What It Means to Be a Consultant: Taking on Responsibility

Francis Chan - The Chinese University of Hong Kong, Hong Kong

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If you’re a highly skilled doctor who has completed specialty training, have top-notch people and communications skills, are capable of identifying and resolving potential problems and has a strong sense of responsibility, you might have the potentials to be a consultant! If you aspire to this career advancement path, read on to find out valuable advice from Francis Chan, Dean of Medicine at The Chinese University of Hong Kong, an experienced panel judge of consultant interviews.

 


 

After becoming Dean of Medicine, I often receive invitations from major hospitals to sit on the consultant selection committee. I observe intense completion for consultant posts and personally ensure that the selection progress is stringent in order to choose the most appropriate candidates for this important role. Applicants must not only possess extensive clinical experience but also demonstrate excellent administrative and leadership skills. In my opinion, the willingness to accept ultimate responsibility is the single most important quality in a consultant physician. To illustrate this point, I will share one scenario based question that I pose at recruitment interviews and an episode that clearly stands out in my interview experience.

 

 

 

My scenario based question is this:

 

The chairman of Hospital Authority is visiting your unit today. This is an honour and a rare opportunity for your years of hard work to be recognized. As the unit head, you are the one most familiar with the operation of your unit. While you are excitedly awaiting the chairman’s arrival, a front-line doctor reports to you that due to human negligence, a patient has fallen into a coma after consuming ten times the prescribed amount of warfarin. The patient’s family is outraged and demands a meeting with the supervisor in charge. Otherwise, they would expose the incident to the media. The ward medical staff cannot pacify the family. Both your associate consultant and supervisor are out of town. All the while, the chairman should arrive any minute. As the highest person in charge, how would you handle this situation?

 

 

 

How would you deal with that situation?

 

COMPETENT CANDIDATES, UNINSPIRING ANSWERS

 

While there is no single “correct” answer to this question, I am surprised that most answers I have heard so far at interviews were hesitant and vague. One candidate’s answer, in particular, stands out in my memory.

 

His immediate response to my question was, “I would consult the hospital’s executive director!”

 

So I reminded him that his supervisor is out of town in the given scenario.

 

He replied “I would consult the Patient Relations Officer. The sweat on his forehead told me he was nervous so I patiently explained, “none of your superiors are in office. You are the highest officer in charge of the hospital for the time being.”

 

After a long deliberation, the candidate came up with an answer. “According to the guidelines, I should report this sentinel event to Hospital Authority within 2 hours of its occurrence.”

 

“Dr L—, apart from following the guidelines and procedures, do you intend to meet the patient’s family or welcome the chairman as planned?” I observed the beads of sweat trickling down the candidate’s cheeks. He continued with a slightly trembling voice “this…is difficult. This is a serious sentinel incident that must be carefully handled…I would ask the Patient Relations Officer to meet with the patient’s family. As for myself…since the chairman’s visit cannot be rescheduled…I would…These events are equally important but…I would…well…”

 

As Dr L— struggled to articulate his thoughts, I couldn’t help asking, “the patient’s family demanded to see you, your front-line colleagues appealed to your assistance, could you really leave this to the Patient Relations Officer?”

 

Dr L— looked clearly embarrassed and unsettled but managed to defend his answer. “I think that the Patient Relations Officer is more experienced than me in handling patient complaints. Besides, I cannot let the chairman wait in vain. I could meet the patient’s family after the Patient Relations Officer’s report.”

 

With this response, I was not entirely pleased so I proposed, “have you considered giving up the chairman’s reception? Explain to him that you place patients as a top priority, and then go meet the patient’s family with the Patient Relations Officer?’

 

Confusion spread across the Dr L — ’s face as if my suggestion had never occurred to him.

 

 

 

 

Qualities that a consultant should exemplify

 

Finally, after the selection committee had interviewed all the candidates, a discussion on which one of them was most qualified for consultant position ensued. To my surprise, Dr L—’s department director confidently asserted that Dr L— was the best candidate. “Out of all the candidates, Dr L— is the one most familiar with the operation of the department. He is also the ablest one to share my responsibility. As for his response to your question…he just lacks administrative experience but he can work on that.”

 

Because Dr L—’s response was still vivid in my mind, I made a reply to his direct as such, “Dr L—’s contribution to the department over the years is worthy of recognition and praise. But the issue rests on whether his leadership is suitable for the position of consultant. Though a department head cannot perform every task himself; in times of crisis, however, he should demonstrate wisdom, courage and above all, willingness to shoulder responsibility. These qualities are crucial to gaining front-line colleagues’ and patients’ trust.”

 

At the end, Dr L— was selected for the consultant position.

 

 

 

Responsibility Above All

 

The selection of department leaders depends on many factors. One scenario question alone is inadequate in determining the right candidate. Yet, that particular interview experience raised my concern for the training of future medical leaders. A healthcare team requires a leader with a keen foresight, determination and a strong sense of responsibility, to lead its members by his/her own example and to make critical decisions. In addition to excellent leadership skills, a good leader should exemplify the willingness the take on responsibility in times of crisis in order to overcome challenges. In other words, a sense of responsibility and commitment are just as important, if not more than leadership abilities.

 

Nowadays, leadership training is heavily influenced by the current social climate. Today, hospital management closely emulates the corporate management culture which emphasizes on procedural justice and collective responsibility. In this climate, individuals’ independent thinking tends to be dwarfed as everything requires approval from senior management. As a result, there is a tendency to avoid doing things in order to avoid doing wrong. Over time, doctors’ individuality blurs as they gradually turn into little screws in a large machine while the relationship between patients and doctors becomes that of a customer and waiter. To break this impasse is not to give up the quality of our healthcare system but rather to balance the core values of our medical training. Corporate style management can be practiced but independent thinking should also be fostered.