A member since 2014, Didier was elected to his position as chair in November 2019. He is a prominent figure and advocate in Northern Territory health and emergency medicine
‘I previously chaired the ACEM Standards committee for nearly a decade and I am incredibly privileged to have been voted chair of CAPP and also to sit on the ACEM Board.'
Didier says leadership is a journey of stages.
‘The role of leadership is to create positive change. When you start out you see many things around you that need change and single-mindedly go about solving the problems you see. After time passes you look around and see that you have accomplished quite a lot and want to protect it, silo it. Then with more time passed you realise the only way you can solve further, bigger, systemic problems is to collaborate with others, find compromise, and influence widely.’
He finds he has been on this journey throughout his career – leading to his position and role with CAPP, but also to substantive development in his local health system (in the Northern Territory), and specifically the place of emergency medicine in that system.
‘In my career to date these simple concepts [about leadership] have led to contribution to many groups regionally, from the ministerial advisory group, the health service executive, the hospital executive, the clinical senate, the NT AMA council, ASMOF as lead EBA negotiator and NT ACEM Faculty chair, amongst others. I believe that to create change you have to be sitting at the table, and even more than that, if you are not sitting at the table then you may be on the menu.
‘This, and the truly amazing contribution and leadership of my local FACEM colleagues, has helped develop emergency medicine in the Top End of the Northern Territory from an unaccredited single FACEM emergency department 20 years ago to a tertiary multi-ED service that is now a respected and influential part of the local and regional health system.’
The same world view, he says, has also led him to want to influence the development of emergency medicine.
‘The past fifteen months of the pandemic have touched, in one way or another, nearly every human on the planet. It has also fundamentally changed the way we view the world because government, for the first time – overtly – has had to measure the cost of human life directly against economic loss.
‘I have seen that there has been a palpable sea change in hospital practice and to some extent in the way our discipline is viewed by health service management. There has been far greater collaborative working between specialties, emergency physicians have come to the fore for their skills in system management and leadership and importantly there has been far more civility as we face a common mission.’
‘This is common to disaster management and we have a disaster that will run into our foreseeable future. It has not been perfect and there is already entropy but we must seize the opportunity to harness the positive to improve our health system through and beyond COVID-19.’
He says we need a health system without queues, and that COVID-19 has only reinforced much of what was known before.
‘Emergency care is not delivered only in cities and by FACEMs. Health systems in rural areas are incredibly fragile, especially in COVID-19 times. We need to develop functional networks, contribute to rural generalist pathways and develop a little less of a metro-centric outlook as a specialty.
We need also to think in parallel of fundamental changes to healthcare delivery to decrease the rate of rise of hospital presentations by enhanced primary and chronic disease care exemplified by the Canterbury model.
‘We need to work with health departments to develop enhanced and supported primary care, but if proposed as the only solution to capacity then we and our patients will continue to be doomed to the misery of worsening crowding which I regard as an existential threat to our discipline.’
Didier says policy and advocacy work by CAPP is already underway on nearly all these items.
‘However, we do however need to balance any change by also protecting the discipline of emergency medicine from becoming a simplistic triage service.
‘We add value in the unscheduled diagnosis and treatment of the undifferentiated, in the resuscitation of the critically ill, in being a safety net for the most vulnerable, in education of trainees and others, in system development, in research, in advocacy and many other areas.
‘We must ensure that any new system values us and gives us protection to do and develop the things which give us meaning and agency. It is not all about time.’
Council of Advocacy, Practice and Partnerships