Top Aussie Doctor's Prescription To Cure Our Hospital's Toxic Culture
Top Australian doctor Dr Simon Craig says now is the time for positive change in our hospital systems which are at “crisis point.”
The senior obstetrics and gynaecology clinician, with more than 30 years' experience in the public and private systems, has written a book outlining both the problems in healthcare and the possible solutions.
Dr Craig says a fundamental shift is needed in both how staff are trained, and hospitals are run.
His book - From Hurting To Healing: Delivering Love To Medicine And Healthcare - has been endorsed by fellow senior medical practitioners, administrators and university professors including Royal Children’s Hospital Professor Catherine Crock AM and University of Melbourne Professor Dr Susan Walker – who say Dr Craig’s “voice ought to be heard” and his book “should be mandatory reading to everyone involved in providing care, from medical students to policymakers”.
Dr Craig says the current crisis point provides an opportunity for health administrators to take stock and explore new ways address the key issues such as:
1. Reducing excessive and unnecessary paperwork and red tape;
2. Re-humanising hospital processes which are becoming “mechanised” and treat patients like a product;
3. Changing the competitive, almost combative nature of medical training and practice in some specialties;
4. Improving teamwork and collaboration; and
5. Increasing communication between clinicians and hospital administrators.
“The difficulties that can seem insurmountable may provide the impetus to create positive change,” Dr Craig said.
He says the problems extend from hospitals – where daily news reports show ambulances banking up outside overstretched emergency departments – to general practice.
“The cracks are widening and cannot be papered over anymore, with long waits to see GPs in the community, and hospitals struggling at multiple levels. Doctors and nurses are leaving the system in record numbers due to burnout,” Dr Craig says.
“In attempting to become more efficient our hospitals are developing into cold, dehumanised, and more mechanised environments that are damaging those working within health. With each challenge we grow weaker and more vulnerable. Without change, the system will eventually break down.”
Dr Craig said the strained system was causing a toxic culture of bullying, aggression, and disrespect – plus the silent but more insidious aspects of poor culture such as non-inclusivity, disengagement and undermining behaviors.
In his book – described as “something of a love letter to hospitals” – Dr Craig says it seems incongruous that hospitals, which are devoted to curing disease and caring for patients, could adversely affect the well-being of their own staff.
He says the answers involve reducing red tape, prioritising people over processes, and listening and empowering rather than directing. A critical part of the solution will lie in positive and insightful leadership, as well as the involvement of all workers and all voices in the development of future healthcare systems.
“Our systems should not aim to be a conveyor belt of treatment,” he says.
“We need to care for each person and aim to heal. Part of the solution will be to focus on styles of interpersonal interaction between healthcare workers. How we treat ourselves and our teammates will influence how we treat patients.
“Healthcare staff want to care for their fellow humans, to belong, and to be part of high functioning teams. These elements of healthcare have been neglected and eroded over recent years and need to be restored and emphasised.”
Dr Craig says medical professionals are being buried under mountains of paperwork and data entry – much of it repetitive, duplicated, and often unnecessary. While accurate records are “clearly critical”, Dr Craig says excessive and illogical bureaucratic “red tape” devalues the time of clinicians, offends the intelligence of nurses, and generally leads to frustration.
“Nurses and doctors spend more time completing data entry than in direct patient care,” he says. “We can and should spend more time facing patients than we spend facing a computer screen.”
The way we teach and train medical staff, particularly doctors, is also to blame, Dr Craig says.
“Healthcare is demanding but it should not be damaging,” he says, adding the effects of stress and burnout can have deadly consequences for patients.
“While we want our doctors to be the best of the best, the competitive nature of their study and training sets them up for a career of rivalry and strained personal relationships with their peers – when what healthcare needs is collaborative teamwork and improved communication, with the needs of the patient at its core.
“Changes are needed at medical school level to decrease competitiveness, increase pro-social behaviours and teamwork, and to increase emotional intelligence to deal with challenges that will inevitably arise in a medical career.”
Over 33 years in medicine, Dr Simon Craig says what started as a calling became a career and then just a job as he came to the increasing realisation that hospital systems were “sub-optimal and becoming worse”.
“Work within healthcare was becoming more difficult, frustrating, and joyless,” Dr Craig says.
“I recognised the struggles of those around me and experienced my own loss of fulfilment. My thoughts turned more and more to questioning what was wrong and how we could improve our healthcare systems.”
From Hurting To Healing was informed from a lifetime of working as a health professional in both the public and private systems. The Victoria-based obstetrics and gynaecology specialist is both an experienced clinician as well as a leader and teacher, with further expertise in conflict resolution and wellbeing science through a Masters of Positive Psychology.
With a focus now on coaching and the optimisation of organisational culture, he says guiding the development of junior staff and creating teams have been some of the greatest joys of his career. And while he left the health system in December 2022, he still holds serious concerns for former colleagues with many still working in health struggling with burnout, disengagement and “loss of hope”.
Dr Craig says while junior doctors “should demand that bureaucratic processes do not overwhelm the reason that they started working in health – to look after people”, it is senior clinicians and leaders who will be key if our healthcare systems are to improve.
“Experienced doctors are those who must stand up for change,” he says.
“They have seen the system deteriorate. They, or others around them, have suffered with burnout and loss of purpose.
“This trend must be reversed. The experienced doctors need to become part of the change that is needed.”
Dr Craig also said hospital administrators need to be open to change and recognise that “relying on what has always been done before will not work any longer”.
“If we continue as is, more damage will be done to people working within healthcare, patient outcomes will suffer, and organisations will struggle with worsening culture, disengagement, lack of staff, and poorer functioning hospitals,” he says.
“Now is the time for positive change.”
Dr Simon Craig's book From Hurting To Healing: Delivering Love To Medicine And Healthcare, published by Hambone Publishing, is available at selected bookstores or online at Amazon Books and Booktopia.
