The WHO Sustainable Development goals seek to provide universal health coverage by 2030. Unfortunately, the current narrative is that services are more constrained than ever and costs of holistic healthcare are sky-rocketing.

Dr Andy Carr

The elderly are surviving diseases that would previously have killed them so they’re acquiring more complex co-morbidities that require expensive socio-medical solutions. The young ‘worried-well’ is tech-savvy and engages in DIY medicine. All they need you, the doctor, for is to order the test or see the specialist they’ve already decided they need.

Okay, perhaps it’s not all like that!

But ‘burnout’ is at an all-time high and the sheer breadth and depth expected of a primary care physician is beyond what we can deliver without enormous consumption of resources.

Surely, the secret to the future of sustainable healthcare lies in collaboration and camaraderie, not consumption and competition? Every professional industry recognises that collaboration yields fruit far beyond what any one individual can produce. Yet we seem to both believe and behave differently.

My worldview and yours is not identical, and within such differences are solutions. While you can achieve wonderful things with your patients there will be gaps and weaknesses. There’ll be over-referral in some areas, and under-referral in others. We all do it.

And I think it terrifies some patients that we call what we do, ‘Practice’.

We are continually buffing up our armour. That requires spending some of the precious hours the universe gives us at a seminar or in front of an online learning module instead of spending them with family. Yes, CPD is important, but when is enough, enough?

How do we address the risk of DENs (Doctor’s Educational Needs) becoming PUNs (Patient Unmet Needs)?

Let’s think about how two practices in close proximity respond to each in relation to market share:

Practice A: Bulk-bills everyone. Practice B: follows.

A: Opens in the evening. B: Follows.

A: Offers free flu shots. B: Follows.

A: Results over the phone. B: Follows.

How much energy and resources could be saved if each practice had some level of interest in the success of the other? What if, instead of racing to the bottom, we pooled resources? It could be wonderful! We could be sensitive to each other’s way of working yet still focus on stewardship.

Imagine a day’s work where you can do both your core GP work and a special interest clinic within the co-op your practice belongs to?

A co-op recognises the value of the ‘time saved’ as well as ‘dollars earned’, allowing the creation of solutions to more complex problems, picking that hard-to-reach fruit that nobody wants to pick. Remuneration models in such a system go way beyond ‘see patient/get paid’.

Why not go further? Imagine joining forces with our secondary colleagues in designing holistic health fund products that keep people out of hospital, and are cheaper and more comprehensive. These are health services that are not limited to disease management. We might even be able to choose where to send patients for colonoscopies!

If we don’t like the road medicine seems to be headed down, then let’s get off it.

Maybe it starts with a coffee and meeting the practice owner across the road? Perhaps you’ll find that you both have services, resources and ideas you’d like to share with each other.

Perhaps it’ll be the start of something beautiful?

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