Recently, I recorded a saxophone part for an Aotearoa-based FACEM friend’s virtual performance of Stevie Wonder’s Superstition. My partner noticed I seemed lighter the next day – and I did feel that.

At the same time, I felt anxious and guilty, and worried that somehow me taking this time to do something that was not family or healthcare related would be judged harshly. Shouldn’t I, as President, always be striving and working towards a better health system for patients, and for healthcare workers?

Then it occurred to me that single-minded dedication to work is the exact opposite of what FACEMs, trainees and, perhaps most importantly, emergency doctors of the future, need to see from me and other leaders in this space. They need to see us living our full and wide lives. They need to see us finding joy, taking time out, filling up our own cup.

This realisation was verified to me the very next day. While working one of the busiest shifts of my career, I was receiving messages from colleagues across the system who were assessing patients in hallways, and corners, had to compromise their treatment plans to allow for the lack of space and privacy. They were telling me about waits of 36 hours – and more – for inpatient beds. They were telling me about rosters with chronic gaps and constant guilt about not being able to cover more hours. These patients, and doctors, deserved so much better than the malfunctioning health system could give them right now. It was so upsetting to hear, and to know that I could not do more to help.
But the saxophone day was still fresh in my mind, and it stopped me from ruminating too much, and shored up my capacity to cope.
It is so important to play that saxophone. Ride that mountain bike. Sit under a tree and read a book. Cuddle that puppy – yes, I am pleased to announce that my family has just welcomed a brand-new member, a Golden Labrador called Sandy.
I was also lifted this past month by finally – after many COVID-19-related roadblocks, both literal and figurative – making it to Western Australia to visit with FACEMs, and to attend the WA conference. It was wonderful to listen to inspiring speakers, and connect with friends made over Zoom, all with a stunning view of the Perth skyline.
While I was unable to make it to Aotearoa New Zealand for last week’s Manaaki Mana hui, it was inspiring to see and hear about the many important discussions taking place as part of ongoing mahi towards ACEM's commitment to providing excellent, culturally safe care for Māori, underpinned by Te Rautaki Manaaki Mana Strategy for the period 2022-2025.
It has once again been a busy month since last I wrote to you.
Floods in eastern Australia have devastated many communities, and our thoughts are with them. It is terrifying how often these ‘once-in-a-lifetime’ weather events are occurring. We know that climate and health are linked, deeply.  ACEM is campaign partners to the Healthy Climate Future, calling on our political leaders to urgently deliver a climate-ready and climate-friendly healthcare system. Because we all know that it is the biggest threat to healthcare systems worldwide.
This last month, I represented the College at the Inquiry into the Impact of Ambulance Ramping and Access Block on the Operation of Hospital Emergency Departments in New South Wales. While it was NSW-based, as former college President Dr Simon Judkins tweeted to every health minister in each Australian state, “Please note, the findings here will be VERY relevant to your state and territory. Watch, listen, learn, and act.”
The College stands by every word of the evidence given and will continue to advocate privately and publicly until the health system is accessible, affordable and accountable.
In this work, we hope to be guided by a new report commissioned and recently released by the College, and produced by The Sax Institute. Access block: A review of potential solutions is a literature review that analyses more than a decade of global research to ascertain four clear evidence-based solutions for access block.
This month, Victorians go to the polls. We have seen a lot of health-related discussion, debate and policy pledges and I hope that we see this translated to real change.
In every part of Australia and Aotearoa New Zealand, it is more important than ever to refocus on the fundamental problem – the broken health system – and for every speciality and area in health to collaborate and reimagine and reform the “system” into something that is accessible, affordable, and accountable and that meets the needs of all people.
This isn’t excessive optimism. I am not saying it is going to be easy. But I know we have the skills and the motivation and the means to do it, and that we have no other choice. Because we are living the alternative right now, and it is harming people. It is breaking healthcare workers and it is making people turn on each other. We healthcare workers must refuse to be divided. We must remember the real enemy is a malfunctioning health system and unite to fix it.
I look forward to seeing many of you at the Spring Symposium this month in Christchurch, where we will discuss all the matters that face emergency medicine celebrate the graduation of a new generation of FACEMs and draw strength from in-person connection, and from the stunning scenery of Te Waipounamu, Aotearoa New Zealand’s South Island.
Until then, and until next month’s blog – thank you, for all that you do. As always, whatever the next month brings, we will get through it together.
Dr Clare Skinner
ACEM President