The medical profession's way of organising people

As I continue to journey through the medical profession as a student, now in the wards, it is interesting to ponder how this profession has learnt to organise itself in a way that it sees as the best for managing the stressful tasks thrust upon it. Unlike corporate organisations this is a group of people who have come up with a organisational structure unseen elsewhere. Interestingly, it fails to catch the attention of the media compared to the likes of google's organisational structure, and I associate that with how the hospital comes across as a rather exclusive place where esoteric activities occur in the sterile environment, seemingly void of any room for creativity. But as different organisations continue to search for ways to manage their human resources, I feel that this is a wonderful alternative that everyone should bear in mind.

Merits of the Singapore hospitals' organisational structure

In Singapore hospitals, which I would assume to be highly efficient given how highly the healthcare system is rated internationally (last I heard from a professor, it was 6th). Not only that, this is a system which has continuously trained and produced highly skilled individuals respected locally and overseas for their clinical acumen, in short, a workplace that develops its members. From there, many individuals have gained enough recognition to migrate to foreign countries and continue practicing there as outstanding physicians. Aside from tangible results, I have also seen firsthand how teams are able to bond well and work through tough working conditions. What more could we want from an organisational structure?

How hospitals go about it

Undoubtedly, hospitals have presented themselves as exclusive groups and understanding them requires some insider insights. And of course, there are differences in culture within different hospitals, and between different departments in the same hospital. By my observations, specialties that require and emphasize on teamwork seem to have a higher level of synergy and team spirit, while certain specialties known to take in "type A personalities" are known for fuelling some form of unspoken competition between members. Hence, while we try to generalise on what the system does, let us not forget that, like all theories, this is an oversimplification and there are always exceptions (how ironic that these 2 words go together) to what will be written on this.

Creating a culture of team bonding

Imagine if you were in a company that hires and fires all the time, would you give your all to the TEAM of people you are working with? I mean, I don't even know if I'll be working with them next year, or next month at that. And given that you never know when you're going to be fired, how can you invest much, if at all, on the welfare of those around you? Will they backstab you one day because they can't lose the only job feeding their family of 4 + 2 elderly parents? Will YOU backstab the same people you invested your time and friendship with for the same reason?

In the healthcare industry, everyone knows they are all in it for the long haul, hence it is easier to coax people to be invested in not just individual needs, but those of other members and even the system itself. Also, the medical community is rather small and tight-knit, given the small number of healthcare professionals. Many of them went to the same schools together, or received training in the same hospitals at a certain point in their medical education. Otherwise, mutual friends and similar experiences are relatively common and form a good basis for conversations and establishing rapport. This allows for strong team bonding to occur, and I believe almost everyone is agreeable that this will produce better satisfaction at work and better outcomes for the organisation as a whole.

But doesn't the comfort of a "long-haul" career that is "recession proof" create an environment of individuals contented with maintaining the status quo? This is the common American logic propagated by American multinationals. I guess they do imagine the world to be populated by hedonistic creatures, to which I agree to a large extent. But this just brings me to my next point.

Continuous improvement

In the healthcare industry, there is a strong culture of learning being propagated as well. Everyone within the healthcare system knows that healthcare is dependent on technology, and is hence ever-changing, for the better of our patients.

Being on the ground, seeing the state of our patients, few would be so lacking in empathy as to turn a blind eye to the suffering of such individuals. And for those, there are mandatory learning points to clock so that everyone is kept up to date with the most recent approaches/management plans etc. that are present.

If we were to explore even further, one would notice that conducting research is a common practice in many Singapore hospitals, and from these sprout the new management approaches and knowledge used in clinical decisions by various healthcare professionals.

All these come together to create a system where individuals have both the purpose, incentive, and the avenues for continued skills development throughout their career, forging an organisation that is driven to continuously innovate and improve itself.

Investing in every individual

Hospitals see every member as an asset. Maybe aside from medical students. Every doctor/nurse/allied-health professional is seen as someone adding value to the group and the patient's welfare. Add that on to the fact that this group of people have been rather "recession proof" and you see how it comes together to give the administration the confidence to invest in its people. This is a stark contrast to the corporate world where a corporation would simply fire one of its own and replace that member with someone who has already been trained or has already proven himelf/herself in a particular field, which makes companies hesitant to provide training given the ease of getting replacements, and the uncertain loyalties of those it trains.

In the local healthcare scene, every doctor (and though I have never asked, I'm quite sure every nurse too) is required to teach their more junior members in the team. Everyone is well looked after by every other member of the team, who continuously provide them with the learning opportunities present. This is aside from courses organised by the hospitals to provide staff with opportunities for growth. Healthcare professionals also regularly go on conferences overseas to learn the best practices or soak in the latest results from research going on in other countries. If that is still insufficient, doctors would go on fellowships in other renowned hospitals overseas to observe and learn on the job what other healthcare professionals elsewhere are practicing.

Beyond the more serious side of hospitals, they are also known to invest in individuals in other ways. For example, weekly welfare buffets, comfortable rooms for doctors who are on call, as well as lounges for resting or some peace and quiet are present in all hospitals. Team bonding activities are organised by departments, and some teams are known to have drinks together at certain points of the day (some overlap with the first point on team spirit here)

Not a panacea, but probably worth considering

As mentioned, such are the merits of the system, and how hospitals go around it here. While it is an overgeneralisation of what hospitals are doing, those are some notable points which I feel are the strengths of the system. After all, recent surveys into people's attitudes with regard to jobs have shown that individuals now rate certain characteristics of jobs, such as opportunities for growth, future job opportunities and good working culture rather highly, as contrasted to the age old thinking that money controls the world. While it may still be true that money does keep people in check, let us not forget that the healthcare industry is not slavery, and healthcare professionals are paid decently if we were to look at their monthly pay, instead of their average per hourly pay. Of course, we could say that the motivations of medical personnel are rooted in the fact that many of them were selected via stringent interview criteria, or point to the incredibly high rates of substance abuse and health complications in medical professionals in certain fields, and those are indeed an extremely negative reflection on areas of improvement in the system. But it is still a unique culture that I feel other industries should explore.