When I edited DeskDemon.com between 2000 and 2007, I watched with growing concern as medical secretaries across the UK were steadily replaced by junior doctors.

These secretaries weren’t just typing pools or appointment setters. They were institutional memory banks who often knew patients as intimately as they knew the filing systems.

Medical secretaries could tell you that Mrs Thompson in bed 7 was allergic to penicillin before anyone checked her notes. They remembered which consultant had seen which patient three years ago.

They knew when something in a prescription looked off and weren’t afraid to question it, potentially preventing serious errors.

Junior doctors, despite their medical training, lacked this patient connection. They rotated through departments, rarely staying long enough to build the institutional knowledge that made medical secretaries so valuable. They were trained in medicine, certainly, but not in the complex administrative systems that keep hospitals functioning.

Growing recognition of the critical need for high-quality management support

Twenty years later, the landscape has shifted again. Now it’s technology that threatens to replace the human touch in healthcare settings.

Self-service kiosks stand where receptionists once greeted anxious patients. Automated phone systems replace the reassuring voice that used to answer calls. Digital patient portals substitute for the secretary who once knew which doctor to contact for urgent matters.

This technological shift promises efficiency and cost savings – always appealing in our chronically underfunded NHS. But conversations I’ve had recently with board-level healthcare executives tell a different story.

There’s actually a growing recognition of the critical need for high-quality management support at senior levels.

“Queuing up with people to have someone tick you off in a diary makes no sense, but there’s a point when the human touch matters. Continuity of care goes out of the window without it,” one executive told me last week. “The challenge is moving organisations from being task focused to patient focused. And watch them resist!”

Drowning in administrative demands

The paradox is striking. At the front line, human support roles are being automated away, while at the top, executives are desperately seeking skilled assistants who can help them navigate increasingly complex healthcare systems.

“I could double my effectiveness with the right support,” one medical director confided. “But I can’t find anyone with the right skills . And even if I could, the budget constraints make it nearly impossible to hire them.”

Her situation isn’t unique. Healthcare leaders are drowning in administrative demands that pull them away from their core responsibilities. Strategic planning, patient care improvements, staff wellbeing – all take a back seat to the daily avalanche of emails, meeting requests and reporting requirements.

Fragmented career pathway

The challenge is threefold. First, many healthcare leaders don’t recognise their own support needs until they’re completely overwhelmed. Having been trained in a culture of self-sufficiency, they soldier on rather than seeking help.

Second, when they do recognise the need, funding is a significant barrier. NHS trusts and healthcare organisations face relentless pressure to cut administrative costs, making it difficult to justify investing in high-level support roles.

Third, there’s genuine confusion about where to find properly trained management support professionals. The career pathway for medical secretaries and healthcare administrators has become fragmented, with no clear progression route into executive support roles.

Creating capacity for leaders to lead

What’s been lost in this evolution is the recognition that good management support isn’t just about task completion. It’s about creating capacity for leaders to lead.

Every hour spent by a clinical director managing their diary is an hour not spent improving patient care. Every afternoon a chief nurse devotes to preparing presentation slides is time not invested in supporting frontline staff.

The healthcare sector faces unprecedented challenges, including ageing populations, staff shortages, technological disruption, and of course, the long shadow of the pandemic.

Meeting these challenges requires leaders who can think strategically and act decisively. But that’s impossible when they’re buried in administrative tasks that could be handled by skilled support professionals.

Reimagining management support for today’s healthcare environment

The way forward isn’t about returning to the past. Those medical secretaries of the early 2000s were products of a different healthcare system.

What’s needed now is a reimagining of management support for today’s healthcare environment: professionals who combine traditional administrative skills with digital fluency, project management capabilities and strategic thinking.

For those of us who care about both effective healthcare and the future of administrative professionals, this presents both a challenge and an opportunity.

How do we create clear career pathways that develop the next generation of healthcare management support? How do we articulate the value proposition in such a compelling way that budget-holders can’t ignore it?

Most importantly, how do we ensure that in our rush to embrace technological efficiency, we don’t lose the human touch that has always been at the heart of good healthcare?