Sharp Scratch

How to navigate the hospital hierarchy

Apr 17, 2025

Lorelei Jones, a medical anthropologist and senior lecturer at Bangor University, shares insights on navigating the complex hierarchy within healthcare. She discusses the challenges junior doctors face in advocating for patient safety in a system that can stifle their voices. The conversation highlights the shift towards more collaborative, patient-centered care post-COVID, emphasizing the importance of psychological safety and open communication. Lorelei also encourages empowering medical students to speak up and voice concerns, fostering a healthier work environment.

40:17

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Episode guests

Lorelei Jones

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Episode notes

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Quick takeaways

Understanding hierarchical structures in healthcare is essential for navigating roles and advocating for necessary changes while prioritizing patient safety.

Fostering collaboration and psychological safety in medical education can empower future doctors to improve communication, creativity, and overall healthcare outcomes.

Deep dives

Understanding Hierarchies in Medicine

Hierarchies in the medical field often serve as a mode of control based on formal authority, a characteristic that is particularly evident in publicly funded healthcare systems. The NHS, with its vast workforce, requires some organizational structure to effectively manage its operations, leading to the existence of these hierarchies. While this structure may help maintain order and accountability, it also raises concerns about the potential for power imbalances and the impact on doctors’ morale. Understanding these hierarchies can help medical professionals navigate their roles and empower them to advocate for necessary changes.

Intro

2min

Navigating Hierarchies in Healthcare

16min

Navigating Collaboration and Hierarchy in Medical Teams

2min

Evolving Collaboration in Medicine

14min

Navigating Hierarchy and Collaboration in Healthcare

3min

Navigating Feedback and Safety in Medical Hierarchies

2min

Empowering Voices in Healthcare

4min

In this episode of Sharp Scratch, the panel gets together to talk about hierarchies starting in medical school and continuing through our working lives as doctors.

The panellists, made up of medical students Maz, Sarah and George, chat with expert guest Lorelei Jones, medical anthropologist and senior lecturer in Health Sciences at Bangor University.

Together they discuss what is meant when we talk about the existence of hierarchical working in medicine, how hierarchies can be problematic, and how we can challenge this. The episode also discusses the importance of collaboration in work environments, the importance of psychological safety, and how we can work to empower medical students and residents to speak up when they have concerns.

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