Macquarie brings US-style model to Australia’s hospital system

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Macquarie University is planning to disrupt the traditional model for specialist medical care in Australian hospitals by adopting a system used in the United States.

As reported by the Financial Review, the higher education provider has announced that it will start directly employing doctors who will do research, teach students and treat patients.

The university has established a new company, Macquarie University Clinical Associates, to recruit doctors interested in working under the US-style model.

Macquarie University vice-chancellor Bruce Dowton said the new model would better integrate clinical care and research leading to improvements in patient care.

Professor Dowton said the new plan would be attractive to doctors at the beginning of their career because they would be relieved of the cost and responsibility of establishing a private practice.

“They don’t have to be worrying about having their own support staff whom they are directly responsible for, they don’t have to be worrying about their own information systems,” Professor Dowton told the Financial Review.

Central to the plan is the Macquarie University Hospital, which is fully owned by the university.

Macquarie is the only university in the country to own a hospital, while other universities around Australia work with public hospitals. Under the latter system, the two institutions have to jointly manage specialist medical staff who split their time between clinical care, teaching and research.

While this system generally works in a balanced way, conflicting priorities can emerge.

“The levers and drivers of universities and hospitals in Australia are sometimes aligned and sometimes they are not,” Professor Dowton said.

“If the public hospital system comes under increasing financial pressure they appropriately have the number one priority of delivering patient care as opposed to teaching or delivering research.

“They do a very good job of managing this balance, but Macquarie University has the unique opportunity to put it all under one organisation.”

Professor Dowton, who was formerly a professor at Harvard Medical School, said Macquarie was following a model that worked very well in the United States where it is used by both public and private universities.

“We’re looking to adapt the best parts of it while respecting the fact that the two [health]systems are quite different,” he said.

Professor Dowton said that some doctors already working at Macquarie University Hospital had already decided to transfer to the new system.

“We are very respectful that a whole range of doctors who are in private practice want to stay that way, but as we go forward this will be the vehicle that new folks come on through,” he said.

“And we believe that once we start to show success in the model that some of the doctors who are currently in private practice will consider moving in.”

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