“…there’s something wrong, can you hear me Major Tom?”

18 04 2009

Sue Llewelyn in her paper, “clinicians as medical managers,” addresses some of the issues of doctors in roles of management. At the centre of her thesis is the use of analogy; the clinician manager as a two way window. This she asserts allows each group to effectively view the other through the faciliation of the window. The suggestion is, that originating from a medical background the window will garner respect from clinical colleagues offering medical insight into the world of management and working within  management gain respect from managers and offer insight into the world of medicine from management.

The topic of the clinician-manager interface seems to come up a lot in conversation around me, even without me bringing it up. Doctors want to talk about it; most have strong opinions on the matter. There’s alway a lot of negativity and, a little respect here please people, I always try to turn the conversation towards positivity and solutions for the problem rather than simply allowing the routine regression to negativity and criticism.

Recently I think I have hit on the problem. It’s not about respect, it’s not about experience, it’s not about understanding or insight, authority or knowledge, hieracrchies, budgets, control or indepencence. It is not about departmental interactions, committees or working parties, cascaded emails or a newsletter stapled to your payslip. It’s not about looking.

It’s about communication.

Yes, it is a complex professional bureaucracy with multi-faceted relationships and interactions but at the very centre of them, and of course every relationship, is communication. Without effective communication every relationship is doomed whether that is between kids in the playground, star crossed lovers, governments or even between clinicians and management. And the key word here is between.


“Can you hear me Major Tom?”




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