Humanities vital to improving Australian healthcare

Can you name the Australian health researcher who has saved the most lives? It's Simon Chapman, the anti-smoking researcher. He also happens to be a sociologist.

It's a distinction I've been thinking about since the federal government announced its overhaul of university funding that will double fees for humanities courses.

I'm the director of NSW Regional Health Partners, one of nine Australian centres working to facilitate the integration of healthcare, health and medical research, and professional education to deliver better outcomes for Australians. We bridge the gap between research and what happens to people in the health system.

It's a pretty big gap; people don't get the care they need, and then they get care (tests, operations) they don't. The system is wasteful, and it's estimated that 20 per cent of annual healthcare spending - $34 billion in 2016 - is waste. This includes unnecessary care and harm caused to people.

Responses to Education Minister Dan Tehan's claims that humanities education isn't needed in the future Australian workforce have pointed to the critical thinking and writing skills valued by employers, and the breadth needed to maintain and improve civil society and meet global challenges.

Many working in health pinpoint the virtues nurtured by the humanities, especially philosophy. How does a clinician not practising a religion - like 30 per cent of Australians - cope with the daily distress of patients and families, and their own actions in a flawed and fragmented system?

As an educator in Sydney University's post graduate medical school, I saw the value of humanities to clinicians' wellbeing and the care they give. I found the students with non-STEM backgrounds a joy to teach, highly reflective, with wisdom and insight to bring to clinical encounters and the operations of the health system. They were strong team players.

For some students with STEM backgrounds such development was to come, but their narrow education, then busy endeavours undertaking biomedical research projects to advance future speciality careers, wasn't going to aid them.

The humanities aren't fluffy, worthy or nice but simply necessary to improve patient outcomes. There is evidence that we need the humanities and their "soft sciences" - forms of enquiry and ways of understanding - to extract value from our "hard sciences", like biomedical research.

For instance, it's easy to understand swabbing things and then growing a micro-organism - perhaps COVID-19. It's harder to understand the intricate infection control routines that keep patients and staff more-or-less safe, day after day, encounter after encounter.

I was part of a team that studied how to improve infection rates. One surprise was that infection control rules weren't simply "applied". Instead their use varied considerably, but practice could be improved by helping clinicians focus on the intent of the rules, on safety itself. More surprises lay in the actions infected patients took to keep themselves and others safe.

These observations flow into patient health literacy - crucial now that Australians live much longer with chronic diseases. All this practical work, and Simon Chapman's, fits into sociology, with roots in philosophy.

I now work with researchers to ensure their results are implemented into practice, and with health services to help them become better research users. The behavioural sciences connecting these groups and aims are the humanities.

I have experienced many academic disciplines, with an undergraduate medical degree and an MD in neuropharmacology (rat brain slice work). I was a specialist in anaesthesia, which is centred on understanding physiology and pharmacology. But anaesthetists are also leaders in improving patient safety through teamwork - rooted, again, in the humanities.

I became interested in patient safety and improving care, undertaking a sociology PhD on medical (doctor) culture. I had to understand why colleagues, who cared deeply about their patients, were so difficult to engage in improvements to make the processes of care more reliable.

I loved every minute of my PhD, sometimes outraged at the knowledge denied me during five years learning medicine. So much time wasted on trivia like the histopathology of rare types of renal disease, neither retained nor needed.

That PhD, though, gave me the tools to use and create research to improve healthcare; from how narrative develops vigilance in anaesthetic trainees, to a national approach to clinical handover.

I owe a debt to countless humanities scholars. We must ensure they continue to emerge.

Professor Christine Jorm is the director of NSW Regional Health Partners.