John Cartmill, MBBS, BSc(Med), MM, FRACS | Surgical Leadership Program

John Cartmill.John Cartmill is a professor of surgery in the Faculty of Medicine, Health and Human Sciences at both Macquarie University Private Hospital and Nepean Public Hospitals in Sydney. His research interests—informed by linguistics, engineering and psychology—focus on safety and quality improvement, medical communication and medical and surgical learning. 
 
As a surgical trainee, Cartmill was intrigued by the behaviors surrounding medical error, which was not a hot topic at that time, and by the groundbreaking changes unfolding in laparoscopy. Following a laparoscopic surgery fellowship in the US, he worked as an engineer at a biomedical company, acquiring several patents. After completing a colorectal surgery fellowship at the Cleveland Clinic, he returned to Sydney to practice as a colorectal surgeon at a growing hospital. 
 
When a brand-new hospital opened at Macquarie University, Cartmill accepted the offer to join the surgical staff and was excited to see how much the school was influenced by Harvard. “The vice chancellor and deputy vice-chancellor all rave about Harvard programs and return for refreshers,” he says.    
 
An advocate for integrated and collaborative ways of learning in his own clinic, Cartmill selected the Surgical Leadership Program at Harvard Medical School to delve deeper into accounting and business modeling. In light of his lifelong interest in personal development, he found the sessions in these two areas to be particularly powerful as they provided the opportunity to reflect in between and then pull all the threads together.  
 
“I was talking to an early career surgeon about how being exposed to this material earlier in my career would have made such a difference,” he says. “I had big ideas but couldn’t work out why they didn’t always turn out the way I wanted. That’s the reason I took the Surgical Leadership Program, and I was not disappointed. It was one of the best learning experiences I’ve ever had, and I made some good friends.”  
 
Learning how to develop a business model was the foundation of his capstone project, which focused on ways to increase the market share of colonoscopies at an underutilized new facility in Macquarie University Hospital, while also taking into account the social justice implications. 
 
“Currently, you can’t get a colonoscopy in Sydney in a public hospital or a government-funded hospital on a weekend,” he explains. “So our plan was to make that available at our private hospital at an affordable rate that would still make it worthwhile given Saturday penalty rates.”  
 
Given that private hospitals are often more efficient than public facilities, a public-private partnership was the business model. Cartmill was able to apply insights he gleaned from the program to quiz the C-suite executives and then develop a strategically targeted business plan.  
 
“They had the resources to tell us where patients were going to get their colonoscopies, what proportion of that market our relatively small hospital enjoyed and what the capacity was to grow,” he notes. “While the business plan hasn’t yet been put into practice, it looks to be more and more viable.”  
 
As Cartmill matures in his career, he is being asked to serve on committees in a position where he has the capacity to help bring about change. Now he feels more confident about going into a meeting with nonmedical financiers, accountants and business people because he can engage at their level and contribute to the conversation. 
 
“As a professor,” he notes, “I have insight into remote learning, face-to-face lecturing and how to run a workshop and engage a group. But I was just blown away by the quality of the Harvard program. So, for me, an unexpected takeaway was just how good the adult education experience could be—and that’s with my adult educator hat on. It was extraordinary.”  


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