There are a number of very big pieces of work ACEM is currently involved in (there is always something happening!); work that I want to continue to be involved in through my ongoing engagement on various ACEM committees and working groups as the Immediate Past-President.
There are a number of significant projects happening right now (our new position on Time-based Targets, the Safe ED project, FACEM Training Program review and EM workforce planning), all of which will have impacts on the future of EM in Australia and New Zealand.
Some of these are in the throes of being finalised. Others will be coming to you for consultation, while others are just getting up and running. There are great people involved and we will be seeking your thoughts over the next weeks and months.
This is, of course, on the back of our mental health advocacy, the development of our Global Emergency Care work and commitments, the restructure of CAPP, Advancing Women in Emergency Section’s arrival, Board changes… the changes at ACEM have been many over the past two years and will continue under our new President, Dr John Bonning.
Australia’s EM workforce is a piece of work of significant importance to us all and something I wanted to let you know about. Over the past decade or so, the evolution of Australia’s wider medical workforce has gone ahead without much structure. While we have seen a huge increase in medical student numbers and new doctors, we continue to see issues like the maldistribution of doctors, with the metro/regional/rural imbalance and the obvious consequence for health outcomes; EDs which are understaffed and struggling to recruit, part-time contracts, VMO “zero-hours” contracts, job insecurity, predictions of “FACEM oversupply”, a lack of mental health services, etc., etc. But these are not just EM issues; each craft group, from rural GPs, to pathologists and psychiatrists, have workforce issues they have to deal with, and it’s not easy for any of them.
One of the more unique challenges for EM is that the intersections between training, workforce, public hospital budgets and multiple levels of government and administration impacting on how and where we work are probably more distinct and interconnected than any other speciality. There needs to be a plan and there needs to be a robust structure so you can ensure that your ED is staffed and safe into the future. Another thing, of course, that makes it just a tad tricky for us is that we perhaps don’t just need one plan; we need quite a few for different regions, but the development needs clear leadership. This is where we are stepping in.
So, my task (cue Mission Impossible music), if I choose to accept it (and I have), is to try to unravel all this, make the impossible possible and come up with a strategy which will guide the evolution of the EM workforce for Australia. New Zealand won’t be missed out, and the in-coming President can do a lot of the groundwork that equally needs to be done over there.
Neither of our tasks will be easy and, in Australia in particular, will require multiple inputs from many, many people. It will also take an understanding from all of you that what we have now in our EDs will not be the same in five or ten years. While I don’t want to pre-empt any outcomes, it may well be that we will have more EPs in more EDs for more of the time. We will need to see some rethinking on trainee numbers, as we can’t continue to rely on EM trainees to form the bulk of ED workforce and have the annual recruitment drive to try to fill ED rosters.
We will need to evolve the separation of training and workforce needs. We need to embrace and find roles for ACEM diplomates and certificants across our EDs and look at the significant roles for other craft groups. And we need to work with our colleagues in ACCRM and the rural GPs to understand how we can work together to ensure rural communities have access to the best emergency medical care.
This will require coordination, conversation, collaboration, vision and trust… it is about our future and how we best serve our communities… and the work has started already…
I look forward to hearing your thoughts on this. I look forward to seeing you in Hobart and discussing these and other issues with as many of you as I can.
Thank you for allowing me to have the enormous honour of being the President of ACEM for the past two years. It has been a wonderful two years… a busy, rewarding, inspiring, tiring, challenging, unforgettable two years. I feel like we have done some good things and I remain convinced that I have chosen the best career in medicine, surrounded by the best people medicine has to offer.
We do good things. And, your new President, Dr John Bonning, will take on the role with the passion and enthusiasm we all know he has in spades. John will lead from the front, ensure that the role of ACEM, as a College which is inclusive, diverse, outward looking, working for the best health outcomes for patients, the best standards in EM training and care we can achieve, continues to evolve and grow.
Please remember that and continue to push the boundaries, challenge the system, advocate for change, for your patients, your ED and embrace what it means to be a member of this College; Respect, Integrity, Collaboration and Equity…
Signing off for the last time as El Presidente.