Have it done to you or get involved

I was intrigued when I first heard about the Faculty of Medical Leadership and Management (FMLM). As a doctor, who took the unusual step of moving into full time NHS management in 2004, I have felt somewhat unsupported by the medical establishment in my chosen path. The creation of the FMLM, suggests to me, that this may be changing.

I have recently returned from a study visit to integrated care organisations on the West Coast of America. What struck me was how integral and valued medical leadership was in those organisations. Right from the very top of a large health group down to a clinic in a shopping mall the medical profession informed, influenced and led the organisation. Is the time right for the medical profession in the UK to embrace leadership and management in a way never seen before?

My own transition, from full time working with patients to full time working on the system to support individual care and health, happened over many years. Prior to August 2004, I had worked as a GP for 14 years during which time my development and acquisition of management skills was supported by the NHS. It was, however, incredibly ad-hoc and mostly adapted from training provided for consultants who were interested in getting involved in hospital management. I would have welcomed something like the FMLM at the time.

There were some formative moments in those years. The first was in a learning set when a Vice Chancellor from a well known university came to talk about the reforms in progress at the time. It was 1998 and the new government had announced the proposals for Primary Care Groups. The VC leant forwards and said “Well you lot have a choice. You can either have it done to you or get involved. What’s it to be?” That challenge is one which is still pertinent – sometimes I feel the medical profession views management of the health system with a degree of disdain; yet is bemused by what is done to the profession without its involvement.

A second event in my career was the opportunity to attend the clinical strategist course at INSEAD. It offered me a whole new insight into ideas, experience, evidence and concepts that could be used to improve health and health care. Given the challenges which health systems face worldwide, I feel similar courses should be made more available to doctors – perhaps something the FMLM could/should promote?

Finally, I would reflect on a comment a long-time mentor made, very early on in my transition. Nearly twenty years ago he told me that taking on a leadership role could be very lonely at times and one of the most important resources you need to draw upon is yourself. Understanding yourself is critical, in my opinion, to enter the world of leadership and management. However, it is also an immense support to know others in a similar position who you can call on for support, advice and help. That, to me, will be a great role for the FMLM and I urge the medical profession to support its development and membership.