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26. Whose Job Is It Anyway? 239all similarly well known within the community. Many of the VMOs had also had longlinks with the hospital. A number of them had held staff positions within the departmentbefore setting up their own private practices.Unfortunately, prior to the accession of the current director the department wassliding into oblivion. The previous director had been unable to recruit and retain staff,with posts often being filled by short-term locums, some of whom were not wellrespected. Long-standing and aging VMOs occupied many of the visiting posts. Thisled to some abuses such as inadequate supervision of junior staff and poor attendancefor public clinics if more lucrative private work was available. Matters came to a headwhen senior hospital management forced the departure of the director.A new, younger doctor was appointed in his place, and she set about rebuilding thedepartment. Her first priority was attracting new staff. I was recruited to a senior positionas a newly qualified consultant. I had trained within a very well-managed departmentand had been offered a consultant position within it. The offer of such a seniorposition was too good to refuse, however, so I took it.Five months after I began, the director became ill and was off work for 4 monthsduring which time I was acting director. Throughout this time I became enveloped ina number of conflicts, all occurring between two separate groups—a number of olderVMOs and some staff specialists.Conflict OneThe conflict with VMOs involved rostering arrangements and attendance. As Ihave already mentioned, some VMOs had worked within the department for manyyears. As such they were used to things being done in a certain way. A small groupof these VMOs often arrived late and performed little supervision or teaching ofresidents. Assumptions that I made about this group were that they regarded theirpublic practice to be of peripheral importance to them. I found myself in the situationof having to speak to individuals about showing up on time and the importance ofproperly supervising residents. I found these situations very uncomfortable, as I wasdealing with very senior and experienced clinicians who in some cases had practicedmedicine longer than I had been alive. Without exception, the VMOs I had talks withall chose to resign their public appointments. In retrospect I feel that I could havehandled the situation better, though I am sure that the ultimate outcome would havebeen the same.The needs of the department at that time were to have reliable consultant staff. Forsome of the VMOs their time within the department was a very small fraction of theirworking week.They were juggling private commitments and other public appointmentsand often found it difficult to arrive at work on time. As long-standing staff members,they probably felt that they were due some slack in view of their past service. Undoubtedlythere would have been some resentment toward somebody who had been on thejob 5 minutes telling them what to do. More recognition of their needs on my partcould have led to their departing on better terms. The regret also is that the memoriesof these long-standing members form part of the historical record of the department,a link to the past that is now broken.