This week: AMA Queensland's Junior Doctor Conference

Coming up this weekend is AMA Queensland’s annual Junior Doctor Conference.

There will be many sessions available to help boost your career and friendships in Medicine, whether you’re from Queensland or interstate; working as a doctor, or as a medical student.

I’m looking forward to Chairing the Tech in Medicine panel on Sunday; we’ve been busy preparing and rehearsing our questions and sessions, and I’m excited to see the other sessions, too!

(Image courtesy of AMA Queensland)

There is tons on Career Planning; variations on this year’s theme of Crossroads, including Alternate Career Paths in Medicine; how to land that College place of your dreams; Clinical Skills workshops; medicolegal issues; and other current topics that junior doctors face in Australia and around the world.

Tickets are still available; there’s also a Cocktail night on the Saturday night; and you’ll get to make new friends and enjoy Brisbane while at it! Previous conferences have been fantastic for building new skills and knowledge to set you up for the wards. #whattheydontteachyouinmedschool

For the full program and tickets, please visit AMA Queensland’s website.

Doctors Want To Be Innovative, But They Don’t Know How

First published June 20, 2016

Since embarking on this journey, I’ve been fortunate to explore innovation in medicine and learn what makes a medical entrepreneur, by talking to people first-hand outside of hospitals and clinical environments.

From working full-time in hospitals, I know first-hand what it’s like to want to create change, but not know how to. The constraints of protocols, hierarchies, specialty college milestones, and expectations of supervisors- not to mention full-time rosters- they all exist for safety and for high-quality medical training. I value my time in that world like nothing else. It made me into the doctor and person I am today.

Yet, I had to forcibly step away in order to figure out my odd journey.

Looking up at the possibilities. Gaudi built his vision, which millions enjoy today. Credit: The Medical Startup

Medicine is a long road, signposted by those milestones I mentioned earlier. You graduate from med school. You start Internship. You score your first Resident job in the field you want to enter. You gain entry into the specialty college of your choice. You survive your first day as a Registrar. You pass your college exams. You become an Advanced Trainee. Then you’re a Fellow.

Then, one day, you finish that, and you’re finally a Consultant. (What many in the public refer to as a “specialist” or, in the case of General Practitioners, Fellows of the RACGP– fully qualified and accredited family doctors.)

It is odd if you step away.

Will people point you out for daring to be different? – Grand Canyon. Photo: The Medical Startup

It is odd if you take a break. (Okay, maternity/paternity leave, marriage, other life events, they obviously do happen.) In the recent past, not even five years ago, it may have been more acceptable to take a break for a year. But with the ferocity of job competition amongst junior and senior doctors alike in Australia, the walls are closing in on flexibility.

And now, taking a step away from training; even for just a few months; even by remaining employed but putting off an exam for a year; even if you just need a 6 month “half-gap” of a year, because you’ve not had a proper study break since you were 5 years old – even if – sorry to hear –  a tragic life event has shaken your world – it can be seen as detrimental to a person’s chance of being rehired.

And when you’re surrounded by colleagues and well-meaning friends who don’t understand, and who actually say that those who take a break, even to work on a startup, are “unambitious” or “unmotivated” – is it any wonder, then, why doctors feel isolated and stay under the radar when they come up with an idea?

And, even if a hospital or clinic is supportive (and they usually are; unfortunately, it tends to be particular influential individuals who aren’t) – you have to go a step higher, and try explain to colleges that you’re still doing valuable work in healthcare, by working on your startup- it just doesn’t fit their definition of training.

And this is why doctors find it hard to Innovate.

Leaping through the clouds- daring to dream. Photo: The Medical Startup

How can you innovate when you are feeling weighed down by all these pressures?

How can you innovate where your environment is slow to respond to change, and, despite best intentions, has trouble understanding the few (or many) employees who want to do more, but can’t articulate their feelings?

How can you innovate when you risk being penalised or even kicked out of a specialty college that you’ve worked so hard to enter?

How can the medical profession realise that a step away doesn’t equate a permanent career change, and that it is vital for the future of healthcare for motivated health professionals to gain experience building something outside of their day-to-day work environments in order to bring optimal change for their patients and colleagues? 

Entrepreneurship doesn’t suit everyone. This is not a comment on forcing everybody to become entrepreneurial. It’s about creating the supportive ecosystem for those who are motivated and capable of change, to create that good change.

We should connect our different ways of thinking, and allow ourselves to shine. Credit: The Medical Startup

Many Australian hospitals have rotations in Clinical Redesign and Innovation, or other similarly-named Medical Resident positions. A junior doctor has the opportunity, usually for 10-12 weeks (the standard duration for hospital rotations) to work on innovating within the hospital system. They are usually assigned a senior Supervisor and observe, advise, discuss, formulate, and strategise solutions and carry out these solutions during these ten weeks.

Projects are varied. They can improve the efficiency of completing discharge letters sent to the GP when patients go home. They can improve the allocations of night shift duty. They can create more structured Handover meetings at the start of each shift, so the staff finishing can “hand over” outstanding tasks and patient updates to incoming team members. These roles give junior doctors the opportunity to innovate. However, very few of these roles exist, and to be honest, I am not sure of the demand for doctors who want to rotate in these roles over Cardiology, Nephrology or other critical specialties that count towards training and clinical care. (Feel free to let me know.)

I’ve been really fortunate (and also worked hard!) to attend events where I get to meet people in the health tech space; and others who are medical entrepreneurs in non-medical fields; and I find, that non-medical people are, very graciously, applauding those of us who innovate. Those of us who choose to step away. This whole post has been stimulated by yet another Twitter comment by a non-medical entity encouraging more doctors to innovate. It’s fantastic that the non-medical community are eager to see more doctors and health professionals innovate. If they only knew how hard it was, and how much doctors risk by choosing to innovate, they might understand why there are, perhaps, fewer Australian doctors in the entrepreneurial spotlight than in other fields.

Dreaming big at Yosemite National Park. Photo: The Medical Startup

I’m going to shine this spotlight on inspiring health professionals who are doing great things with their time, to help normalise this situation, and to celebrate their wins as well as their journeys. And I challenge you, too, to be inspired, to value your time, and give your best to the world, no matter what field you’re in.

Do you agree? How can healthcare ecosystems and communities in general improve inclusion for health professionals to innovate, in and out of their workspaces? What cultural issues need to be addressed and how can they be fixed? Or do you think things are fine as they are? Feel free to comment below, or send us an email via our Contact page. 

Part 2: Interview with Dr Gregory Sam, Psychiatrist and Director of Conduit Health

First published April 28, 2016

We hope you enjoyed Part 1 of our interview with Dr Gregory Sam of Conduit Health. His telehealth psychiatry service provides nationwide consulting services which benefit rural and remote or mobility-affected communities. Consults can be done from the comfort of a patient’s local GP clinic or residential care facility, with no sign-up fee for GPs, and bulk-billing for patients.

Greg hopes to expand one day into other areas of the globe. Learn more about his journey below.

Dr Gregory Sam, Consultant Psychiatrist, Australia. Image courtesy of Dr Sam.

How did you go about funding your project?

I’m a big fan of lean startups. Not needing huge capital. Also a huge advocate of self funding. Conduit Health was completely self funded. I was confident I could make the business model work.

I didn’t seek outside funding. There are alot of strings that come with outside funding, and you’re suddenly answerable to the government or your VCs (venture capitalists) or your angel (investor), and I didn’t want to do that. So I self funded everything. The benefit of the lean startup was, it didn’t cost me anything. I set my budget and said, “this is what I have to work with, what can I do with it?”

I started my company in the garage at home and a small office– which used to be for boys’ nights! So I said, no more poker nights, and converted it into an office. Conduit started from there. No overheads, no rents or anything. Yes, it was a home, and my wife helped me with marketing, pictures- I remember days sitting in the back office packing thousands of letters to send to GPs nationally- just me and my wife. More and more, big successful companies have that kind of beginning, they don’t have the multimillion dollars to spend at the start.

Sometimes you have to be able to sacrifice the ego and go, I’m doing the secretarial work. I typed up letters for my psychiatrists. I needed to do all this for the company, and if I didn’t have the money to employ a secretary or typist, I’m doing it. It’s rewarding at the same time, you get to see the company growing. From one referral to multiple referrals a day.

You must be critical of what you do. I always think, is this the right thing to do? Reflect and analyse, ask, “in terms of the business strategy, is this a good idea?” Not being complacent, “oh I can spend all this money now,” it’s about growing your business. Some people create meaning without making money.

Often if a company has created meaning, they then create money. But often people focus on making money first.

What got you interested in entrepreneurship in general? 

Wanting to make a change on a larger scale, to create something and grow it organically. And it’s exciting. Hard to describe the feeling but it’s a huge challenge. Something that can consume every moment of every day. But very rewarding. 

What sort of doubts or worries did you come across?

I didn’t study business. The difficulty within the medical field is, there aren’t many entrepreneurial people. I keep thinking of so many examples where my medical colleagues have such great ideas but don’t have the support or environment to foster that development. 

And I think taking myself out of that comfort zone,being with my business friends, listening and learning from them, really addressed those doubts.

One thing I know is that I’m a doctor, I know the medical part as well as the business side of things. Psychiatrists I work with feel comfortable with me because I know what it’s like to be a psychiatrist, I know the difficulties they face, I know what it’s like to treat patients. Whereas if it’s a purely business person,  you wouldn’t know what to give the patient, or how to be a psychiatrist, you’d possibly be like “oh it’s good for business, let’s do it.” That’s my advantage.

I think a lot of doctors should see it as an advantage, “I’m in business but I have a medical background.” So my doctors and nursing staff, they all understand. Which is why I’m all for doctors getting into business. As a doctor you would be able to empathise, with a business heart.

The other fear was, I got into medicine to be a doctor, and do my clinical training and be a psychiatrist. The path is very set. Once you start thinking of deviating from that, it’s quite scary. The reality is, actually it’s very refreshing. Because all we’ve known for ages is patients, medicine, being a clinical doctor. So actually, its very liberating.

Conduit Health, Telepsychiatry Service. Photo courtesy of Dr Gregory Sam.

 One of the problems when starting out with telehealth is the many barriers. Like technology, for example, Internet speed, willingness to try out technology, video technology, and costs.

I thought, what are all the barriers? One by one, I addressed them and ticked them off. We bulk bill, so patients don’t pay. GPs win because patients get seen by specialists for no sign-up fee. Patients win because they don’t have to travel. Psychiatrists win because they don’t have to have room fees, which can amount to $70-80K a year. It’s an untapped market. Lots of patients need help. Whereas the metropolitan market is completely saturated. So we’ve tried to knock down all these barriers, and create a win-win situation for everybody. 

I think less so that people choose entrepreneurship, more so entrepreneurship chooses people. I think about ideas all the time. There are all sorts of naysayers who will come and tell you it’s not going to work. Why does this person say it won’t work, and how do I prove them wrong? I take what he says, think of the meaning behind what he says, and maybe he’s thinking it won’t work for xyz reason, how do I address xyz?

I think more and more power to doctors who become entrepreneurs in the medical field, or outside of medicine. So that studying medicine doesn’t become this one-track path, you will see patients and that’s it. People can become disillusioned by it, it’s so straight, the path doesn’t have any chance to vary. Yes, medicine does offer many specialties to choose from. But it’s still so contained like a nucleus, and no one’s thinking of addressing the outer shells.

Specialty training itself is all-encompassing. It will suck your life dry so that you just focus on training and that’s it. Same thing happened to me til I failed a few times, then you step back, and I said I don’t want my life to just be about training and fellowship. I want it to mean more, and that’s where the value is. 

Did you have a mentor?

 I had a few different mentors for different things. I try to draw upon the things that I want to gain.Positives and negatives. I draw analogies with badminton training. I had a coach for 6-12 months, and I drew as much as I could their positives. A certain coach would be good on physical stuff, another would be on mental aspects of the game. Same with psychiatry training. One would be clinically good so I’d take those aspects off them. Another had a good lifestyle setup, so I wanted to draw upon that.

For a business, it’s more offsite. I’m a member of business groups. The guy who did my websites runs an IT company in Malaysia, from a business perspective I love bouncing ideas off him, and learnt lots of things from him.

It’s important to be able to have many mentors for different things, because there’s a risk, if you follow just one person, you absorb all their flaws, and are unable to see their flaws. That’s a risk in medicine, too. 

I also learnt heaps from watching talks by Guy Kawasaki and Elon Musk and a few others. 

Part 3 will be released soon! In the meantime, if you’ve got any comments or questions about our article, comment below.

You can view Part 1 here and visit Conduit Health here. 

If you wish to contact Greg for more enquiries about Conduit Health, or to sign up as a GP or psychiatrist for his service, please email enquiries@conduithealth.com.au. Conduit Health is also on Facebook.