2022 Medal of Merit oration

Duncan McKenzie

BPharm(Hons), MSHP | Pharmacy Manager, Royal Hobart Hospital | Clinical Advisor, Office of Premier Jeremy Rockliff, Premier and Health Minister, Tasmania

[Pharmacy GRIT Article No: 20231382]

Oration presented at Medicines Management 2022, 46th National Conference of the Society of Hospital Pharmacists of Australia, 1–3 December 2022, Brisbane, Australia.

There is a really large part of me that feels like I’m having way too much still feeling like an early career pharmacist — way too early on in my career to be considered for such an honour — but then I see my fully receded hairline and the number of national conference programs that I have accumulated on the shelf at home and I have to accept that I’ve been around the sun a few times doing this pharmacy thing.

Good afternoon to my SHPA family gathered here.

To be recognised in a league with my pharmacy heroes is terrifying but also comfortably the biggest honour of my professional life. Thank you to the SHPA board for bestowing this award and a sincere thanks to colleagues I deeply admire: Tom Simpson, Kelly Beswick, and Camille Boland for the nomination. I also sincerely thank Tasmanian Health Secretary Kath Morgan Wicks and Premier Jeremy Rockliff for their kind support as referees.

Tom alluded to being on each other’s shoulders which is fitting and a testament to how much he and I have always been on the same wavelength, it was in my speech too Tom — to all those who have held this award aloft before I salute you — I believe the whole profession stands on your shoulders, you have collectively helped shape where hospital pharmacy is today.

I want to welcome some VIPs in the audience this afternoon. My parents Ken and Marg, and my lovely wife Amy, here from our beautiful home state of Tasmania. Achievements in life and career do not come without a loving support network and without them I wouldn’t be here, so Mum, Dad, Amy, I am delighted to share this moment with you. Mum and Dad, I know that the wish you have for your children is for them to be happy and have a fulfilling career. And I have been so fortunate to find that in hospital pharmacy.

Your working life can be defined by a series of fortunate moments, key relationships, and gentle nudges that guide us on this crazy journey we call a career. So, in loose chronological order, I’d like to share just a few of my moments with you.

I very nearly didn’t become a pharmacist. My tertiary entrance score didn’t get me in the front door. Local pharmacists from my hometown made representations to the Head of School on my behalf and successfully slid me through the side door as the pharmacy school train was leaving the platform. Thank you, Joe Vascoz and Judy Liauw, who convinced the School that success isn’t always tied to academic performance and in the years that have followed I have come to agree — an optimistic team player with social and emotional intelligence will outperform pure IQ every time.

In 2005, I attended an infectious diseases conference in Victoria. That weekend I spotted a poster that would change the trajectory of my career.

 The poster was about a small antimicrobial stewardship pilot program at the Royal Perth Hospital. Over a beer or three with the author Matt Rawlins, a lifelong friendship and collaboration was born. Stewardship went on to dominate an immensely fulfilling period of my career. In partnership with Dr Tara Anderson, our little Tasmanian project became a widely shared template for programs nationally. To have been on the journey to see a small idea become a national care standard will always remain a thrill.  

The magic of that career changing moment has been an ongoing motivator for my involvement in planning dozens of conferences at both state and local levels. Gathering, sharing ideas, and making connections is immensely powerful and the three years bringing this national conference together will have been worth it if just one attendee can have a similar moment.

The next moment that set me off on a new career direction was a call from Tom to offer me an acting role as Royal Hobart Hospital (RHH) Site Manager. At the time, I was a clinical pharmacist more comfortable with renal clearance and vancomycin dosing than performance reviews, budgets, and rosters. So — as a master negotiator — I offered Tom a compromise. “Tom” I said, “I’ll give you six months…”. That was 11 years ago; I’m still here.

What followed was an immensely productive decade for hospital pharmacy in Tasmania. At the RHH alone we doubled our pharmacy staff and are heading a suite of innovative nation-leading projects. It gives me more than a hint of pride that our Tasmanian initiatives have been broadly showcased here over the last two days.

I honour our entire team and as much as I would love to mention every one of you here individually, please know that I appreciate you all.

To Ed Anderson, backfilling my role as Site Manager at the Royal Hobart. Ed, you are a rightfully respected and talented leader and Australia’s first Advanced Resident in Leadership. For me to be able to step away from my post in the knowledge that I will return to a department that is in better shape than when I left it is a gift.

Kelly Beswick is well known rural and regional pharmacy leader nationally. Kelly, you have an enviable ability to remain constantly energetic, engaged, and hands down the most emotionally intelligent leader I know.

When I think about the saying ‘surround yourself with people who are better at things than you are’ I think of Liza D’Ettorre. Liza is our Statewide Operations Manager and Logistics Manager, and it makes sense that Liza has two titles because she does the work of two people every day… before lunch.

Camille Boland has been a perfect stabilising presence and influence throughout my entire career. For me, Camille is my go-to as the most level-headed sounding board for big, tough decisions and I know many others, both in Tasmania and across the nation, use Camille for that superpower.

Almost everything I have achieved in hospital pharmacy has been positively contributed to by Tom Simpson. Tom is a mentor, a leader, and a friend. And to be handed this award by Tom is a moment I will cherish. You ain’t seen nothin’ until you have witnessed Tom — fuelled on nothing but unreserved ambition and diet coke — punch out a 20-page business case in a single afternoon, fully referenced with tables, graphs, and images. I am not exaggerating. SHPA board and secretariat, strap yourselves in to work with someone who never stops thinking, strategising, or innovating. Unless of course his caffeine levels fall below his therapeutic threshold of 25 mg/L, after which I recommend always having a loading dose on hand stat.

My most recent career shift was tectonic. I was nudged by senior health leaders to consider the opportunity of a lifetime — to take up a role as the Clinical Advisor to the Minister for Health.

Minister Rockliff became Premier Rockliff and uniquely (or perhaps madly) retained the Health portfolio. I have advised the Premier during the pandemic, through substantial legislative changes, and right now, navigating the most significant changes to pharmacist scope of practice in a generation.

If you’ve got no idea what an advisor does — don’t worry neither did I — a grounding as a hospital pharmacist has provided an extraordinarily relevant foundation for this role and I am pleased to report that I am at least slightly useful to the Premier every day.

Partnering with SHPA has been another of those key career highlights. SHPA has afforded me countless opportunities to learn, but more importantly, to build strong connections and friendships across Australia and across the globe.

And I’d like to pay a personal homage to Peter Fowler as he leaves his role as SHPA President. Over the years Pete and I have bonded over a shared love of Tasmanian Whisky, trout fishing and aminoglycoside pharmacokinetics. Pete, I know I speak for all of us when I thank you for your leadership through a once in a century health challenge. I trust that time away from the presidency will afford more time for those shared passions, along with your newfound love being a granddad.

I have worked alongside and been mentored by Pete and many other inspirational leaders at the very top of their game including our Health Secretary, our Premier, Tom, and most importantly, my parents — and I’ve developed a sense of what good leadership looks like to me and what I choose to model myself on.

Great leaders have shown me that you can be an effective, inspiring, and respected leader while remaining calm, being decent, and being kind, no matter how far up the creek you find yourself.  Temperament beats intelligence every time.

I suppose what I’m trying to say here is that you can be an effective leader without being an arsehole.

Successful leaders nurture the next generation, build up those around you so that instead of floundering in your absence, they thrive.

Mentors are vital throughout your career — I recommend surrounding yourself with heaps of them — but let me introduce you to by far your most important mentor you will ever have, and they are sitting right here in this room. Not me, not your friends, not your boss, not your premier. Your most important mentor is you. Seventy percent of what you need for any job is gained from experience. You learn from your good decisions — even more from the bad ones — wisdom comes from time spent in the arena. Sadly, there are no shortcuts, no self-help books to get you there faster. This is why I have decided to say yes more than no, to be open to trying new things. This is what accelerates your learning and ultimately improves your capability to serve others. 

Now, of course careers aren’t all defining moments and amazing opportunities; the daily grind can bring anxiety, sadness, and burnout. Self-care is vital and I believe I have tapped into my greatest antidote to the melancholic parts of my job which is a childlike embrace of curiosity. Perhaps that why I still feel like an early career pharmacist as I have never been able switch off that insatiable thirst for knowledge and experience and still delight in feeling like I’m constantly on a steep learning curve.

Have a career that surprises you; leap sideways out of your comfort zone, be receptive to nudges from trusted colleagues and friends as they often know what you’re capable of even more than you are willing to admit to yourself.

I couldn’t end an oration without a brief love letter to Tasmania. Not only is it the most naturally beautiful place on earth, it has also proven to be a cradle of hospital pharmacy innovation and a fertile patch for pharmacy leaders and thinkers so don’t be shy to come down for air and join us. Tassie is also the only place I know of where a mid-level hospital pharmacy manager could be on a first-name basis with all the government ministers… except for the Premier who calls me “big Dunc”.

To my family. There are times when saying yes and seizing opportunities can impact on the time you spend with those most important to you. To my children, Sebastian and Lily, thank you for keeping me grounded and still being excited when I come home from work every night. And to my lovely wife Amy, we have partnered to build our lives and careers together and none of this would be possible without you. I dedicate and share this award fully with you Aims.

Thank you.