Ian Cheong wrote:
At 9:02 pm +0930 11/7/06, Oliver Frank wrote:
Dear colleagues,
I asked NEHTA to tell me the names of the GPs involved in advising
NEHTA.
Please see my message below, and below it a small part of the reply
from NEHTA, with my reply to Gabrielle Lloyde's reply.
A lone voice in the wilderness has little chance against a large
bureaucracy. A co-ordinated attempt by the professional bodies would
have more impact, but we all know how good they are at
co-operating....hence the support they give to a national voice on GP
informatics.
That is an interesting response.
I believe that the days of lone voices in wildernesses are over. They
are over because the tremendous power of improved communication via the
Internet has blown away the previous ability of organisations and
bureaucracies (of any size, large or small) to ignore the voices of
those who feel that there is a problem with what the organisation is
doing or not doing.
I remember when I was a medical student and a young doctor the
frustration of knowing that if I wrote to a medical or other
organisation to with a question, suggestion, proposal or complaint, I
had to depend entirely on the decisions of those who were running those
organisations about whether they took any action or even responded to my
letters. I say letters, because that was all that we had in those days,
apart from attending any meetings that may be held. There was no easy
way to inform any colleagues of my concerns or to seek their views and
support in any campaigns for improvements to existing systems or ways of
doing things. If organisations and bureaucracies didn't like whatever
was being suggested to them, or judged the issue as not worthwhile, they
could just ignore the correspondence and nobody would be any the wiser.
The status quo could be maintained and life for those in power could
continue peacefully undisturbed.
Now hundreds or thousands of colleagues can know immediately what I am
concerned about, and can easily and swiftly let me and each other know
their views and opinions about the issue. I no longer feel that I am
thinking or acting alone, but that I am part of a large group of
intelligent, skilled, thoughtful, creative and active colleagues who
have influence and many contacts.
If an organisation or bureaucracy to whom I have written fails to reply
to my concerns or to respond in any meaningful and considered way, many
colleagues (and sometiems the medical press as well) will hear about it
very quickly and will know that this organisation or bureaucracy has a
problem. Organisations that are functioning reasonably effectively
ensure that they reply politely, promptly and thoughtfully to all
messages that they receive.
Everybody on this list now knows that I have written to the Minister and
to the RACGP, AMA and ADGP about NEHTA's strange and unacceptable
behaviour, and will judge those organisations by their responses to my
message. Others on the list may be inspired by this also to express
their feelings to the Minister:
[EMAIL PROTECTED]
(don't forget to politely address your message to him as:
Hon. Tony Abbott
Minister for Health and Ageing
House of Representatives
Parliament House
Canberra ACT 2600)
and to whichever organisations they wish about what NEHTA is doing. A
message from one GP can be dismissed as a message from a crank. It is
less likely to be dismissed if is respectful, considered and makes a
reasonable and reasoned request or argument and doesn't abuse people or
say just "Somebody orta do sumpin".
Receiving messages from ten GPs in different States all expressing
similar concerns is a rare event for any organisation and for the
Minister, and starts alarm bells ringing.
I often prefer to make my initial approach to organisations and
bureaucracies as a "lone voice". One reason is that it is quicker and
easier to do so than to try to organise a group of people to agree on a
message to be sent. Another reason is that before getting heavy with
any organisation, I believe that it is important to actually just ask in
a quiet polite way for the information or response that one wants,
because sometimes one just gets the information or a reasonable response
quickly and efficiently and the issue has been resolved. There are many
times that I have seen messages on this and other lists from colleagues
who are concerned about something and use roundabout methods to try to
get the answers they are seeking, rather than just to ask directly. For
example, if it's a question about how to bill an item under Medicare, I
always recommend writing directly to Medicare with the question rather
than asking for advice from colleagues, the AMA, Divisions or anybody
else. In the case of questions to government authorities like Medicare,
it is especially important to ask those authorities because by
definition their answer (whether we like the answer or not) is and must
be legally correct.
Another reason for writing as a "lone voice" initially is to test the
organisation's responsiveness, assess its degree of function or
dysfunction and to gauge whether the organisation hopes that one will
just quietly go away if one is brushed off. I like the allegedly true
story of the little old lady who went to a bank and told the teller that
she was hoping to get some investment advice. She was allowed to wait
for quite some time. When the manager eventually decided to see her, he
found that she had won many millions of dollars in a lottery and that
his disregard had very nearly caused her to leave in search of a bank
that would talk to her. A similar thing that happened to me is that
there used to be an old hobo at our local shopping centre who we would
sometimes see fossicking around in the bushes with a broom. When I
hadn't seen him around for a while and asked what had become of him, I
was told that he had died. This mattered to the shopkeepers because he
was not a tramp but the owner of that shopping centre.
Did you see this report?
http://news.bbc.co.uk/2/hi/europe/4175143.stm
"Prague's mayor has had the chance to see for himself whether the many
accounts of city taxi drivers ripping off unsuspecting tourists are true.
Posing as an Italian visitor, in a fake moustache and sunglasses, Pavel
Bem hailed a taxi for a short ride - and was promptly overcharged by
some 500%.
Mr Bem said he was shocked by the extent of the problem and has vowed to
step up controls on taxi drivers."
It is how we behave to the unknown stranger that really shows what kind
of person we are and whether we usually fulfill our obligations and do
the right thing.
I agree with you that "a co-ordinated attempt by the professional bodies
would have more impact" and that is why I often ask my professional
organisations for their support, which I find they generally give and
which I am sure has a useful effect even if the organisations don't
co-operate or co-ordinate their support. In the same way as hearing the
same unsolicited message from increasing numbers of individual GPs
impacts in a non-linear and perhaps geometric way on bureaucrats and
politicians, I believe that this also applies to hearing the same
message from increasing numbers of usually fiercely independent medical
organisations.
I have also learned over the years that the results of writing to
organisations and bureaucracies can take years to be apparent and that
the effects can be subtle and easy to miss. For example, have you
noticed any improvement lately in the communication from our
psychiatrist colleagues about your patients? I am not talking about the
compulsory letter that they must send about patients they have seen on
an item 291, but about their communication about routinely-referred
patients. I have noticed an improvement. If you want to know why I
think that this has occurred, I can tell you.
So, in summary, I believe that we are no longer lone voices in the
wilderness, and that all organisations and bureaucracies now need to be
very careful in how they respond to all messages. The world is now much
more likely than ever before to hear about strange and bad behaviour and
about failure to fulfill one's obligations.
--
Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens, South Australia 5086
Phone 08 8261 1355 Fax 08 8266 5149 Mobile 0407 181 683
_______________________________________________
Gpcg_talk mailing list
[email protected]
http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
