Improving working lives for doctors - part two
Q: What can doctors do to increase their job satisfaction?
A: Accountability isn't going to go away, so one thing doctors could do is find ways to concentrate on what they are good at and what they enjoy, which will usually be clinical work and patient care - and find someone else to do the things they are less good at and enjoy less. GPs are particularly well placed to do this. They can bring in proper managers to manage the practice, under their medical direction. GPs have a big advantage here in that they would be employing the managers rather than vice versa in the hospital system.
I'm talking about managers here, incidentally, not administrators - people who can help work out what the different people in the practice are good at and help them play to their strengths, who can look ahead as well as ensuring things run smoothly on a day to day basis and who are genuinely concerned to help the practice deliver a better medical service to patients. There are some good managers out there who don't want to work for the big corporates but would rather use their skills for the public good.
Q: I can see how that might work for GP practices - but what about hospitals?
A: Hospitals are very different and there has been a history of tension between clinicians and managers brought in from outside. If we had more clinicians trained to be managers and able and willing to take on roles like chief executive and head of HR they should have much more empathy for and understanding of the clinical side of running a hospital. Here at Lancaster we're just starting down the road of developing a prospective new medical school (working with Liverpool ). We're looking at how we can draw on expertise from Lancaster University Management School to incorporate management into undergraduate medical education.
We ask a lot from doctors these days - to be good clinicians, to keep up to date in their field, to be good people managers, to operate in a more business style environment, to meet government targets and to find time for a private life. So we need to think how we can help doctors prepare to manage all this.
Q: Are there parallels elsewhere in the world of work, for instance in other professions?
A: Engineers used to be trained just to be engineers, which was fine until they found themselves moving into management positions part way through their careers. Now the top universities offer four year degree courses for engineering, with management included from the start.
If you're a successful doctor, whether in a hospital or a GP Practice, you're going to find yourself managing people and resources, deciding priorities, making a business case for projects and so on. Traditional doctors may say that's not what they came into medicine for but this kind of responsibility is a part of the job, so it makes sense to prepare doctors for it.
Q: I know you've suggested a three pronged strategy for stress management - to reduce the causes of stress, manage the symptoms of stress and provide 'rehab' support for those suffering from it. One final question then - what can we do to reduce the causes of stress?
A: A few years ago I developed a stress audit, which I piloted in a hospital, a PCT and a number of other organisations, with a representative cross section of staff. It was an online diagnostic tool, looking at all the issues known to cause stress. The findings were then used to discuss and work out solutions. You can find out more about the audit tool ('ASSET') on http://www.robertsoncooper.com/ if you're interested in using it yourselves.
People were able to use this to work out the causes of stress for them in their particular organisations. For instance was it lack of clarity in people's roles, the way people were managed, a bullying colleague, hours of work, the impact on their home life or whatever. They were then able to use this to work out solutions.
It's worth treating the organisation you work in as seriously as you would treat a patient and using the same rigour, not just managing the symptoms but finding and treating the underlying causes of the problems being encountered. For this, just as for medicine, diagnostic tools help. They can also help you break down your analysis. For instance were the causes of the problems perceived to be different for doctors compared with support staff, for men compared with women, for different grades and so on. This approach also works because it helps you see where things are OK, so that you can focus on the problem areas.
Professor Cary Cooper CBE, professor of organizational psychology and health and pro vice chancellor (external relations), Lancaster University.