Fiona Pathiraja: Investing in future clinical leaders

Fiona PathirajaFor a medic still just under thirty, I have deviated from the traditional medical career path several times. Working as a healthcare management consultant, setting up a start up enterprise and being on secondment to the Department of Health have broadened my understanding of the healthcare landscape.

The controversy over the planned NHS reforms has got me thinking about clinical leadership.  Empowered clinical leaders will be crucial to implementing the reforms and the NHS should look to other industries for lessons on developing future leaders.  Whilst junior doctors are treated as bottom of a hierarchy, their private sector counterparts are nurtured, trained and valued. Retaining and investing in talent is big business. Other industries wouldn’t dream of labelling the next generation of leaders with the pejorative term “junior.” Yet this is exactly what we do to future medical leaders.

As an avid Twitter user, I crowd-sourced opinion on this issue with the following tweet: “Why do McKinsey associates feel more valued than NHS junior doctors?” Responses came from a wide range of medical and managerial colleagues – one notable theme was the greater sense of organisational identity and belonging, and greater respect from seniors in the private sector. Even the most junior management consultants feel they have a stake in their organisations.  They are viewed as bringing a fresh perspective to problems as opposed to being inexperienced beginners.

My own experiences support this. One day I was a junior doctor at a London teaching hospital and the next, I was in a plush management consultancy office with a company laptop, Blackberry and business cards.  Where I once struggled to get a hospital manager to listen to my audits, I was now working with senior healthcare clients including PCT executive boards and the Department of Health. Even as someone new to the job, I felt my opinions were important to the managing director of the firm. Most junior doctors never have the opportunity to speak with the chief executive of their trust, let alone contribute to transformational change initiatives.

Why does any of this matter? At a time of financial restrictions and uncertainty, clinical leadership needs all the energy and knowledge capital it can source.  Many junior doctors are driven, interested in making a difference and experienced in healthcare at the front line. There are benefits for all involved if juniors are engaged, rather than being told to wait until they’ve “grown up” before they can create system change.  Several national leadership and management schemes now exist for juniors looking to develop these skills and a few enlightened chief executives have set up local training programmes to incentivise young doctors to lead from the frontline.

In financially constrained times, it is easy to forget the long game. However, the NHS must invest in its future clinical leaders. Management consultancies are paid vast sums of money to streamline NHS processes and reduce waste. Junior doctors on the frontline are in a position to notice daily system inefficiencies and often have innovative ideas to improve productivity. Perhaps it’s time we consulted them for a change.

Fiona Pathiraja is navigating a medical portfolio career. She has worked as a junior doctor, management consultant, entrepreneur and most recently as clinical adviser to the NHS Medical Director at the Department of Health. Follow her on Twitter @dr_fiona