experiences and utilize them as source of reflection in improving care. Studies suggest this is important in improving the confidence of junior doctors to indentify matters that require improvement as well as direct patient benefits due to improved safety (Chadwick, 2013).

According to Chadwick (2013) junior doctors can be trained to be leaders through “pace-setter” leader ship style from senior doctors where the junior doctors also get engaged by the “pace-setter”. This form of training is characterized by leaders laying down demanding targets to the junior doctors, delegating leadership roles as well as leading from front. This leadership style puts emphasis on teamwork, collaboration and removes communication barriers. This leadership model challenges the status quo and therefore the ideas of junior doctors are listened to, valued and at the same time innovation and entrepreneurship are prompted. However, this approach brings some challenges due to the skill and risks involved and the likelihoods engagement brings (Chadwick, 2013).

2.3.Junior doctors and quality improvement

In the health care system today, the recognition of the roles and contributions of junior practitioners in rectifying current health care system is slowly emerging. However, acknowledging this potential could involves shifting general perceptions, history and traditions (Ibrahim, Jeffcott, Davis, & Chadwick, 2013).

Traditionally, the senior doctors were the key factors of the quality and safety of medical services; they are usually seen as leaders due to their experiences and knowledge within the industry (Scott, 2009). Whereas, junior doctors were often seen as a “high-risk’ group or group of amateurs with lack of experience, receiving insufficient supervision, elevated stress levels due to coping with bullying and nothing of value to offer (Grant, 2011).

In Australia, junior practitioners or junior doctors may be an intern, junior house officer, and senior house officer – first year, second year, and third year post-graduation respectively, and is employed by hospital or general practice under the supervision of senior medical specialist (Martin, Laurence, Black, & Mugford, 2007). A recent study suggested that, by encouraging junior doctors to practice in various clinical areas; including general practice, it is not only offer them a better clinical skills, but also good understanding on how services interlink or how important transitions are (Martin et al., 2007).

Studies have shown that a better engagement from junior doctors in running hospitals provides better results (Ibrahim et al., 2013). Although, there is a lack of concrete evidence and poorly described – predominantly due to contrast to their limitations, when junior doctors enter clinical practice, the offer a unique set of attribute, this include: “a beginners’ mind, heterogeneity of values, contemporary knowledge, skills from non-medical disciplines, the peripatetic nature of their role, their presence at the front-end of care, and non-threatening position within healthcare teams” (Ibrahim et al., 2013 p.275);these attributes subsequently need to be utilized to improve patient safety and quality of care immediately, as waiting for them to become a medical specialist or senior is needless and wasteful. Additionally, it is also a counterproductive as some of these traits are usually lost as they progress to become specialists (Ibrahim et al., 2013).

Ibrahim (2012) explains that junior doctors bring a “beginner’s mind” which means they bring a fresh perception to a situation. This is a vital capability to recognize and question practices that are long-standing yet invalid, and to offer substitute approaches to the situation. In addition, junior doctors bring values and belief system that are still not homogenized into the current organizational culture and this helps the organizations in identifying the sub-optimal practices. Still, junior doctors bring enormous knowledge including all the benefits of latest medical school curriculum developments, for instance high attention to formal self-reflection, inter-professional communication, as well as strictly adhering to error-monitoring processes and practice standards (Ibrahim, 2012).

More importantly, junior doctors are the leading edge in the implementation of the clinical diagnostic and management decisions. This is because they effectively comprehend and possess the actual experience regarding the difference between how management and senior medical personnel considers the organisation and the operation of the organization in reality; junior doctors make diverse contributions at various points during their training, on viewing the system for what it is to being able to tackle and make improvements on the system afterwards (Ibrahim, 2012).

Apart from the nursing personnel, junior doctors spend a lot of time with the patients and their families and hence they formulate a detailed and whole picture of the medical and psychological requirements of the patient. In addition, junior doctors give the daily continuity of care (Ibrahim, 2012). Finally, the peripatetic position of junior doctors offers an opportunity for valuable knowledge transfer within and between services and sites and this helps in bridging professional subcultures and information gaps. These attributes are the ones that enable junior doctors to make great contributions to patient safety as well as improving the quality (Ibrahim, 2012).

References

Chadwick, L. (2013). Recognizing junior doctors’ potential contribution to patient safety and health care quality improvement. J Health Organ Manag.
27(2):273-86.

Ibrahim, A. (2012). Junior doctors’ contribution to patient safety and quality improvement. Victoria: State of Victoria.