Arise the systems physician

Abstract

Healthcare in Australia faces significant challenges. Variations in care, suboptimal safety and reliability, fragmentation of care and unsustainable cost increases are compounded by substantial overuse and underuse of clinical interventions. These problems arise not from intentional actions of individual clinicians, but from deficiencies in the design, operations and governance of systems of care. Physicians play an important role in optimising systems of care and, in doing so, must rely on enhanced skills in a range of domains. These include: how to evaluate and improve quality and safety of clinical processes; analyse and interpret clinical and administrative data in ways that can be used to enhance care delivery; build and lead cohesive multidisciplinary teams capable of solving operational defects and inefficient workarounds; and implement new and effective innovations in clinical service delivery. While clinical skills are essential in individual patient care, skills that improve systems of care targeting whole patient populations will become increasingly desirable and recognised as core skills.

Arise the systems physician: a comment

“…I read with interest the article by Scott and colleagues in the December issue of the Journal and their concern regarding the lack of system-improvement training in the Royal Australasian College of Physicians' (RACP) curricula. 1 This came as some surprise to me, as I am approaching the pointy end of my post-Fellowship training with the Australasian Faculty of Public Health Medicine (AFPHM). The Public Health Medicine Advanced Training Curriculum 2 includes specific learning objectives, themes and even a whole domain that cover many of the system-improvement sciences listed in the table in their article ( Table 1).…”