I’ve recently returned from a trip to Sydney Australia and SMACC, one of the premier emergency and critical care conferences in the world now in its 7th and final iteration.  

It’s the first continuing education conference I’ve attended since residency training where I was not actively networking or recruiting other physicians, and it’s been great to be an attendee with no responsibilities outside of being present.    Over 3000 attendees traveled from around the globe to learn new skills that can be applied to the actual practice of clinical medicine – a nice change from the trade show conferences I’ve grown accustomed to in the States.

I’ll share my observations from my week in Sydney.  First of all, apparently I’m the only physician in the world without a Twitter account.   And now with Tom Brady’s announcement this week, the only American male as well. But I digress.  

What I found interesting:

1.   There were just as many lectures on communication skills, empathy, and other “soft” skills in medicine as there are on traditional clinical topics.    It’s clear the world view on medicine is changing. One quote from a medical school dean in Australia that I found particularly insightful is that the “value proposition in medicine has shifted from knowledge collection to communication”.   I’ve heard a similar message in articles from Steve Klasko, the President and CEO of Thomas Jefferson in Philadelphia, who advocates for a new approach to selecting entrants into medical school. Basically, less IQ and more EQ.

Perhaps this is all foreshadowing of the changing workforce and the impact that artificial intelligence will have on medicine in the near future …  We need to get a leg up on the machines, and focus on the advantages that human doctors will have!

Or perhaps it represents a renewed recognition around the importance of communication in allowing patients to make informed decisions about their healthcare, especially as they assume greater financial responsibility for their own care in the future.   Either way, much of this conference felt more like a TED talk than a medical school lecture. It was refreshing.

2.  There was plenty of discussion around physician wellness, but no mention of “burnout” or “moral injury”, two descriptors that have dominated US physician discussion boards over the past 12 months.

Emergency physicians outside the US are dealing with very similar issues regarding ED overcrowding, the “boarding” of admitted patients in the ED, increasing mental health related visits, the challenges around end-of-life care, etc.  


  • Perhaps the rest of the world’s physicians have a greater sense of autonomy and control about their profession, and are therefore able to accept these problems as their own to solve.   
  • Perhaps they work less clinical hours than American physicians (my sense is they do).  
  • Perhaps they have greater resiliency… or simply that less financial stress in the form of educational debt gives international physicians a sense of an “out” that many US physicians lack.   

Regardless, there is not much self-pity in the international community with regards to being a doctor.  It is certainly regarded as being a difficult profession, but I didn’t get the same sense of fatalism that I’ve grown accustomed to hearing among American physician circles.

3.  I’m so glad that there are physicians out there this passionate about the practice of medicine.  From doctors doing basic scientific research, to clinical trials on new therapies, to pre-hospital retrieval physicians practicing in austere environments… there are some very cool docs doing really great work out there.  

After spending so much of my career (pre-NZ) focused on the business side of medicine, I felt humbled to be in the same room as these doctors who are so dedicated to the study of how actual clinical care can be improved.   I’ve got some serious nerd envy here for academic physicians.

And so it’s back to life in Gisborne this week.  Next week we’re off to the South Island for some more Kiwi adventures for the kid’s Fall Break.

Wishing everyone a happy Spring back home.  

Jesse Irwin

Jesse Irwin

It's Jesse. I'm an emergency physician and healthcare leader, a Navy veteran, a father of three children, and until recently a land-locked Washingtonian with dreams of living on the ocean. I'm also a Luddite and an unapologetic introvert. But I'm going to give you, my family and friends, and this blog my best attempt at sharing my experiences here in Gisborne.
Jesse Irwin

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