Tuesday 14 August 2007

QANTAS Club

A long time ago, Uncle Beattie decided to rid all public hospitals of their doctors' lounges. These were quiet places of varying sophistication where a cup of tea and a sweet biscuit were served each day at 10 am and 3 pm, without fail.

It was, of course, on the basis of removing all traces of professional elitism that the lounges were turned into things like pre-admission clinics and administrative offices. (I'm sure Uncle Beattie employs a band of builders whose only job is to partition larger hospital spaces into smaller ones).

What Uncle Beattie didn't realise was that these quiet spaces were an integral part of the medical staff's work routine. It was the place you would go to find that elusive visiting colleague for a consultation for one of your patients. You knew exactly where and when he would be for at least ten minutes of the day and you could get the answer to whatever the problem was quickly, efficiently and with privacy for your patient ensured.

(Uncle Beattie could not possibly understand such a way of working because it would mean doing away with the layers of faceless decision makers that absolve him from responsibility).

Beyond work efficiency, it was the place where the expertise of a wide range of specialists could be brought to difficult cases and the place where junior staff would hear their seniors discuss difficult problems in real time rather than at retrospective case review hearings and formal grand rounds. This teaching on the hoof was much more effective than any tutorial or text.

Finally, it was the place where you went to crash on a vinyl lounge chair when for some reason the night duty was long but quiet. It was the place where a half cold cheese and hummus toasted sandwich from the Lebanese deli across the street could drip down your blouse because you were too tired to hold it upright without a complaint ensuing and it was the place where you went to fall apart in safety and privacy when the day went horribly pear shaped if that's what you needed to do.

It's not all bad though. My latest registrar, seconded from a major teaching hospital told me that with the return of a clinician to the chief executive officer role at his hospital, the new staff work contract included the building of a new tea room. An empty space was allocated and quite mysteriously, the budget was left open, as in the sky's the limit sort of open. Further to that, the design was left in the hands of one unusually talented and enthusiastic senior registrar who took his brief to design the new tearoom firmly in both hands and set forth.

The new lounge, christened "The QANTAS Club" after the airline's swanky $600 per year establishment, has been built with smokey sliding glass doors, mood lighting, a full bar, media and Internet connections, telephones, elegant bathrooms and bedrooms with en suites. I gather there is also modern art gracing the walls and ceiling!

I think this is where the pendulum has finally started to swing back. Uncle Beattie has run people into the ground so far that there is nowhere else for them to go and for the medical staff, at least, there-in lies a strength. The only way is back again. For our patients, this is a very good thing.