The medical director is the manager of the medical consultants. The speaker likened it to being a bit like Manchester United. The medical director is the manager and the players are the consultants.
The players need to be kept as happy (through good management), with good team-working and the best possible patient outcomes. There are 350 consultants in this hospital. This was the model that Salford adopted. Focus on valuing your consultant workforce and focus on safety.
In recruitment terms: IBM would probably spend days recruiting people over a several day interview. John Lewis has a much flatter structure. The Princes trust has a different structure. All the decisions are values based decisions in these above organisations.
The NHS is still often using older models based on short 1 hour interviews. This causes some problems when it comes to medical recruitment and allows some of these different characters into the consultant workforce. Some of the more eccentric types include:
The difficult ones – professors etc. Lots of idiosyncrasies. Need a few but only a few.
The throw the toys out of the pram type – poor insight. They will cause fights and distract department focus.
The Mr Burns type – moneybags. They will drain resources.
Saboteurs – few but very destructive. Even one of these can decimate your department or even your hospital.
It has to be emphasised that these groups do not represent the majority. The last 3 – no insight, Mr Burns and Saboteurs that they are trying to screen out. Some ‘professors’ are necessary but only a few.
The Medical Directors’ Roles
The Medical Director has to deal with Job Planning, Doctors in difficulty, SUI’s (serious incidents), SIRI’s (serious incident report investigation), Conflicts, Dysfunctional Departments, Consultant morale, Trust performance, Patient safety, Clinical performance.
Everyone will look at the consultants to lead and make decisions. They are the leaders in the hospital.
They are the key decision makers. They may be perceived as difficult from the outside and sometimes from within but they have to think differently because they are key decision makers.
The key question is where do you put them? They are a finite resource and you need to put them where they are most required.
The consultants need to be team players. They need to teach and manage. They need to know the business. They are the guardian of the quality agenda and outcomes. They forge partnerships between doctors and management. They have to be adaptable.
Previously there have been clinician lecturers, clinician scientists/researchers and clinician service providers. However, now the clinician manager is coming to the fore.
The idea is that clinicians will be forming and developing their services. We shall see whether or not people engage with this.
At the end I asked the group how many would consider becoming a clinical manager as their primary role. At least a quarter put their hands up! Impressive. Perhaps there has been a significant scene change of late.