The scourge of managerialism and the Royal Australasian College of Physicians

Paul A Komesaroff, Ian H Kerridge, David Isaacs and Peter M Brooks
Med J Aust 2015; 202 (10): 519-521. || doi: 10.5694/mja15.00170

The managerialist organisational model has penetrated deeply into our institutions, with destructive consequences

Many health practitioners will consider the theory of business management to be of obscure relevance to clinical practice. They might therefore be surprised to learn that the changes that have occurred in this discipline over recent years have driven a fundamental revolution that has already transformed their daily lives, arguably in perverse and harmful ways. They might also be interested to discover that these changes have by and large been introduced insidiously, with little public debate, under the guise of unquestioned “best practice”.

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  • Paul A Komesaroff1,2
  • Ian H Kerridge3
  • David Isaacs4,5
  • Peter M Brooks6

  • 1 Monash University, Melbourne, VIC.
  • 2 Centre for Ethics in Medicine and Society, Melbourne, VIC.
  • 3 Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW.
  • 4 The Children's Hospital at Westmead, Sydney, NSW.
  • 5 University of Sydney, Sydney, NSW.
  • 6 Centre for Health Policy, University of Melbourne, Melbourne, VIC.

Competing interests:

We are Fellows of the RACP and all have held honorary positions within it over a number of years. Paul Komesaroff was chair of the RACP Ethics EAG and its forerunners from 1995 until it was disbanded by the College in 2013, and was a member of the Therapeutics EAG, the Policy and Advocacy Committee and many other committees. Ian Kerridge was a member of the Ethics EAG from 2008 to 2013. David Isaacs is Editor-in-Chief of the Journal of Paediatrics and Child Health, a former chair of the Written Examination Committee, and a member of the disbanded Ethics EAG. Peter Brooks was a member of the College Council from 1985 to 1995, Honorary Secretary from 1990 to 1995, chair of the Workforce EAG until its disbandment in 2011, a former chair of the Research Advisory Committee and the Fellowships Board, and a member of many other committees over a 30-year period. Paul Komesaroff was chair and David Isaacs and Ian Kerridge were members of the working group that prepared the guidelines for interaction with industry (awaiting ratification) between 2011 and 2014. We all advocated for a “No” vote in the constitutional referendum of 2013, were signatories to a call for greater transparency and democracy in the College, and were subject to legal action in the Federal Court by the College. Paul Komesaroff teaches ethics at Monash University, and Ian Kerridge and David Isaacs teach ethics at the University of Sydney.

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