You might not guess it from our national health debate that is tiredly rehashing outworn arguments about hospital financing, but the pandemic could open the door for transformative changes for health.

Since 2018, the Australasian College for Emergency Medicine has collaborated with the Swinburne University of Technology on a research project to understand and enhance the leadership capacity of emergency physicians, beginning with Australasian Directors of Emergency Medicine (DEMs). This programme has revealed the complexity of leadership in emergency medicine.

The Australasian College for Emergency Medicine continues with significant advocacy on ED overcrowding and access block. We ask that colleagues in other specialties and professions stand with us to advocate for change. Together, we must engage with decision makers and work towards a common goal: timely access to affordable, safe, and effective health care for all Australians.

I had a fantastic shift the other night. It (mostly) worked well. It reminded me about what I loved about Emergency Medicine when I started out and why I chose this specialty. I've been thinking on why it went so well.

Clinical all-rounders are the glue of health care. We see and treat the whole person. We interact with the entire system. We’re mostly very good at what we do. Our skill-set includes knowing when and how to ask for help.

The majority of public health boards have close to equal representation of women as board members however women are underrepresented in Chair roles. Victoria has significantly more women on health boards, whereas New South Wales has significantly less women on health boards and in Chair positions. 

The ED CoP has served two equally important roles: sharing information, resources and working through service challenges collaboratively has been enormously helpful; and connection with colleagues, including regular communication, sharing our concerns, and checking in on each other, has been invaluable for health care worker wellbeing during stressful and uncertain times.

No one wants to end up in the ED, whether they present with emotional distress or a broken leg, but the experience can be especially confronting, even traumatising, for those needing mental health support.

Addressing and limiting burnout and its significant impacts on emergency physicians is an important and ongoing challenge, requiring much more than a focus on individual resilience. This is a key understanding which guides and informs the Australasian College for Emergency Medicine's holistic approach and advocacy efforts when it comes to the wellness of emergency physicians and the health systems in which they operate.

After a career of shared lockers, I suddenly had my own office. The sign on the door said ‘Director’. There was no shying away – I was Impostor-in-Chief. I spent the day rearranging the furniture, hoping no-one would notice how ill-equipped I was for the job.

Learn about the many cultures in our world so you are better equipped to recognise racism. Read, travel, make friends and be curious. Don’t make assumptions about what people think or believe, or how they would like to be treated, based on their appearance or accent. Ask them.

It’s the beginning of a new clinical year and a good time for us all to think about how we can best work together. We should all reflect on our behaviour occasionally and think about the impact we have on others.

If large numbers of Australians require urgent hospital treatment for the novel coronavirus, how will the system cope? With great difficulty, one would assume, given the widespread concerns raised in recent months at Croakey about the pressures on Emergency Departments. In this timely wish list for health system reform, emergency physician Dr Clare Skinner offers 11 suggestions for improving emergency care, many of which would have wider flow on effects.

While the scale of the current fires is unprecedented, bushfires are a regular occurrence around here. Most Australians have been touched by fire. When we see the pink ‘bushfire sun’ we know what it means. For me, the smell of bushfire smoke triggers complex memories.

As admitting officer, I’m here, on the end of the phone, to help you. It’s so much easier when we’re nice to each other, and it’s better for our patients as well. We’ll work together. We’ll be polite, professional and well prepared. We’ll respect each other’s skills and be mindful of our contexts. And we’ll be forgiving when things don’t go perfectly. Who knows? One day, we might become friends.

We work on the edge. We see all of humanity. We feel the cracks in the system. We meet people on their worst days and we know how easily lines can be crossed. We need to be social justice warriors – because our skill and experience can drive important structural and cultural change for good.

I arrived early. Dressed in plain clothes. The butterflies in my stomach fluttered so hard I thought they might escape through my mouth.

A talk delivered at the ACEM Annual Scientific Meeting, November 2019

Last month, the Medical Journal of Australia called for manuscript submissions on the topic of “Women in medicine and medical leadership in Australia — is there gender equity?” We answer with a resounding no. Indeed, we believe the question itself perpetuates gender disparity by suggesting that the answer is up for debate.

He spent a few minutes showing me how the safety device worked and giving me tips for getting cannulas in first time. ‘Don’t tell anyone I did your cannula’, he whispered, and left. This small act would become central to my philosophy and practice of medicine. Civility saves lives.