Knives out over surgery appointee

July 14, 1995

John Hunter once said a surgeon was no more than a savage with a knife. The father of modern surgery was referring to the barber-surgeons of his day who hacked off limbs at the first sign of disease.

In Hobart, 200 years on, surgeons seem equally ferocious in protecting their livelihoods, as the University of Tasmania discovered.

The university has been trying to fill a vacancy for a professor of surgery in its medical school since 1993. Late last year, a selection committee that included representatives of the Royal Hobart Hospital nominated a highly qualified American academic to the post.

The university council approved the nomination, made an offer and the American accepted. But he was a cardiothoracic specialist and, had he taken up the post, Hobart's two experts in the field would have had to split their caseload - and presumably their income - three ways.

After much lobbying, doctors on the hospital's clinical privileges committee declared the American would be denied privileges - he could not operate there. "He was blackballed on purely economic grounds," a committee member said.

Months of wrangling followed until the American finally gave up. The state committee of the Royal Australasian College of Surgeons then warned that unless someone acceptable to the profession was appointed quickly, the surgeons would refuse to teach in the school and would give it a negative report when an accreditation committee from the Australian Medical Council arrived in September.

The Tasmanian school is the country's smallest and there were fears it could face closure after a decision to cut medical student enrolments in Australia by 200. Also, a medical council team had in 1990 given the school an interim accreditation for only five years, instead of the usual ten, because of concerns over its curriculum and number of departments. The school has now been restructured and its 11 departments cut to six.

But the row looked set to negate these efforts. With most of Hobart's 30 or so surgeons taking classes in the school, the doctors were in a powerful position to dictate terms.

Bob Linacre, chair of the college of surgeons' state committee, said the college had simply "gently reminded" the university that surgeons provided much of the teaching and that they would be asked to supply testimony to the accreditation committee.

University vice chancellor Alan Gilbert said: "For the college to oppose reaccreditation of the medical school after the applicant had withdrawn would have been vandalism. It would be self-defeating to obliterate the school because of the way appointments had been made."

Now a settlement has been reached. The professor of surgery in Tasmania will be a joint appointment at the hospital and the university. Another advert will be drafted and the vacancy filled temporarily.

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