18 OPINION
18 OPINION
12 DECEMBER 2025 ausdoc. com. au
Insight
Doctors vs hospital managers
It’ s time to call a truce.
Dr Sue Ieraci Emergency physician in Sydney, NSW.
THE situation at Albury Wodonga Health looks bad. Recently, the contract of Dr John
Stuchbery, a highly respected breast surgeon who had worked at the local hospital for 27 years, was terminated.
It was claimed it was because he had publicly criticised a planned redevelopment of the existing hospital on the NSW – Victoria border, which he believed would be inadequate for the real needs of the community. It has triggered a series of very public accusations about bad management, resulting in a recent vote of no confidence by doctors in two senior hospital bosses.
Reading about what is happening has got me thinking about my many years of interaction and collaboration with managers in the hospital system.
As a previous head of department, and having been involved in policymaking in both state and federal spheres, I have worked with a large number of individuals in management roles.
The range in motivations, training and skill has been very wide. In my view, much wider than the spectrum of clinicians.
As an emergency physician, I have generally felt that we should be natural allies with career managers.
We are responsible for managing multiple patients simultaneously, for the smooth running of an entire department, for supervising a large number of junior doctors, for juggling multiple competing demands.
We understand the art of compromise.
Unlike many of our colleagues, we cannot ignore those who are lined up, waiting for care. We understand budgets and the impact of low-value care.
Those managers who come from a medical background will naturally understand how clinical decisions are made to balance the risks of doing versus not doing.
They understand what it means for that risk to sit firmly on one’ s own shoulders, to hold responsibility for outcomes.
Does that mean, then, that only managers with a medical background should manage medical services?
There are pros and cons to having doctors as managers.
As a clinician, it is far too easy to indulge in‘ administrator bashing’.
It can be difficult for a clinician to avoid the inherent bias related to their own clinical niche. Doctors who are already in the system may have ingrained ways of doing things that may not be amenable to change.
Those who have forgotten what it was like on the clinical front line may only recall their own past triumphs and forget their previous shortcomings.
On the other hand, managers without a medical background may be more open to consulting widely, to considering divergent opinions and new systems.
What is really essential, though, is that managers value and respect the work done by their staff.
Rather than being excessively controlling or risk averse, they need to trust their staff to work in patients’ best interests. They need to foster, to empower, to encourage— not just to control.
It can be argued that managers should be just as skilled and held to standards just as high as the clinicians they manage are held to clinical standards. If such skilled people are to be retained, however, respect needs to be mutual.
As a clinician, it is far too easy to indulge in‘ administrator bashing’.
Let’ s face it: there are no medical dramas celebrating the heroism of hospital administrators. And yet, if they are not doing their job well, clinicians cannot flourish.
Managers and clinicians should work in a complementary way, using complementary skills, for the benefit of all the patients needing their service.
I have no inside knowledge about the situation in Albury-Wodonga— the terminated VMO contract and the vote of no confidence in the CEO.
But the battles surrounding the planning of new facilities are not new.
The managers are given a limited budget, impossible targets and are expected to reach the sort of compromise that could be summarised as‘ if nobody is really happy, it is probably about right’.
The clinicians see a lost opportunity for a once-in-a-lifetime chance to get a facility that solves all their problems, and they see the administrators as obstructionist.
Imagine, however, if it could go like this: both clinicians and administrators trust that the other group is as skilled as they should be for the job and motivated to do their best with what is available to them.
Imagine a meeting of minds where everyone understands and respects the other’ s role. Imagine one group being able to explain and defend the priorities of the other.
In such a world, the clinicians would feel heard, the managers would retain their confidence, the new hospital would be as good as it could possibly be and everyone keeps their jobs.
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