Liz Marles: leading the way
RACGP President Dr Liz Marles talks about her love of general practice and being at the helm of the College for the next 2 years.
Talking to Dr Liz Marles about the role she took over last October as president of the RACGP, it becomes obvious she’s both a highly gifted communicator and a steadfast advocate for GPs and their patients. But there’s so much more to the quietly spoken and manifestly intelligent woman who is now leading the RACGP. She exemplifies what Jack Welch, the chemical engineer and charismatic former chairman and CEO of General Electric, once said: ‘Before you are a leader, success is all about growing yourself. When you become a leader, success is all about growing others.’
After serving as RACGP vice-president for the past 2 years, and a national council member and chair of the NSW and ACT Faculty since 2008, Marles moved into her new role with confidence. As chair of GP Unity NSW and a member of the GP Council NSW, she was already advising the NSW Health Minister on healthcare. And as a board member of General Practice Education and Training (GPET) and chair of its Prevocational Training Advisory Committee, she was adept at working for GPs on the ground, at the coalface of general practice.
For Marles, the privilege of leadership is an opportunity to make general practice a profession of choice for graduates and to further develop an academic basis for general practice. She also wants to continue the profession’s successful lobbying, which has seen it squarely on the radar of state and federal health ministers and politicians.
Her commitment to develop the profession goes hand-in-hand with a desire to make healthcare more equitable for all Australians. ‘I would like to see those people in Australia who currently have difficulty accessing healthcare to have better access to higher quality healthcare,’ she said, adding that she wants the Australian public to see general practice as something it needs. Marles also said she’d like GPs to feel empowered about leading the future of primary healthcare and she intends to work so that ‘our ability to care for our patients in a continuum improves, rather than fragments’.
Medicine, interestingly, was an indirect route for Marles. Her first love was science and she graduated from The University of Melbourne as a secondary school science teacher. Naturally, many of those skills have served her well as a primary care doctor, a GP supervisor and an unflinching lobbyist for the profession. And while her love of science has accompanied her on her journey to becoming a doctor, it has also reinforced her belief that evidence-based research is a necessary foundation of the profession.
Marles said she first started speaking out and putting her hand up in her registrar training. ‘I was given some fantastic opportunities,’ she said. As a registrar liaison officer she loved the collegial discussions, the problem-solving and the workshops she was asked to present at. ‘I don’t think I ever decided that this was what I was going to do,’ she said, about her leadership roles. ‘I guess I’m the sort of person who can’t stay quiet!’ But she also believes that GP leadership is dependent on good mentorship.
‘I was very lucky to have a couple of key mentors,’ she said, adding that Professor Michael Kidd, who was her academic supervisor at The University of Sydney between 2000 and 2001, became an important mentor. ‘He really encouraged me to just get out there and have a go.’ In fact, Professor Kidd persuaded her to submit an abstract to a Wonca conference and, as a result, Marles attended her first Wonca conference as an academic registrar. ‘I’ve really valued his support’, she explained, adding that he’d also encouraged her to take on a General Practice Registrars Australia (GPRA) role on the GPET board when the board was first setting up.
Another important mentor was well-known academic and Professor of General Practice at The University of Sydney, Simon Willcock. ‘Way back when I was an intern, I went to Hornsby Hospital and the Director of Clinical Training was Simon Willcock,’ Marles said. ‘He was really encouraging about taking on some leadership roles, but also very grounded about being a GP and how valuable that is.’
While the encouragement provided by her mentors was essential in her development as a strong leader, there were other reasons Marles stepped into the RACGP president’s shoes with such ease and grace. Her parents, who were both great role models and trail blazers, loved academic conversations and encouraged their children to not ‘just sit there and complain about the world’, but ‘to actually go out and do something about it. We were all raised like that,’ she said.
Marles’ mother has had a great influence on her life. Appointed the first Commissioner for Equal Opportunity in Victoria in 1977, Faye Marles is a strong woman who cares deeply about social justice. She remained commissioner until 1987, when she left to establish a consultancy specialising in dispute resolution and human resource management. As a lecturer in social work at The University of Melbourne since her twenties (with time off in between for marriage and a family) Faye Marles was elected to its council in 1984. She became deputy chancellor in 1986, and in 2001 was appointed the 18th chancellor of The University of Melbourne.
Faye Marles’ tremendous achievements were applauded by women everywhere, especially her daughter who was developing into a dedicated GP and lobbyist for her profession. Liz remains her mother’s greatest admirer, and has just got used to the idea that she retired a few years ago at 80 years of age.
Her father, Donald Marles, was headmaster at Trinity Grammar School in Melbourne, and prior to that he was a teacher at Geelong Grammar School where his family lived on campus. In fact, Donald was Liz's maths teacher and taught her in her final year of school. He had and still has a great love of intellectualism, she said. ‘When we had family dinners we’d all sit around the table and there were always lots of arguments around political issues; it was always a very lively affair.’
Liz’s brother Richard Marles is the Federal Parliamentary Secretary for Pacific Island Affairs and Parliamentary Secretary for Foreign Affairs. A former lawyer and now a popular MP for Corio, he secured more than 51% of the primary vote in his electorate at the 2010 federal election. Respected by both sides of politics, Richard has a great love for science and, with a degree in law and another in science, he has a strong academic base for his passion.
Last September, together with his colleague Karen Andrews, Richard launched the group Parliamentary Friends of Science, ‘to strengthen links between the scientific community and parliamentarians and increase engagement between the two’.
Not surprisingly, there are other high achievers in the Marles family. Elder sister Victoria is a former Legal Services Commissioner for Victoria and a current CEO at Trust for Nature. And sister Jenny is an academic in the School of Business at the University of Technology in Sydney. With special interests in the not-for-profit sector and intellectual disability services, Jenny – like the rest of her extraordinary family – is devoted to intellectual debate and the exploration of ideas.
A propensity for hard work and social justice issues, a love of science and the ability to work across political divides is a common trait of the Marles family, and Liz brings these same qualities to her role as president of the RACGP. And for those who know her professionally, it’s clear that she brings a little extra.
President-elect of Wonca Professor Michael Kidd, Marles’ academic supervisor, as noted, was also there mentoring her when she was appointed the registrar member of the GPET board. As an advocate of developing leadership skills by ‘gaining practical experience in being a leader’, Professor Kidd said he ‘spent considerable time discussing governance and policy and strategy, and ways to be effective in a role where Marles needed to ensure that the voice of the registrars was being heard’. He said she ‘did a great job and proved herself’ in the role.
Professor Kidd added that ‘Liz is a caring and knowledgeable GP with sound experience as a clinician, teacher and researcher'. He said he was confident Marles’ current experience as a GP at the Redfern Aboriginal Medical Service would enable her ‘to ensure that the RACGP becomes even more effective as a strong participant in ensuring improvements in Aboriginal and Torres Strait Islander health and tackling continuing disparities in morbidity and mortality’.
According to Marles, she ‘will always still be a GP’, despite her many leadership and lobbying roles. It’s clear speaking to her that she loves general practice, and it becomes increasingly apparent that her patients’ needs are as important to her as the meeting she had with the Health Minister earlier in the day in Canberra. ‘I really enjoy the opportunity to talk to people one-on-one, to get to know them,’ she said. ‘It’s such a privileged position to be the person they bring their problems to.’ For Marles, being an effective GP means getting to know her patients well because knowing their personality type is intrinsically linked to understanding their history.
Not one to be daunted by seemingly difficult consultations, Marles sees the challenges of heartsink patients as opportunities. ‘They’re the patients who, if I can get them to think a little differently, I know I can actually make a big change in their health,’ she said. ‘You really need to get people talking to find out who they are; a trusting relationship is at the core,’ she explained.
Another aspect of general practice important to Marles is continuity of care. With many GPs choosing to work part-time and the potential for patient care to become fragmented, Marles said practices need to consider continuity of care when setting up for business. Effective handover, a team approach and selecting one member to own the management issues for each patient are the components that constitute continuity of care, she said.
Marles, who has been an RACGP member since 1994, wants to build the profession during her term. She wants to support GP supervisors, increase training places and financially reward practices that implement continuity of care for their patients.
The new RACGP president appears to have the minister’s ear. After two meetings with Tanya Plibersek in a week, Marles said the minister is very ready to listen, interested in the solutions coming from the profession and wants to work with GPs. However, Marles said, it is an election year and there may be a change of government in September.
‘We’ve had lots of good conversations with Dr Andrew Southcott’, the Shadow Spokesperson for Primary Healthcare, whose medical background provides an added insight, Marles said. ‘Peter Dutton has flagged that there’s potentially money to be saved in administration. We need to be talking with him so that if there are going to be savings they aren’t going to impact on our ability to provide the high quality care we want to.’ Marles is more than ready, she said, to work with any incoming government to ensure general practice is on the agenda.
An expert communicator, Marles punctuates her conversation with warm and generous laughter. Genuine concern for people accompanies her whip-smart intellect, and it’s no accident that her past mentors and professional colleagues have become steadfast admirers. Former RACGP president Dr Eric Fisher said Marles ‘has a wealth of life experience’ – as a former science teacher, and ‘being involved in a teaching practice and an Aboriginal medical practice’, he said, ‘she is at the sharp end of generalism that is looking after the whole person.’ Fisher added that her approachability, ‘willingness to listen, as well as an acute social awareness, will stand her in good stead as she leads the College in its endeavour to make general practice more relevant to the 21st century.’
With the RACGP in such strong hands, the next 2 years are bound to be a time of meaningful growth for general practice with an emphasis on education, research and science. And science – as Carl Sagan said – ‘is a way of thinking much more than it is a body of knowledge.’
Written by Sharon Lapkin. Reprinted from Good Practice - Issue 3 – March 2013.