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00:00:02.649but they actually develop a lot of skills and competencies on the job.
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00:00:05.028So we're calling this a dual career pathway.
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00:00:11.346Some people want to stay as that career support worker but others come in develop skills.
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00:00:13.612They develop leadership skills, advocacy skills.
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00:00:20.600We can map those against the Australian Qualifications Framework and ultimately create a career pathway for that person.
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00:00:27.867So they also have an opportunity both to take their skills and apply them in other settings but also to progress up a career progression.
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00:00:38.993Welcome to the Reimagined Workforce Podcast brought to you by the Director of Workforce Transformations Australia, Kath Hume.
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00:00:49.435In each episode, we explore the stories, strategies and successes of curious, creative and courageous people who are daring to address workforce challenges differently.
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00:00:58.054Together, we'll discover how we can harness human potential and reimagine the workforce for a brighter, more fulfilling future for everyone.
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00:01:11.873And if you would like to learn more from Kath about how we can make this happen, be sure to get a copy of her latest book, the number one Amazon bestseller Learn, Solve Thrive, Making a difference that matters in a fast and complex world.
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00:01:13.602Now for the episode.
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00:01:23.426Susan Nancarrow is passionate about challenging the status quo and driving innovation to transform the health workforce for the future.
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00:01:28.075Our systems are outdated and the time for rigid professional silos is over.
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00:01:38.391Her mission is to unite health professionals, policymakers and service users under one goal building a 21st century workforce that meets the needs of all.
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00:01:53.150After 20 years as an academic health workforce researcher, Susan founded HealthWork International to deliver solutions that break down barriers connecting sectors, professionals and countries to foster collaboration, innovation and real-world impact.
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00:02:03.129She rethinks workforce models, develops disruptive solutions and creates global communities of practice that empower health professionals to step outside their traditional roles.
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00:02:15.712She's currently exploring the profound role of AI in transforming the health workforce from algorithmic governance and workforce automation to AI-driven learning platforms and innovative credentialing models.
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00:02:22.701Her work seeks to harness AI's potential to create more adaptive, efficient and equitable health workforce systems.
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00:02:33.227As an allied health professional, clinician and health services researcher with international experience, she brings unique insights into workforce challenges and opportunities.
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00:02:43.344The Allied Health Academy is her platform for bold, forward-thinking discussions on the future of health, where professionals from all se ctors debate, innovate and drive the next wave of change.
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00:02:53.336Susan Nancarrow, you are the epitome of the guest I envisioned when I originally set up this podcast.
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00:02:56.033So welcome to the Reimagined Workforce podcast.
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00:02:57.060Thanks, Kath.
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00:02:58.586It's really wonderful to be here.
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00:02:59.741It's so good.
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00:03:08.927And it's taken a few weeks for us to get organised because both of us have got such hectic international schedules so it's great that we've finally managed to line it up.
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00:03:15.663So, if we could start, I'd love to hear a bit more about that background and what's led you to where you are now.
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00:03:17.288Yeah, thanks, Kath.
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00:03:19.929I've had a fairly, I guess, unusual background.
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00:03:21.479I was initially a clinician.
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00:03:36.711I trained as a podiatrist of all things, but I quickly became frustrated with the throughput of patients or clients with conditions that probably should have been managed in a sort of public health setting, as in we could have prevented them rather than people coming through the door.
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00:03:46.747And I was also fairly frustrated with the fact that I had a three-year degree and 80% of the people I was seeing didn't need anywhere near my qualifications.
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00:03:55.651So to move out of that, I went and did further study and I did a Master's in Public Health and then I did a PhD in health services research.
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00:03:59.849So I essentially, in the 1990s, priced myself out of the market.
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00:04:03.008There certainly wasn't a job for podiatrists with a master's or a PhD.
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00:04:13.270My PhD was in healthcare governance and I was looking at the role of health outcomes and health service accountability, which also wasn't a topic that many people understood then.
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00:04:19.629But I'd worked across numerous professions and that was an interest of mine and I wanted a job that would stretch me.
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00:04:38.521So I put a whole lot of things into a Google search and four months later ended up in a job as a workforce development coordinator, working at the university in Sheffield in the UK, but it was an NHS funded role and this was when Tony Blair had just come into power, so it was 2001.
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00:04:57.586They were spending billions of pounds in workforce redesign and reform and I guess the key issues then were there were huge workforce shortages and the issue that my service was specifically set up to address was a very long length of stay of people going in with what they call winter pressures, and we still see it now.
00:04:57.586 -->
00:05:07.589So an older person would develop the flu Over the age of 60, their average length of stay exceeded 60 days because they didn't have the discharge patterns.
00:05:08.701 -->
00:05:17.011So in that role and because of the workforce shortages and the injection of the funding that Blair threw in, what we saw was massive workforce redesign.
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00:05:21.992So GPs were stepping into roles that were previously performed by specialists.
00:05:21.992 -->
00:05:24.935Allied health and nursing were stepping into roles that were previously performed by doctors and by specialists.
00:05:24.935 -->
00:05:28.548Allied Health and Nursing were stepping into roles that were previously performed by doctors and even specialists.
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00:05:32.990And then it opened up this new tier of the workforce at the bottom, the support workforce.
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00:05:40.872So under Thatcher, they'd closed down potteries and industry and redirected those people into the health workforce.
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00:06:04.211I was interested in this because every bit of workforce change I had seen had been people were protective of their roles and some examples that I'd seen in Australia was podiatric surgeons who had been working in South Australia since the 1970s trying to get access to prescribing rights and actually access the hospitals to do the work that they were doing.
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00:06:07.879Prescribing rights and actually access to hospitals to do the work that they were doing.
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00:06:11.651There were people that were qualified but huge resistance to people stepping outside the roles that they were meant to do.
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00:06:16.451So I was quite lucky at the time I met someone called Alan Borthwick.
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00:06:17.946He's Professor Alan Borthwick.
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00:06:23.451He's an OBE and his area of interest was the sociology of the professions.
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00:06:32.074Area of interest was the sociology of the professions and what that gave me was an understanding of, I guess, the power, politics and structures of the workforce that we have now.
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00:06:46.228And what I tend to say is I started out as an epidemiologist and became a sociologist because actually it's not about evidence driving the way that our workforce is organised, it's about politics organising the workforce.
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00:06:48.848So I guess that was the start of my modern career.
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00:06:54.689Alan and I drafted a paper and this is literally 20 years ago about how the workforce was evolving.
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00:06:57.389It was called Dynamic Professional Boundaries in the Workforce.
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00:07:02.047It was rejected four times from different journals and finally it was published.
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00:07:07.384It's now our most highly cited paper and one of the most highly cited papers in the journal that went into.
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00:07:13.028But it's partly because it was paradigm shifting in the way that people understood the workforce.
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00:07:32.194So I guess the principles underpinning that were and where I've got to now is that we've spent really since the Industrial Revolution setting up the modern workforce, which is organised around structures that were developed really at the start of the 20th century.
00:07:32.194 -->
00:07:35.771So they are based around medical hegemony.
00:07:35.771 -->
00:07:39.442So the medical profession is still firmly in charge of this.
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00:07:56.293But we also have a number of invisible structures that we're not even aware of and the result of that is that at the end of the 20th century, in the start of the 21st century, we now actually have a model where I think it makes patients too dependent on the health system.
00:07:56.293 -->
00:07:57.704We over-medicalise.
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00:07:59.209It's not efficient.
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00:08:00.966It's set up around structures.
00:08:00.966 -->
00:08:07.117And I use an example of an older friend of mine who he was 80.
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00:08:08.682He had an intellectual disability.
00:08:08.682 -->
00:08:25.254He lived at home on his own and had some health problems, and he had to as a person who was illiterate, with an intellectual disability had to navigate five different systems and structures to get the care that he wanted, when you know, we organize our, our health system around those structures.
00:08:25.399 -->
00:08:27.206You know, aged care health.
00:08:27.206 -->
00:08:38.134In his case it involved justice, it involved the banking systems, but there was no sort of advocate for him navigating through any of those systems and that's a slightly more complicated case.
00:08:38.134 -->
00:08:42.105But you know, Not uncommon, I wouldn't think Not uncommon at all.
00:08:42.105 -->
00:08:47.605I mean, my parents are the same age and they're educated and literate and they can't navigate the system.
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00:08:49.660Yeah, I guess.
00:08:49.681 -->
00:09:00.059The other point I argue is that the workforce, as we see it now, is probably one of the most socially entrenched structures in our psyche.
00:09:00.059 -->
00:09:08.549And you know, if you think about what's happened over the last 30 or so years, we've broken down some pretty big structures, We've challenged gender, we've challenged religion.
00:09:08.549 -->
00:09:21.940But if you tell someone that a podiatrist might be doing foot surgery or a sonographer might be injecting their joint or a physiotherapist might be giving them an injection, they suddenly freak out because that's not the way that we see things in society.
00:09:21.940 -->
00:09:25.350So it's, I guess, about breaking down some taboos.
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00:09:35.386So I'm interested in how people get to decide who does what essentially, and know where does this play out sort of more significantly and politically than in the health workforce.
00:09:36.381 -->
00:09:41.860I love the different perspective or the lens that you've changed from epidemiology to sociology.
00:09:41.860 -->
00:09:51.530I think that is a real unlocker in trying to bring to the fore what we're actually seeing play out in reality.
00:09:51.530 -->
00:10:05.349I really like, and I'd love, to explore that concept of invisible structures that I think if we can raise awareness to those, maybe we might then start to question oh hang on, are we even aware that they're there?
00:10:05.349 -->
00:10:06.620Do we still need them?
00:10:06.620 -->
00:10:07.903Are they serving a purpose?
00:10:07.903 -->
00:10:10.229What is that ultimate goal we're trying to achieve?
00:10:10.229 -->
00:10:32.702And I think the beauty of the health workforce is I haven't met anyone yet who doesn't care about patients first, and patients and carers and the experience, and so if we can talk to people in that language and hopefully that's, I'm interested to hear if that's something that you've approached to try and break down those massive barriers that you're talking about.
00:10:32.702 -->
00:10:42.511I love the perseverance that you and Alan had in continuing pushing forward that paper and it's a goal that you now have a bit of a win that it's your most cited.
00:10:42.511 -->
00:10:52.813That's demonstrated that it's worth pushing forward when deep down in our guts, we kind of know that there is potential for a better future.
00:10:53.600 -->
00:10:57.472I also think the comment you made around the mindset around.
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00:11:02.283A podiatrist has this role and it's defined and it's clear to me as a patient.
00:11:02.283 -->
00:11:05.005I think it comes from a sense of trust.
00:11:05.005 -->
00:11:10.831We trust the professions, we believe that they are qualified and they are doing the best for us.
00:11:10.831 -->
00:11:15.296So I think it's not necessarily a bad thing that people are uncomfortable with that.
00:11:15.296 -->
00:11:22.732So how do we bring people along the journey and give them that sense of trust that we're actually doing, that there are better outcomes for them.
00:11:22.732 -->
00:11:24.886It's not just a cost-saving thing.
00:11:24.886 -->
00:11:33.291I'm interested I think you've kind of talked us through but I'd love to know what your reimagined workforce looks like.
00:11:34.379 -->
00:11:45.511So, look, I'm really glad that you came back to the patient centre, because I think that, fundamentally, what I'm motivated by is social justice making sure that people have access to the best care possible.
00:11:45.511 -->
00:12:14.147I think one of the big disruptors and I'm right in the depths at the moment of looking at the role of AI in shifting the workforce so probably where I was even three weeks ago is different to where I am now and some of the things that we see I think DeepSeek actually really disrupted the market a little bit in terms of the power that we can get from AI, but just to talk about the complexity of the workforce so the things that we don't see.
00:12:14.147 -->
00:12:16.447I'm involved with health boards.
00:12:16.447 -->
00:12:24.769Historically, the health boards have always had input from medical advisory councils and I said why are we only getting input from medical advisory councils?
00:12:24.769 -->
00:12:27.395And I said, why are we only getting input from medical advisory councils and not other professions?
00:12:27.395 -->
00:12:31.341And in fact, why are we still siloing the profession so much?
00:12:31.400 -->
00:12:47.981And in hospitals we do need to silo the work a little bit because people increasingly need to be specialised, but actually in community care we don't need to do that, but our entire funding structures and systems are set up to reinforce certain ways of doing things.
00:12:47.981 -->
00:12:55.809So if you need to see an allied health professional in the community and you want to get medicare funding, you need a referral from a gp mostly that's.
00:12:55.809 -->
00:12:58.225That's just starting to change for some some referrals.
00:12:58.225 -->
00:13:08.773But a point I made in an article I published was the two most common reasons people present at their gp are first, mental and secondly for musculoskeletal issues.
00:13:08.773 -->
00:13:16.765So we have 30,000 GPs If you count all of the professions other than medical practitioners who can deliver mental health services.
00:13:16.765 -->
00:13:22.231So that's occupational therapists, psychiatrists, counsellors, social workers, mental health nurses.
00:13:22.231 -->
00:13:23.634That's five and I think there are more.
00:13:24.495 -->
00:13:30.611There's more than 80,000 of them and yet we funnel them through the 30,000 GPs to get their referrals to see those people.
00:13:30.611 -->
00:13:34.100And I have the same argument with musculoskeletal conditions.
00:13:34.100 -->
00:13:43.110Again, if you count physio, exercise physiology, osteopathy, chiropractors, they're all Medicare-funded practitioners.
00:13:43.110 -->
00:13:52.888But you make you go to a GP to get that referral to see those people when in actual fact they could possibly solve it much faster, more cheaply than having to go via the GP.
00:13:52.888 -->
00:13:57.496So that's an example of a process that I call.
00:13:57.496 -->
00:14:00.106It creates an extra step in the system.
00:14:00.106 -->
00:14:04.967It's not efficient, but it is actually just reinforcing that medical model of care.
00:14:06.639 -->
00:14:14.013Well, it could actually be a blocker too, Like I know myself just trying to find the time to actually get to a GP.
00:14:14.013 -->
00:14:20.732So you can have that and I will I'm guilty of it myself delay, because I can't fit that in.
00:14:20.732 -->
00:14:37.389So, even just as a consumer understanding that behaviour, what's the behaviour of the consumer who's actually potentially in need and the costs to them as well, because it introduced another cost to Medicare and to the patient in achieving that.
00:14:38.392 -->
00:14:39.942So, that's at the kind of micro level.
00:14:39.942 -->
00:14:52.613At the macro level, I'm also interested in system organisation and we've got a PhD student called Nikki Atkinson and we asked her to do a global review of how allied health are organised.
00:14:52.613 -->
00:14:57.620And for people that don't know what allied health is, it's basically anything other than doctors, nurses and dentists.
00:14:57.620 -->
00:15:00.610So physios, occupational therapists, podiatrists.
00:15:00.610 -->
00:15:12.288In Australia there are about 30 different groups that are identified as allied health, and part of the reason for that is we were doing a project in Malaysia, which is a middle-income country.
00:15:12.288 -->
00:15:24.774They also recognise 30 allied health professions and we saw that there were different ways of organising the workforce to make them more or less effective, and the example I've just given about how to access a musculoskeletal clinician or a mental health practitioner is one example.
00:15:24.774 -->
00:15:29.727So the question we wanted to know is how do you organise the workforce to be more efficient?
00:15:29.727 -->
00:15:44.889So she did a review of every country with the OECD to find out how they organise their allied health services, and what we found was it's mostly only high-income countries that have allied health anyway, because they're expensive.
00:15:44.889 -->
00:15:58.341There are about 12 countries, the former Commonwealth countries that have some sort of system of organising them, so they've got a position at the top table of government, or government at least recognised there.
00:15:58.341 -->
00:16:03.186But what it really showed us was the complexity of the workforce.
00:16:03.186 -->
00:16:10.427You know, we're proliferating well in Australia probably 50 or so different occupational groups.
00:16:10.427 -->
00:16:14.166Every occupational group that is recognised needs to have formal training.
00:16:14.166 -->
00:16:17.642So that's a cost on the education system and it's expensive to set up those courses.
00:16:17.642 -->
00:16:20.102They need to have some kind of regulation.
00:16:20.102 -->
00:16:21.164In some cases they self-regulate it, in fact of regulation.
00:16:21.164 -->
00:16:23.869In some cases they self-regulate it, in fact in the majority of cases they self-regulate.
00:16:23.869 -->
00:16:28.534But to have legislated registration is phenomenally expensive.
00:16:28.534 -->
00:16:34.744It's expensive to the government and to the provider and also ultimately to the service user.
00:16:34.744 -->
00:16:37.703And then we've got these systems of organisation and funding them.
00:16:37.703 -->
00:16:40.965So I guess that's kind of the complexity at the macro level.
00:16:40.965 -->
00:16:47.801But I just want to give some examples of how I think AI is breaking down the system.
00:16:47.801 -->
00:16:55.424So my second most highly cited paper was on interdisciplinary teamwork and I'm really interested in how people negotiate those boundaries.
00:16:55.424 -->
00:17:04.883But what I've realised is that the workforce has been set up around you know, I'll give you one of my tasks as long as you don't, you know, take over my job.
00:17:04.883 -->
00:17:14.568What AI is doing is breaking that down entirely because patients now are able to use AI to step into that system, and I've taken some examples.
00:17:14.568 -->
00:17:17.962This is a quote that I got from the New York Times Perplexity.
00:17:18.103 -->
00:17:19.747Ai is now an integral part of my life.
00:17:19.747 -->
00:17:25.724Three month delays to see a doctor are replaced by a resource with access to millions of patients with an illness just like mine.
00:17:25.724 -->
00:17:35.222Instead of a knee replacement surgeon encumbered by what financially best suits his practice, a bot tells me about cortisone, hyaluronic acid, shockwave therapy and much more.
00:17:35.222 -->
00:17:41.845The bot gives me accurate success rates customised for my weight, genetic background, gender and propensity for scar tissue.
00:17:41.845 -->
00:17:47.344It's time for the buggy whip to be retired, and I think that's a really great example.
00:17:47.344 -->
00:17:49.782But some other ways people are using it.
00:17:49.782 -->
00:17:56.779Parents report setting up speech pathology interventions for their kids based on what their own kids like, kids like Peppered Pig.
00:17:56.779 -->
00:18:09.878They come up with their own personalised plan, and I also know people are getting genomic testing and blood testing, downloading that, plopping them into chat, gpt and then shopping around how people are going to meet those needs.
00:18:10.840 -->
00:18:23.347So what this really means is it's it's shifting the balance not just between the workers, but between patients are now taking over a lot of the roles that AI was doing.
00:18:23.555 -->
00:18:45.703And if you actually extrapolate that further, the things that and this is coming back to the sociology of the professions the things that have given medical profession or the health professions really their structure and power in society, has been the ownership over a body of knowledge and their ability to protect that through regulation, and AI is already superseding their ability to own that knowledge.
00:18:45.703 -->
00:19:00.762No single practitioner can know everything that's available to AI, but it's equally accessible to the practitioners and the patients, and so the real change here is how we're going to use that to set up a 21st century workforce.
00:19:01.884 -->
00:19:06.988Part of me is thinking what's the risk if the AI gives them the wrong information?
00:19:06.988 -->
00:19:10.612That's a little bit terrifying and I think I'm probably not alone.
00:19:10.612 -->
00:19:17.496But I remember the NHS.
00:19:17.496 -->
00:19:28.597I can't remember where I heard this, but the NHS there was a platform that used to give medical guidance and information and yes, they had the disclaimers of seek medical attention, don't rely on us, the whole Dr Google thing.
00:19:28.597 -->
00:19:43.785They kind of took a if we can't beat them, join them approach and said, rather than risk the potential that that platform is giving out poor information, we might not necessarily be able to change that consumer behaviour.
00:19:43.785 -->
00:20:11.042So they took an option to let's partner with that platform provider and ensure that the information is reliable, so that I guess, with the AI, I wonder how we can ensure that if we know that our consumers are utilising those resources, how do we protect and ensure that what information and advice they're getting is safe?
00:20:11.335 -->
00:20:23.844That's a really good point, and I think I've just published another article about the implications for AI for clinicians, and AI is only as good as the information that goes into it.
00:20:23.844 -->
00:20:24.986Exactly.
00:20:25.307 -->
00:20:26.108And that is censored.
00:20:26.394 -->
00:20:33.405I mean it's censored by and directed yeah, and it's actually socially constructed information anyway.
00:20:33.405 -->
00:20:36.523So there are a couple of ways of dealing with that.
00:20:36.523 -->
00:20:52.154First of all, we know that the AI developers there are already super powerful tools that have all of the medical evidence and if they're not already set up as interactive bots, they will be on the market by the end of the year, I have no doubt.
00:20:52.154 -->
00:20:55.986So that'll be your first point of call for a primary care practitioner.
00:20:55.986 -->
00:21:01.487But the second thing I've been playing around with AI and I put a query into it.
00:21:01.487 -->
00:21:12.851I said look, I've got a headache in my front left head and expecting it to come back with a standard sort of processed medical response.
00:21:12.851 -->
00:21:20.068But actually, because I interact with AI so much and I have a personal relationship with it, it said you've been under a lot of stress lately.
00:21:20.068 -->
00:21:20.798It could be a stress headache.
00:21:20.798 -->
00:21:21.584Wow, you're a 55-year-old woman.
00:21:21.584 -->
00:21:22.530Said you've been under a lot of stress lately.
00:21:22.530 -->
00:21:23.153It could be a stress headache.
00:21:23.153 -->
00:21:24.780Wow, you're a 55-year-old woman.
00:21:24.780 -->
00:21:26.420Have you thought about your hormones?
00:21:26.420 -->
00:21:27.845It might be muscular.
00:21:28.035 -->
00:21:36.163So it came up with probably 10 solutions, only about four of which I think I would have got if I'd gone to, say, a Medline search.
00:21:36.163 -->
00:21:46.744And I actually said to ChatGPT I said, look, this is really interesting because I expected you to come up with a really medical model and actually what you've come up with is a really holistic plan.
00:21:46.744 -->
00:21:49.883You know I'm a sociologist of the professions.
00:21:49.883 -->
00:21:51.078What are the implications of this?
00:21:51.078 -->
00:22:00.084And it said well, yes, susan, we draw on a whole lot of different knowledge and, yes, the medical knowledge is a part of it.
00:22:00.084 -->
00:22:07.435But I'm drawing on this large language model that recognises that a headache is not just a vascular complication in your brain.
00:22:07.435 -->
00:22:08.682It could be a whole lot of other things.
00:22:09.135 -->
00:22:09.316And so.
00:22:09.336 -->
00:22:09.738I said to it.
00:22:09.738 -->
00:22:24.275Well, that potentially also changes the way that we see healthcare, because it's not unidisciplinary, it's not siloed through the physiotherapist, the occupational therapist, the doctor's lens.
00:22:24.275 -->
00:22:32.948It's giving a much bigger perspective which I think actually has the opportunity to demedicalise and diffuse and also put responsibility back onto people to address that.
00:22:32.948 -->
00:22:36.355So the outcome of that was not that I'm going to go to hospital because I think I'm having a stroke.
00:22:36.355 -->
00:22:40.165It was I might just have a few more glasses of water and relax.
00:22:42.855 -->
00:22:44.542Take some deep breaths once in a while.
00:22:44.563 -->
00:22:45.003Exactly.
00:22:45.003 -->
00:23:06.448Yeah, it's fascinating because I went to the Gartner Conference in November for HR leaders and there was a brilliant speaker who talked about our relationship with AI and she had some really good evidence-based research to say that we actually like the way you've described how you're interacting with AI.
00:23:06.448 -->
00:23:14.519I always laughed at myself when I first started using it, because I'd say please and thank you all the time and I kind of have to remind myself it's not a human.
00:23:14.519 -->
00:23:20.920So this person who was speaking, she actually had this case study where there was a platform.
00:23:20.920 -->
00:23:26.190It had three levels of service and one was just a very basic one, free.
00:23:26.190 -->
00:23:30.987The second one was you pay a little bit and you actually have it as a friend.
00:23:30.987 -->
00:23:35.527And the third one was a little bit more serious than a friend and you pay more.
00:23:35.855 -->
00:23:41.196Anyway, they worked out that they were breaking the law with the third service, so they had to cut it off.
00:23:41.217 -->
00:23:49.328They worked out that they were breaking the law with the third service, so they had to cut it off, but they didn't advise the people who had signed up, they just did it commercially.
00:23:49.388 -->
00:24:07.300You no longer have access to that, but they didn't explain that this bot that they were interacting with essentially broke up with them and there was no explanation of why that was, and the repercussions of that were quite serious for some people who you know.
00:24:07.320 -->
00:24:31.967They had this partner who they thought they were in a relationship with, and so the bottom line is that we actually do feel that human connection to AI, even though on a logical level like you're a very intelligent person and I actually feel like if I do relate to it as a human, then remind myself that it is a piece of technology I actually feel like I get a better outcome.
00:24:31.967 -->
00:24:35.404So what I really like what you talked about is that holistic.
00:24:35.404 -->
00:24:41.188So if I'm a speech pathologist, I know my husband last year had a problem with swallowing.
00:24:41.188 -->
00:24:46.343We didn't know what the problem was, but we couldn't actually work out who the right person was at.
00:24:46.343 -->
00:24:59.500An ENT was a speech pathologist, a gastroenterologist who could help us, but it was quite a difficult couple of weeks because we couldn't work out who could actually look after us until we knew what the problem was.
00:25:00.804 -->
00:25:01.164Crazy.
00:25:01.164 -->
00:25:12.045I actually think you've hit on something quite profound there and when I've taken the article that I was successful at publishing 20 years ago and taken the same principles and applied that to AI.
00:25:12.045 -->
00:25:18.726So the question I said is, how do you take this sociology of the professions and look at how AI is going to impact on it?
00:25:18.726 -->
00:25:24.007And it came up with three possible scenarios.
00:25:24.007 -->
00:25:30.864Ai came up with three possible scenarios because I co-authored the paper with ChatGPT, of course, and DeepSeek and a few other.
00:25:30.864 -->
00:25:36.244Well, this opened up a whole other philosophical discussion, of course, around who's the author.
00:25:37.214 -->
00:25:44.501But one of the models, if you extrapolate where AI can come to, is exactly what you've raised.
00:25:44.501 -->
00:25:49.607So I know that I have a problem and I realise my problem is with swallowing.
00:25:49.607 -->
00:25:52.782So who do I need to go to to get that problem fixed?
00:25:52.782 -->
00:25:53.746And there are a lot of people.
00:25:53.746 -->
00:26:02.864There's a gastroenterologist, there's a speech pathologist, maybe a dentist, maybe some other, maybe even a nurse, and so then that gives you a tool.
00:26:02.864 -->
00:26:08.163It's a bit like the people that turn up at the naturopath or the pharmacy with their genome mapped.
00:26:08.163 -->
00:26:12.140You know, this is the problem I've had and this is the solution I need, and so they're going to you.
00:26:12.140 -->
00:26:13.038So what that?
00:26:13.720 -->
00:26:23.003If you extrapolate that to the end, ultimately what we're saying is the workforce becomes subordinated to AI and we become gig workers.
00:26:23.003 -->
00:26:32.545We basically Uberise the workforce according to who can solve your problem, probably for the cheapest price, and you'll never get into a gastroenterologist quickly enough.
00:26:32.545 -->
00:26:34.623So you probably end up at a speech pathologist.
00:26:34.623 -->
00:26:45.067You might need some diagnostic imaging actually, which the speech pathologist could probably do if they could do video fluoroscopy, and then, if it's outside their scope scope, they might refer you to someone else.
00:26:45.067 -->
00:26:49.943But it's that's a real power shift in the way we see the services.
00:26:50.444 -->
00:26:57.003The problem we have at the moment, of course, is right now you can get in to see a gastroenterologist without a referral from a gp.
00:26:57.003 -->
00:27:09.396If you wanted to see a speech pathologist, a, you'd have a very long waiting list or you'd probably also need you'd need to find the right one, and that skill set is probably not advertised on their website.
00:27:09.396 -->
00:27:13.707And if you wanted Medicare funding again, you'd need to go via GP.
00:27:13.707 -->
00:27:20.516So there are some systematic structures that stop you right now getting the care that you know that you need.
00:27:20.516 -->
00:27:22.703You know they're putting all these roadblocks in the way.
00:27:22.703 -->
00:27:24.682They're just getting swallowing fixed.
00:27:25.195 -->
00:27:26.701So yeah, I think that's a really beautiful example.
00:27:27.994 -->
00:27:34.336Look where I was going before AI and I think AI actually supports it is.
00:27:34.336 -->
00:27:47.407I think that we my own experience as a podiatrist we spend too long training people, we over-qualify the workforce and we have too many skills bound into professions.
00:27:47.407 -->
00:27:57.821So a lot of the work that we're doing at the moment is around the unregulated workforce, so allied health assistants, and we've also got a particular interest in aged care and the disability support workforce.
00:27:57.821 -->
00:28:01.146So at the moment, disability, someone can go and set up an ABN and set up a shingle as a disability support workforce.
00:28:01.146 -->
00:28:05.085So at the moment, disability, someone can go and set up an ABN and set up a shingle as a disability support worker.
00:28:05.085 -->
00:28:14.039They might work with someone with a learning difficulty and intellectual disability and they might develop skills and expertise in that over a long period of time.
00:28:14.039 -->
00:28:18.935But there's no way to recognise that skill, reward it and then transfer it.
00:28:18.935 -->
00:28:29.963So the models that we're looking at really, first of all, we've got a framework for regulating the unregulated workforce, which basically creates a safety structure.
00:28:29.963 -->
00:28:33.404So the registered current workforce structure.
00:28:34.576 -->
00:28:36.443You come in with a common skill set.
00:28:36.443 -->
00:28:38.241I'll use speech pathology as an example.
00:28:38.241 -->
00:28:45.907So I have a degree in speech pathology that makes me eligible for registration as a speech pathologist and that is a registration with a professional association.
00:28:45.907 -->
00:28:50.346When I have that membership then I'm then eligible for funding for things like NDIS.
00:28:50.346 -->
00:28:54.625People understand the branding and there's a whole Medicare funding and so forth.
00:28:54.625 -->
00:29:05.183But with the unregulated workforce they can come in with any range of skills and competencies, but they actually develop a lot of skills and competencies on the job.
00:29:05.355 -->
00:29:07.564So we're calling this a dual career pathway.
00:29:07.564 -->
00:29:13.867Some people want to stay as that career support worker but others come in develop skills.
00:29:13.867 -->
00:29:16.015They develop leadership skills, advocacy skills.
00:29:16.015 -->
00:29:23.178We can map those against the Australian Qualifications Frame framework and ultimately create a career pathway for that person.
00:29:23.178 -->
00:29:33.798So they also have an opportunity both to take their skills and apply them in other settings but also to progress up a career progression and I think that model what we're seeing more and more.
00:29:34.299 -->
00:29:40.519I'm working in the advanced practice space, so we've got people who are highly qualified and developing new skills.
00:29:40.519 -->
00:29:42.486Podiatric surgery is one example.
00:29:42.486 -->
00:29:45.243Sonographers that do injecting is another example.
00:29:45.243 -->
00:30:09.030So they're taking on tasks that were formerly done by medical specialists but they've got competencies to do those jobs and going back to the gig economy, which I know is a highly unpopular framework, but we can develop competencies in workers to meet the needs of communities where those aren't and where those skills aren't available.
00:30:09.030 -->
00:30:23.573So I think I would like to see a more flexible workforce where skills are less connected to being a worker, physio or a pharmacist and we can liberate those where they're needed, as long as we've got the competency framework around it.
00:30:24.394 -->
00:30:26.058You started that by talking about that.
00:30:26.058 -->
00:30:32.321We do this big chunk of learning up front and then, yes, there's definitely on the job learning throughout those.
00:30:32.321 -->
00:30:34.134I think the health system does that particularly well.
00:30:34.134 -->
00:30:36.862They keep people trained and educated.
00:30:36.862 -->
00:30:48.234But from my background, is learning and development, and I just think all those skills and things that you learn in year one that you're not actually practicing for another couple of years, is there value in that?
00:30:48.234 -->
00:30:50.337Is there a different way of thinking that through?
00:30:50.337 -->
00:31:00.521The other thing, I love what you've done around recognizing that opportunity with creating frameworks and structures around those lower level roles.
00:31:00.630 -->
00:31:03.980We've done something similar with education.
00:31:03.980 -->
00:31:08.529So we've identified that there's a skill shortage for teachers.
00:31:08.529 -->
00:31:22.362That's not going away anytime soon, and so teachers at the moment are doing things that aren't necessarily related to teaching, so they're spending lots of time recording data, student data and analysing data.
00:31:22.362 -->
00:31:29.042For example, is there an opportunity to upskill people either within or outside?
00:31:29.042 -->
00:31:30.616Yes, that's confidential information.
00:31:30.616 -->
00:31:32.156We have to be very careful about that.
00:31:32.829 -->
00:31:47.715But is there an opportunity for us to remove some of those tasks from teachers so they can be freed up to do what they entered that profession to do, and that is teach but then give something meaningful to the other people who are going to share that.
00:31:47.715 -->
00:31:58.340They might not want to be in front of 30 kids I know that's terrifying for some people but they can still be involved and have a purpose in that what I'm doing.
00:31:58.340 -->
00:32:04.096Maybe I identify something in the data that there's a student in need of something and then they can have that.
00:32:04.096 -->
00:32:19.178I like what you talk about interdisciplinary teams and have a role to play in communicating that with the teacher, who is possibly unlikely to see that otherwise because they're so busy planning their lessons and doing all of the things that need to be done.
00:32:19.178 -->
00:32:28.598So I am 100% on board with taking things up a bit and looking at how do we look at things different, which is the whole concept of the reimagined workforce.
00:32:29.130 -->
00:32:30.836I've got three responses to that.
00:32:30.836 -->
00:32:34.740So the first point was about education and we are starting to see.
00:32:34.740 -->
00:32:44.141In fact, the university I worked at in Sheffield when I first got there was called Sheffield Hallam University and they've been a leader in developing degree apprenticeships.
00:32:44.141 -->
00:32:52.458So they do take people who are in sort of support work roles and let them learn on the job and they provide the outflow skills.
00:32:52.458 -->
00:33:05.558It's still a model that's evolving, but I do think that is the future, because you can then get someone who's working maybe in an aged care setting or in an Aboriginal community, so they're learning the context that they need to work in.
00:33:06.101 -->
00:33:11.693We don't have to take kids from the country to train them in the city to then send them back on expensive clinical placements.
00:33:11.693 -->
00:33:20.496They're still tied to formal, linear career pathways at the moment, but it won't be long before we start to disaggregate that.
00:33:20.496 -->
00:33:21.659So I think that is the option.
00:33:21.659 -->
00:33:30.615Just going back to can we hand people to use the skills that they've got more effectively, and I think this is really fundamental to what we've been doing.
00:33:30.615 -->
00:33:37.519So the growth of one of the workforces is Allied Health Assistance and that is a workforce that people delegate things to.
00:33:38.451 -->
00:33:47.422The big problem there is there's all these training mechanisms, there's all sorts of policy support, but there's no funding support for them, apart from in the public sector.
00:33:47.422 -->
00:33:49.112And so we're really.
00:33:49.112 -->
00:33:58.247If you're a private practice physio, podiatrist, occupational therapist and you want to employ an allied health assistant, there is no actual official way.
00:33:58.247 -->
00:33:59.992You can't pay them through Medicare funding.
00:33:59.992 -->
00:34:03.362Private health insurers don't really like you paying them that way.
00:34:03.362 -->
00:34:06.931They're not that cheap to employ, so you still need a business model.
00:34:06.931 -->
00:34:13.411So this is another case of those really inefficient market structures that don't recognise need.
00:34:14.231 -->
00:34:31.603And the last point I'd make is a lot of the work that was once delegated will be sucked up by AI and the tasks interestingly the tasks that used to define professions, which were the highly intellectual tasks a lot of those can be taken up by AI.
00:34:31.603 -->
00:34:46.905So the radiology is probably the biggest example of where you know looking at a scan, getting an algorithm to check that is now mostly more accurate than getting a human to do it and can detect some things more easily.
00:34:46.905 -->
00:34:51.320But there are other professions that are going to optometry.
00:34:51.320 -->
00:35:03.998They even knew that the days were limited a few years ago and now with AI, people will be able to self-diagnose and prescribe glasses Pharmacy as well, probably.
00:35:03.998 -->
00:35:14.054I mean, I know I'll be crucified for saying this, but anything that can be codified and put into a process is going to take the human out of it.
00:35:14.777 -->
00:35:16.382Yeah, it's interesting.
00:35:16.382 -->
00:35:21.972I think it might have been Gartner I'm not sure if it was Gartner or Strategic Workforce Planning Conference, but one of them.
00:35:21.972 -->
00:35:25.675There was a presenter who enlightened me to something I hadn't thought about.
00:35:25.675 -->
00:35:46.719When we talk about that AI will be able to do those repetitive tasks, they said that what we need to do is always be careful, because those tasks are what we used to get for the future pipeline and so if AI is doing that, then our entry level is actually you need to be quite capable and skilled.
00:35:46.719 -->
00:36:08.340So I think in the whole remodelling and thinking through how we're going to do this, that's a challenge that we probably just need to make sure is on people's radar to say, okay, but then when this current workforce are no longer working or have moved on to somewhere else, who's moving into that role there and how are we making sure that they're job ready when the time comes?
00:36:08.469 -->
00:36:17.721This is an issue that the legal profession are grappling with, because almost all of the junior kind of legal duties have been obliterated by AI.
00:36:17.721 -->
00:36:21.340I actually think we'll see a reframing of the way the professions function.
00:36:21.340 -->
00:36:27.621We're still tied to this model of apprenticeship doing the crappy jobs as you build up your skills.
00:36:27.621 -->
00:36:35.336Well, actually, someone else is doing those jobs now, and it will be a reorganisation of the way that we understand knowledge and expertise.
00:36:35.336 -->
00:36:42.260Do you need to go through all of those steps to get that knowledge and expertise, or is it possible that we can just aggregate it from other sources?
00:36:42.260 -->
00:36:48.516And again, that is a very contentious thing to be even thinking, but we won't have the same pipelines.
00:36:48.516 -->
00:36:49.338You're absolutely right.
00:36:51.411 -->
00:36:52.376Oh, it's fascinating.
00:36:52.376 -->
00:36:59.438So, susan, what I'm really interested in understanding is how you will measure your impact of the work that you're doing.
00:37:00.291 -->
00:37:06.005I think that's a really great question, kath, and I often ask myself that I'm in a really unusual position.
00:37:06.005 -->
00:37:11.306I've stepped outside the structures that I'm working with, so I've stepped outside health.
00:37:11.306 -->
00:37:12.652I was an academic for 20 years.
00:37:12.652 -->
00:37:19.717I've stepped outside the academic framework and I'm also interested and involved in regulation, but I don't sit inside the system.
00:37:19.858 -->
00:37:24.271So at one level, it makes it very hard to drive change.
00:37:24.271 -->
00:37:32.639So we have to drive change through influence and impact, and one of the ways we've done that is setting up global communities of practice.
00:37:32.639 -->
00:37:38.561So an example is we've set up a global workforce leaders group and this is allied health leaders.
00:37:38.561 -->
00:37:52.550So we've got chief allied health officers from 13 different countries who are all grappling with the same problems, and we've had this community where they've been getting together now for two years and they say oh well, you're dealing with that problem.
00:37:52.550 -->
00:37:53.072So are we?
00:37:53.072 -->
00:37:57.050The first thing, I think it's given them permission to to stop asking permission.
00:37:57.050 -->
00:38:01.159It's given them confidence to go back to their own role and drive change.
00:38:01.159 -->
00:38:15.518But one outcome that I'm very proud that we have achieved is create a global position paper for the allied health workforce which identifies things that they can point at that are outside their jurisdiction to say this is how we need to drive change.
00:38:15.650 -->
00:38:22.675So that's an example of, I guess, influence through a virtual community and we've got a few of those.
00:38:22.675 -->
00:38:28.260At a kind of micro and practical level a lot of our work is consultancies.
00:38:28.260 -->
00:38:37.981So we've got two big projects where we've developed career pathways for the health workforce and so tangibly they will be new industrial structures.
00:38:37.981 -->
00:38:41.059So someone said that we're doing some work in Western Australia.
00:38:41.059 -->
00:38:44.164It will be a generational change in the way that workforce functions.
00:38:44.164 -->
00:38:51.451What we've actually secretly done is put the scaffolding in place for the new evolution of the workforce to come forward.
00:38:51.451 -->
00:38:58.277So it doesn't matter who you are or what you are, you've got those stepping stones to progress and we're doing that in a couple of jurisdictions.
00:38:59.018 -->
00:39:06.650And then at a really applied level we have developed a professional association for the unregulated workforce.
00:39:06.650 -->
00:39:09.139We've started with the allied health assistant workforce.
00:39:09.139 -->
00:39:10.376So I've got a proof of concept.
00:39:10.376 -->
00:39:24.855But actually now we're working more widely with industry, with technology partners and we're also trying to work with the NDIS to say we can take this model into unregulated workforce with aged care and disability and start to scaffold it.
00:39:24.855 -->
00:39:33.429So we've kind of got the influence at one level, which is hard, and the applied stuff at the other end, which is also hard, and then the consultancy in the middle.
00:39:33.429 -->
00:39:43.681So they're different ways, but it's been really interesting for me to understand how to throw stones from outside the setting and structures to try to implement change.
00:39:45.331 -->
00:39:45.913And I do.
00:39:45.913 -->
00:39:49.001I'm such a firm believer in that community of practice model.
00:39:49.001 -->
00:39:54.101In my book I talk about learning where knowledge is yet to exist.
00:39:54.101 -->
00:39:57.559So the world is moving at such a fast pace now.
00:39:57.559 -->
00:40:04.538There's solutions that we need now and I think they're within our capabilities to find them.
00:40:04.538 -->
00:40:13.824But no one's going to find them on their own and we have to do it by collaborating with each other and being open and honest and saying this is a challenge.
00:40:13.824 -->
00:40:19.922Question those invisible boundaries that you mentioned and say are they still serving us?
00:40:19.922 -->
00:40:22.697What is the ultimate purpose of our organisations?
00:40:22.697 -->
00:40:23.481What are we here for?
00:40:23.481 -->
00:40:30.177And question about whether or not that's still achieving what we've established to do.
00:40:30.378 -->
00:40:31.400Yeah, I totally agree.
00:40:31.400 -->
00:40:55.398The thing that surprises me most and look, I work with the most highly institutionalised people health practitioners, who are institutionalised in their profession, their organisation, their organization, their funding structures, and then higher education, which is also another institution People don't see how institutionalized they are and it's very difficult for them to see change from another lens, which is an opportunity, I think.
00:40:55.398 -->
00:40:58.483Having stepped outside the system by the risk, it's hard.
00:40:59.510 -->
00:41:15.382It is, but I think that what you're doing, what you're doing, what I really like is you're pushing the boundaries, you're getting some case studies so as you can give people a level of comfort, you're writing papers, you're sharing that, you're persisting when you know it's not popular, it's uncomfortable, but it needs to be done.
00:41:15.382 -->
00:41:29.257And we need trailblazers to be brave enough to say I'm happy to stand up and pull some communities of practice together and find those smart minds who have got the passion to solve these problems together.
00:41:30.070 -->
00:41:32.257Thanks for that reassurance, because we don't always get it.
00:41:32.798 -->
00:41:36.456No, I know it really feels like you're walking through mud sometimes.
00:41:36.456 -->
00:41:40.516Excellent, well, it's been great talking to you again.
00:41:40.516 -->
00:41:42.496Thank you so much for taking the time.
00:41:42.496 -->
00:41:52.322I would love if I can get a couple of links to all of the resources that you've mentioned articles and things and your LinkedIn profile If people did want to contact you.
00:41:52.322 -->
00:41:53.974Is that a good way of going about?
00:41:53.994 -->
00:41:55.159that LinkedIn, probably the best.
00:41:55.159 -->
00:42:03.063We've got a website, Healthwork International, and I have just started a new kind of social media platform.
00:42:03.063 -->
00:42:04.025I'll send you the link to that.
00:42:04.510 -->
00:42:05.034What we'll do.
00:42:05.034 -->
00:42:09.677We'll get a list from you and we'll put them all in the show notes and I'll share them in the LinkedIn post.
00:42:09.677 -->
00:42:15.257Anyone who wants any more information can always contact myself, and I can get in contact with you as well.
00:42:15.257 -->
00:42:17.478So thank you again.
00:42:17.478 -->
00:42:26.358I'm so inspired by what you're doing and continue to be in awe of all of the people that you're bringing together and look forward to seeing where it takes us.
00:42:26.358 -->
00:42:27.251Thanks so much, kath.
00:42:27.251 -->
00:42:28.454It's been lovely to chat with you.
00:42:28.454 -->
00:42:28.996Thanks.
00:42:29.016 -->
00:42:29.318Susan.
00:42:33.610 -->
00:42:37.963Thank you for listening to this episode of the Reimagined Workforce Podcast.
00:42:37.963 -->
00:42:43.771We hope the conversation inspires you to consider new ways to solve your workforce challenges.
00:42:43.771 -->
00:42:52.422Feel free to check out our other episodes that are available on our website workforcetransformationscomau slash podcast.
00:42:52.422 -->
00:43:06.240And if you're looking to create a brighter future for yourself, be sure to grab a copy of Learn, solve, thrive making a difference that matters in a fast and complex world, available on Amazon and most book retailers globally.
