Everyone move on, there's nothing to see here ... except things don't actually work that way
I think I mentioned last Friday that this story wasn’t likely to just fade away, as we suspect the RACGP was planning for by refusing to go on the record. There are too many loose ends still.
So we awoke this morning to hear that Australian Doctor didn’t take too kindly to the GPDU post last week, particularly we guess to the insinuation that it might have made things up. We hate to say “we told you so”, but it’s not the history of that title to make things up. Australian Doctor does tend bleed journalism as a core value.
So this morning deputy editor Paul Smith asked a GP friend if they could post a reply to Dr Seidel’s post last week, as he was not able to access GPDU himself but he felt that if things were being aired on that forum he should somehow get a reply on that forum.
We have published that post in full HERE for a couple of reasons:
- GPDU, for all it is clearly a very useful GP only discussion and ideas sharing forum, only has 3500 members, or so. But there are a lot more GPs out there, most of them members of the RACGP. Between registrars and fellows, the RACGP has nearly 35,000 members. So we figure this discussion should be aired to a wider audience.
- There are broader issues here. They aren’t what people might expect though. Australian Doctor and The Medical Republic don’t think that this incident, per se, is a particularly big deal. What we think might be interesting, and might say something important that would be useful to discuss, is how something so banal (though very annoying) – a couple of RACGP Council members going rogue for whatever reason – is being treated in the manner it has been by the RACGP.
I have been on a lot of boards in my life. The RACGP Council is very much a board. You can read their role HERE if you like. In shorthand, the Council is a representative group which meets regularly to oversee the development, and then the monitoring, of strategy, and the employment, and monitoring of, the key people who will execute that strategy. To some extent this all involves purpose. Why an organisation exists. It is an extremely important mechanism for running organisations, be they companies, or, in this case, a medical college.
A board or Council of thirteen is quite a lot to maintain cohesion, and control over. Even well and tightly run boards of less than eight can be tricky.
What appears to have happened in “the curious incident” is a couple of board members have either not taken their responsibility seriously enough and not read Council meeting papers after meetings, or they have quite deliberately gone off-reservation, knowing what is in the board papers. Let’s not speculate, yet, on what their agenda might be.
Is this a big story? Council members, probably only two out of thirteen, go outside of governance procedures and attempt some sort of destabilisation of the greater board to make a point? The short answer is no, it’s quite common. It shouldn’t happen, on a well-run board, but boards are full of humans, and humans get frustrated and desperate.
It’s possibly even less of a story in the case of the RACGP because who on the RACGP is a trained board or Council chairman? How much training has each of the Council members had in being on a board, or did they get after they got elected? I don’t know the answer to this, but given what is going on, you’d have to suspect not much – or if you think that’s not fair, not enough.
Dr Seidel is a regional GP. Sure, he’s been very politically astute and involved, otherwise he wouldn’t have made it to the top. But he is very probably a GP first, as most GPs seem to be, and a council president second. Which makes him reasonably green in his first year of trying to keep a large board completely under control.
Big public companies almost always pick a professional “chairman” to run their boards. Someone who has been thoroughly trained and has experience in running people and boards. They tend to be former leaders of people, with a lot of experience. This isn’t the what we see on the RACGP Council, and neither should we expect that, given the structure and governance that has been put in place. New presidents and chairs of the RACGP would learn about running a board or a council, and often about “leadership”, while on the job, we suspect.
It makes this “curious incident”, very probably, quite a small incident. One or two board members either weren’t looking, or were, and went to the press to distance themselves from the Compact, which they thought was pretty lame. From all accounts privately, and certainly publicly, the rest of the board, at least, held the line. Why did these board members go rogue? It’s still hard to tell. But we are guessing it’s got more frustration in it than just them not thinking the Compact was very well handled.
It’s actually a good sign that you have Council members who are prepared to speak out against the decision of their peers. It’s healthy.It’s just not a great look when they do it the way these Council members have done it.
Two things tend to happen when an incident such as this occurs on a company board that has a good chairman.
The chairman somehow pulls the rogue elements in and chats to them about what happened. And listens. Sometimes that can result in a board member having to resign because there are clear conflicts. But the best outcome usually is that members who have conflicting views are heard and allowed to be heard.
A very good chairman will even allow, in the right circumstances, for a board member to voice their contrary views publicly without any repercussion.
Somehow, the RACGP doesn’t seem like the sort of organisation that would allow this sort of thing to take place. Processing criticism, whether justified or not, is not their strong point. The “curious incident” is a good example. It’s way bigger than it needed to be. And you can’t just blame the media for that and say we are a bunch of ratbags, as some kind person did last week on GPDU.
What occurred could have been stopped in its tracks with a little straight talk and a willingness to engage professionally with the media. Say what happened, and get it on the record and clearly understood, then move on. Some mistakes were made, some people aren’t happy, but so what.
But what we’ve ended up with here is the RACGP deciding that the best way to handle the situation was to not talk on the record to the medical media, but to go on a GP-only forum, as if this were a special place, where only sensible and truthful discussions take place. Forget that GPDU only has 3500 members and the audience for this incident is more like 35,000. This is “secret doctors’ business” which we will handle all in-house.
Dr Seidel, in my experience, is a very committed, earnest and well-meaning president. But that was an arrogant and naïve thing to do. Why did he do it?
The RACGP has a large professional executive which advises him, including professionals which advise him on handling PR and the media. Why does the RACGP executive think it is OK to post material suggesting the media is making things up? Why didn’t they help Dr Seidel on this matter? Why do they think it’s OK to just post something on a GP forum and move on?
The pattern here is one that is occurring quite a bit these days.
One explanation for the RACGP doing things like this is, quite simply, because they can. The RACGP is in a position of extraordinary power. Revenues won’t drop and neither will membership if it ignores people and moves on. Certainly not in the term of this president, and quite probably not in the term of the executive and the CEO, will such arrogance harm them.
The college is able to just think “we are right, they are wrong”, and move on. No need to address this issue outside of what we think. Because, unusually for such a big and fast growing and powerful organisation, there are no short-term repercussions for behaving this way.
Many people think the RACGP has done this recently with professional-education providers. The organisation has even stated officially that there are no providers of any note really which have been affected by the recent changes to the college’s education strategy in the new Triennium. That it’s all just noise.
It isn’t. A lot providers are seething with anger. Some are quite literally in despair. Many are run by GPs, or have GPs as key people in their businesses.
Today, many are doing all they can in the background to let GPs know how poorly they have been treated. A lot just have to suck up huge additional costs and accept making less profit. Some are leaving the business because they have gone into loss. Others have their hands in the air saying and asking why are GPs paying so much when there are new ways of education that are more effective and cost a lot less?
There is a lot going on outside of what the RACGP thinks at its highest levels, but it doesn’t seem to matter, because the RACGP has ruled, and moved on.
RACGP revenues have increased by more than 15% in the past year. They are approaching, and will probably exceed, $60 million this year. And the college carries a lot of cash on its balance sheet. It is a very healthy organisation, currently, financially.
Maybe that, too, adds to the thinking that it can do no wrong. After all , look at the commercial scoreboard. It looks pretty impressive.
But this money is coming from both membership and from organisations that have to pay more to take part in an education regime that is wholly dominated by the RACGP. How efficiently, really, is this money being spent? Who asks these questions of the Council? Who really gets to interrogate them?
Like with the “curious incident”, it’s fairly easy in the short term for the RACGP to mark itself and say it is right and everyone else is wrong.
This is a very rare thing to be able to do in normal business. But you do see it. Google and Facebook do it a lot. Because, so far, they can. They have a business model that makes them extraordinarily powerful.
The problem, of course, with that power is that eventually it is very corrosive. Corrosive from within and corrosive from without. Witness what is happening in Canberra today regarding Google and Facebook. People aren’t happy.
If you asked me today if the RACGP has a good strategy and is doing the right thing by everyone I’d be quite conflicted. The college clearly does lots of good things and whenever I interact with Council members I feel that I’m talking to dedicated individuals who are genuine and mean well.
So what is wrong with this picture?
Power probably. When you have that much power you have to work harder at caring. You have to work harder at being empathetic. And whether you think people are right or not, you just have to listen. Or at the very least be seen to be listening. Too often the RACGP isn’t seen to be doing even this.
In the case of the professional CPD businesses, the RACGP might well be right in how it is choosing to move forward. Their PLAN self-reflection initiative might be just what is needed. But the way it was implemented, with little consultation, without empathy, was awful. And worrying.
What would happen if the RACGP is doing some stuff that isn’t actually good for the future of GPs, but the Council and executive think it is? Who puts a brake on that?
One of the most common criticisms I hear from GPs about the organisation these days is that it is a very hard and dense organisation to penetrate and make any impact on if you feel things are wrong.
It’s insular, and it doesn’t tend to listen to detractors. Having a deaf ear to detractors because you can is dangerous, because you’re building yourself a bigger and bigger echo chamber. You can’t test your strategy and manage it, as a board or council is meant to do.
Will the RACGP listen to the words of Australian Doctor and The Medical Republic and take any note at all of the issues we are raising? Or will we be dismissed as the ratbags who aren’t GPs anyway?
For the record, The Medical Republic is run by GPs, and if it ever isn’t, then it will be in trouble. And most of them are still practising, as we all see that as vital.
Do those doctors who see us as ratbags and paper for the bottom of the budgie cage really think that the RACGP and the AMA, especially in their current incarnations, would be better off with no journalism and no medical media? With no questioning of anything?
For reasons I will not go into here, the medical press in Australia can still afford to fund serious and dedicated journalists. Paul Smith is one of those journos. He doesn’t get it right all the time for sure, but like Dr Seidel, he is earnest and trying to do his best job. We are all lucky he is there being a pain the ass.
I’m not going to bag either Dr Seidel or Paul Smith. They are both trying, and, in my assessment, not playing silly buggers.
But there is something wrong here with the RACGP.
As an organisation, it is unusually powerful because of circumstances, and I’m not sure it understands that.
I’ve been told, point blank, that I don’t get it. That the RACGP isn’t actually unusually powerful at all. That it’s all normal. I was told this by someone very senior in the RACGP leadership. I think they believed what they were saying.
If anyone on Council thinks this is maybe just a little scary then I suggest that this, and some recent feedback from the outer reaches, such as the letter written to the RACGP by Professor Simon Willcock, or the response by Paul Smith to the casual assertions about Australian Doctor, are given a good airing at some time by Council.
The solution, if there is one, isn’t going to be easy. Although there isn’t anyone being sinister here, or pulling strings in the background, there is a vacuum of understanding on the part of the members, and if you don’t fill a vacuum with something people will usually fill it for you.
Part of that vacuum is the role and influence of the executive of the RACGP. The executive will say it is just there to serve the Council and therefore will not, and even cannot, comment on anything.
A lot of GPs express to me quite a bit of fear about how powerful and influential this long-serving executive might be. I have nothing to offer them by way of insight. The only time I ever asked the CEO a question she firmly asserted to me that, as the CEO of the organisation, she never commented on anything.
It’s a very opaque part of the organisation and not normal for a healthily functioning company. No one seems to have any handle on how influential the executive actually is. We are just told, mainly by the executive, that it isn’t. And, by inference, I guess that we need to grow up and trust them.
The executive has been long serving, are professionals in the commercial world, have continuity of service and history in their hip pocket, and should, in many people’s view, be open to more scrutiny. Did anyone on the executive advise Dr Seidel to stonewall the press? If they did, they gave him very poor advice. How are they accountable, in any way, if that did happen?
It feels like there is a structural issue which is rapidly emerging for the RACGP as it becomes much bigger as an organisation. How does it effectively look at itself and check itself when it doesn’t have to – and when there aren’t any effective mechanisms in place to do it, and, apparently, not a great deal of desire to put any in place?
