AustralAs J Cardiac Thorac Surg 1993;2(1)

Editorial

Financial Planners And Doctors

T he health industry is growing rapidly throughout Asia, with the building of hospitals, clinics and

health care centres at the top of many national agendas. As the growth continues, senior health professionals

are likely to find that many of the responsibilities for administration and planning that had in the past been invested in them will be shifted toward the “bean counters” - health economists, management experts and the like.

Systems planners are important in creating an insti- tution which can keep track of patients, staff, supplies, medical records and so on. The finance planners must know where the dollars are going and why.

In fact, the shift may be already in progress as multi- national consultant firms are contracted by federal, regional and city governments to plan and build their facilities. These consultant firms consist of accountants, architects, health economists and business managers whose first concerns are budgets and schedules, and to whom improving the level of health in the general popu- lation is of secondary importance.

However, health professionals must be vigilant that the management and finance experts don’t take over the system. When it comes to patient care (which is the reason that the institutions exist), it is the health profes- sionals who know. Dedicated surgeons, physicians and general practitioners have their patients’ welfare at heart.

Unfortunately, in Australia, the role of doctors in planning and administration of the health system has seen a dramatic decline. Concomitantly, the numbers of health bureaucrats have increased while bed numbers have declined and doctors are labelled as self-interested. Obviously, something is wrong.

Recruiting consultants to plan and build new In this edition of the Journal, Professor Peter facilities is prudent, especially as their level of expertise Baume and Mr Roger Mee give their views on health can prevent wastage of resources which could be used for planning and the diminished roles of doctors. Doctors treating patients. For example, architects are important in throughout Asia will be interested in reading their constructing state-of-the-art buildings which accom- warnings. The message is: Keep health care in the hands modate modem medical, surgical and nursing practice. of health professionals.

The Journal Today And Tomorrow

T he Journal’s role in clinical and scientific endeavour is to cater for the special features of cardiac and

thoracic surgery in Asian-Pacific countries. In this region we have a higher proportion of con-

genital heart disease, less access to costly disposables than in other Western countries, and a medicolegal milieu different from the highly regulated, litigious environment of North America.

In most busy cardiothoracic surgical units, laboratory- based research and formal clinical research (as in clinical trials) are the exception rather than the rule. Another area of scientific activity also is important but can be over- looked, that is, the development and reporting of new surgical techniques, and case reports.

A high quality scientific journal is necessary in all these activities.

The Asia-Pacific area needs a peer-reviewed journal of an international standard based in this region but not dominated by any one country. In catering to these special needs, we have been careful to keep our focus on the entire region and not to let Australia and New Zealand predominate. The Journal has assembled, and is continuing to recruit, a group of contributing editors and referees of international standard from Australia, New Zealand, Asia, India, Europe, and North America. In 1992 the Journal was accepted for listing in the Australasian Medical Index.

Our intention is to maintain our commitment to growth, excellence and reducing the delay and diffi- culties in having papers published in the older, more established international cardiac surgery journals.

Franklin Rosenfeldt

Editor

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