How do we heal our healthcare systems?

In this business podcast, Australian trained obstetrician and gynaecologist Dr Simon Craig will be discussing the topic of ‘how do we health our healthcare systems?’, including the indicators of a struggling system at present, how we got to this point, the impact on the hopsital and general practice system, what makes an effective healthcare team and more.

  • Transcript
    Please note this is a machine generated transcription and may contain some errors.
    *As always, all in this PODMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.

    Today I’d like to welcome to the PodMD studio Dr Simon Craig

    Simon is an Australian trained Obstetrician and Gynaecologist, with a special interest in culture optimisation in healthcare. He also provides coaching services to doctors and healthcare leaders.

    Simon completed his medical degree at the University of Melbourne and specialised in Obstetrics and Gynaecology. He practiced In Albury-Wodonga and was head of the Unit from 2007 – 2022. Simon followed his interest in the science of wellbeing with a masters of applied positive psychology at Melbourne Uni and has now moved into coaching and culture optimisation in healthcare. He is the author of a new book ‘From Hurting to Healing – delivering Love to Medicine and Healthcare.’

    Today, we’ll be discussing the topic of ‘How do we heal our healthcare systems’?

    *We do hope you enjoy this podcast but please remember that the advice here is of a general nature and is not intended as specific advice about a given patient. The views and opinions expressed in this podcast are those of the doctor, not PodMD.
    If you do have a patient on whom you require specific advice, then please seek advice from a colleague with appropriate expertise in that area.

    Simon, thanks for talking with us on PodMD today.

    Simon : Thank you for having me.

    Question 1
    The topic of today’s discussion is ‘How do we heal our healthcare systems’?. Simon, can you describe for our listeners the reasons for writing your latest book?

    Simon: Yeah thanks. I wrote the book because I was starting to reflect increasingly over a couple of years on why our systems were struggling and why some individuals were struggling and others didn’t seem to be, and why some teams seem to be thriving and flourishing and others didn’t. And I increasingly started to wonder whether we there were elements that created a good state of affairs or a bad state of affairs, or was it just luck that you were either in a good team or a bad team, or that you had issues on an individual level? And if there were elements that we could identify that helped with teams and individuals, let’s identify them and let’s implement them to help those things. So I started to research that and I couldn’t really find the answers I was looking for. So I realised I had to research it myself and look into these things, and the books resulted from that trying to identify how we can improve systems and improve it for not only patient outcomes but also healthcare workers and those within the system

    Question 2
    What are the indicators that we have a struggling healthcare system at present?

    Simon: I think we all know that we have our healthcare system challenges. We all see the news and we all read the stories in the paper about blowing out waiting lists for surgery, ambulances lined up outside emergency departments, and difficulties getting in to see doctors and lengthy wait times. And we also hear about nurses leaving the system in record rates and we hear about record rates of burnout in doctors as well. So we hear about individual struggles as well as system struggles, so I think it’s quite clear. And for those of us within the system, there is just this this knowing that things aren’t as good as they could be and that lots of us are bearing up under duress and there’s a lot of inefficiency in the system, and I think there’s a common knowledge that that we could improve things.

    Question 3
    What are the risks with this?

    Simon: Yeah, so ultimately a straining healthcare system affects us all as individuals, we’re all patients occasionally, it affects our communities, it weakens society. So, a difficult healthcare system and healthcare system challenges will worsen patient outcomes eventually. We know that burnt out doctors and nurses don’t treat patients as well, and there’s greater error. I think a thing that we need to address urgently is the well-being of healthcare workers. So, doctors, nurses, other clinicians, other workers in the system. That’s some that’s becoming a pressing issue and a pressing concern that I think we do need to give attention to quite quickly.

    Question 4
    Why do you think we are at this point, and is it a crisis?

    Simon: So the problems have built up over a long time, over many years. We all thought things would improve when COVID largely finished. And there are ongoing challenges, things haven’t completely improved and that’s probably appropriate because the challenges were starting before the COVID pandemic began. And I think it’s come about, through over many years with many different decisions and many systems that have served us well, but they’ve become a bit unwieldy.

    Question 5
    What can we do to rectify the situation?

    Simon: Well, the same healthcare system challenges that are occurring in Australia are occurring throughout the world. The same problems with great demand for resource and effects on people, burnouts an issue right around the world and everywhere around the world lots of smart people have tried to fix the healthcare systems, without any great success. And with all of those smart people trying to fix it, and no success, it probably means that we can’t just keep doing the same things. And perhaps we just need a complete paradigm shift and we need to approach the healthcare challenges from a different viewpoint.

    What’s happened? What has worked for us before isn’t working anymore, and it’s probably time to approach this as an opportunity to reimagine the whole system. Do things in a little bit of a different way. The first step might be just to simply acknowledge that we have a significant problem. And by admitting that we have a problem, and rather than denying it or overlooking it, or just continuing down the same path, we might be able to rebuild things differently in a way that serves us as the healthcare workers, our patients, and our communities in a better way.

    Question 6
    Are we only talking about the hospital system or is general practice affected?

    Simon: I think all elements of our healthcare system are affected. General practice is certainly affected. The visible stories on television and in the newspapers often relate to hospitals, but general practice is struggling too. There’s been a lot of demand on general practice throughout the years, both from an administrative and regulatory point of view. Less people are going into general practise. It’s harder to own or run a general practice. There’s challenges every day with that.

    And GP’s are doing it tough and they are the foundation of our healthcare system. Without an effective general practice, the whole healthcare system will fall over. So we really do need to look at general practice but we look need to look at whole system changes rather than looking at different elements at a time. We need to do it holistically and the whole of the healthcare system needs to be addressed at once and collaboratively.

    Question 7
    Can you describe the effects of burnout on healthcare professionals?

    Simon: So burnout affects healthcare professionals in many ways. It clearly is an occupational phenomenon that affects them with psychological distress, and it’s linked to substance abuse, depression, even suicide. But it also reduces our work capacity and the quality of our work and our enjoyment of work and there are spillover effects into relationships, outside work and family. The reason that burnout occurs it very a very complicated problem and some of that is overwork and some of it is work demands and some of it is fairness and not feeling valued and feeling a type of moral injury.

    All of those things are are, are, are definite contributors. One big contributor I think in our system at the moment is the proliferation of red tape and bureaucracy and bureaucratic demands from all sorts of areas, and that’s a type of work that when it doesn’t feel to be relevant or important, it seems to devalue a clinician’s time. And one thing that that the system, that our healthcare systems could do at all levels, general practise hospitals, is to try to cut back on unnecessary red tape and bureaucratic demands and that might be a really good first thing to do to try to improve the health of our workers. Before we look at other elements of the system.

    Question 8
    What makes an effective healthcare team?

    Simon: Yeah. An effective healthcare team not only produces increased performance. But it actually gives us each of us as individuals, it gives us a lot. It gives us increased well-being. Health is really a team sport. It’s not an individual sport. So although we might see a patient as a one-on-one, really we rely on a team and we have to look at it from that point of view. In sports they say that winning teams are happy, but I dispute that. I think happy teams become winning teams. And what creates an effective team? Well, it’s all about human relationships and it’s all about how we interact with each other, how we communicate the ratio of positive to negative comments is really important. We know that that that the greater the ratio of positive to negative comments, the better our relationships are. And the better we perform and we all perform better, when we feel good and we feel connected, we know that.

    Unfortunately, today, a lot of our organisations, we hear things about loneliness, isolation, low psychological safety and these are all things that that indicate a poorly effective team or a team that’s not bonding together and where people aren’t feeling that they belong. So, creating an effective team really relies on relationships talking to each other, having some affection for your teammates, treating them as friends. Because even if you don’t think you need them at the moment you will need them one day and. It’s good to sort of have that strong group around you and it’s better for our patients. So, it’s better for us. It’s better for the patients. How does it start? Probably just the way you talk to each other on a day by day basis and how we say hello. And engineering ways that we can meet as a group and as a team socially and do things around team building even though it doesn’t have to be so formal. It could be just having lunch together.

    Concluding Question
    Thank you for your time here today in the PodMD studio. To sum up for us, could you please identify the key take home messages from today’s podcast on ‘How do we heal our healthcare systems’?

    Simon: Yeah, well, there’s a lot in that question and its that’s taken a whole book to think about it and to address these issues. I think we have to admit that we need to come together and look at this problem from a number of viewpoints to address the issue and we need to collaborate and general practice and hospital systems and all of our other medical systems need to be involved in that discussion.

    From the point of view of general practice, I think that any GP’s that are struggling will probably have colleagues close by who are struggling, and maybe it’s maybe we need to admit those problems to ourselves and our teammates and we might be able to help other people. And also I think we need to remember and commit to our mission that what we do is really important. We’re looking after people’s health and we’re caring for other people and that’s really important. And putting aside the other challenges, that’s something that we really should be proud of. The job that GP’s do for the community is critical. As we’ve said, it’s the foundation of healthcare. We do need to get that right and perhaps starting with our own health is a really good thing to do before we look at the health of other people.

    So I’m very interested in organisational culture and healthcare culture and how we can optimise. That and I’m interested in working with. Healthcare leaders and team leaders to produce their both their best teams. So that’s the work I do and I’m also involved in individual coaching for doctors. So if anyone’s got any interest in in any of those issues, please reach out to me. My website is POS Med P-O-S-M-E-D dot com dot au, I’d love to hear from you and have a chat. Thank you.

    Thanks for your time and the insights you’ve provided.

    Simon: Thank you

*As always, all in this PODMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.