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15 Aug 2016

They say if you want to truly understand an organisation, then you shouldn’t bother looking at their policies and guidelines. Nope. The gold is in the spreadsheets.

If that’s true, then I’m starting to think that modern day hospitals and practices are truly, irreducibly complex. This is probably also the reason why the single easiest way to terrify any employer of doctors is to sneak up to them and whisper the words “flexible work arrangements”. They’ll instantly fall into a catatonic state, as their intricate web of Excel comes crashing to the ground, with the ringing of empty cells filling the corridors and the endless cry of “#VALUE!”.

Yes, there are successful examples of part-time and flexible employment in Australia. Yes, there are fantastic support programs for parental leave in corners of Australia.

However, this isn’t a vision shared across the entire country and the entire workforce.

Part-time work is more often seen as a chore. It’s the domain of a group of doctors who want it all. It’s a lot of hassle for no long-term investment. It’s a waste of time because they’ll quit after all of the work has been done to establish the position. Which to me, is bizarre.

Medicine is certainly not an island, and there are countless professions who have been able to make flexible work arrangements not just a normal occurrence, but an almost preferable one to full-time employment.

I don’t see flexible work as a threat. What I see is the ability for a workforce to become agile to the demands of a modern health care system, rather than a stagnating roster of single digit FTE that can’t be modified to demand.

I see rates of absenteeism that are practically non-existent, rather than sick call after sick call as a consequence of a deteriorating culture due to excessive workloads and a lack of leave.

I see doctors that are able to diversify their professional and personal experiences to the benefit of their employers and workplaces, rather than arriving every day to simply be another turning cog in an endless machine. Hell, I should be worried that a couple of part-time doctors are going to replace me in my full-time job!

Flexible work arrangements aren’t new; they’re just not well publicised.

The AMA first commissioned a work-life flexibility project in 2001 and identified that flexibility was a significant factor for doctors in training when choosing specialist training pathways. This appetite amongst doctors has since increased, and not just doctors in training.

In my conversations with employers, the vast majority support the concept of flexible work practices. They’re just limited in their ability to implement them.

To really gain ground on this issue, we need to understand the needs of the employer.

Pretend for a moment that you are a medical administration manager in a major Australian hospital. Your starting point is a tight medical budget with very little room to move. You don’t have enough FTE to service your leave liability. Your executive expects a greater service delivery at the lowest reasonable cost. You can see the pressures adding up. To really achieve sustainable flexible work arrangements, we have to work together.

To this end, the AMA Council of Doctors in Training have taken the AMA’s Position Statement on flexible work and training practices and we’re developing a National Code of Practice. This code is similar to the one we’ve previously developed on safe working hours and shift rostering patterns. That code led to a significant change in the way employers approached safe working hours by enabling them to turn aspiration into practice, and we’re hoping to gain similar traction around flexible work arrangements.

I’m a glass half-full kind of person.

I don’t think the service demands of modern healthcare and flexible work arrangements are mutually exclusive. If anything, I think they make an employer stronger.

Through the development of the code, we’re hoping to bring employers and employees together on the issue, to the benefit of everyone involved.

It’s a long road ahead, but I’m confident we’ll get there. I promise. After all, I’m tracking our progress in a spreadsheet.



Published: 15 Aug 2016