Not The Impossible Dream.

It seems that not everyone in the world thinks it is an impossible dream to have affordable excellent care for everyone. The Institute for Health Care Improvement based in the USA has been in pursuit of radical health reform for some time now, and in June will hold a seminar on Achieving the Triple Aim: The Simultaneous Pursuit of Excellent Heath, Ideal Care, and Controlled Costs.

Is anyone from Australia with the Triple Abilities of Power, Influence, and Positive Attitude going to go to this?

June 23-24, 2008
Washington, DC

The Institute for Healthcare Improvement (IHI) is now offering Achieving the Triple Aim: The Simultaneous Pursuit of Excellent Health, Ideal Care, and Controlled Costs, a seminar in which we’ll share with a wider audience the work conducted through our innovative Triple Aim initiative. The “Triple Aim” refers to the pursuit of optimal performance across three areas: the health of the population; the health experience of individuals; and the per capita cost for a population. Organizations working on the Triple Aim may focus, for example, on:

• Planning and customizing care at the level of the individual, targeted to the best feasible outcomes
• Cooperating and coordinating with other specialties, hospitals, and community services related to health
• Customizing services efficiently, based on appropriate segmentation of the population using a health risk assessment tool or equivalent

You can read more about it by going to the IHI main page (linked above) or to the exact page HERE.

Online Opinion.

Barbara Reynolds-Hutchinson has summarised the current situation beautifully in an article published today in Online Opinion. You can read it HERE.

It is Happening ... Elsewhere

We here in Mr Rudd's electorate are not alone, which may or may not be reassuring.

In Tasmania, from the ABC: Northern GP shortages for another 6 years
http://www.abc.net.au/news/stories/2008/04/15/2217445.htm

In WA, from the ABC: Acute GP shortage in rural WA
http://www.abc.net.au/news/stories/2008/04/15/2216999.htm

P.S Still no response from Mr Rudd on our specific suggestions to alleviate this problem (see the Solutions Discussion link in the sidebar.) Tell us they are good suggestions, Mr. Rudd. Tell us why they wont work, Mr Rudd. Tell us we are crazy for trying. Tell us anything at all, just for the sake of good manners.

Front Page News.

The South East Advertiser gave us front page coverage in the issue of April 9.

The SEA's intrepid reporter, Luke Royes tested out the trip to the nearest proposed super clinic site from this little community. Apparently the Stones Corner / Greenslopes GP shortage is going to be solved by a clinic in Coopers Plains (near QE II hospital) a $46 cab ride away - or a series of buses taking 45 minutes minimum.

How is that for solving the local problem? Elderly frail pensioners with crook knees and Mums with sick kids are gonna find it very convenient, aren't they?

[The full text of the SEA article can be read HERE, and the newspaper invites your letters of comment.]

"Medical Mess"

A letter from a patient published in the Courier-Mail today, April 7.

Medical Mess.

As an 88-year-old* patient of one of the practices referred to in Madonna King's article "Patients before Paperwork" (C-M, Apr 5-6) I applaud her turning the spotlight on this anomaly in medical care.
I realise this anomaly was not of Kevin Rudd's making but it is now within his power, and it is his responsibility, to bring common sense to bear on the problem.
To suggest that, if my GP's practice has to fold, I could go by public transport to the proposed superclinic 10 km away (which may take a year or two to set up), when there are qualified, competent GPs in my area, is ludicrous. I have been a patient of this practices for the past 12 years, and they have all my medical records, and my doctor is familiar with my care. The solutions suggested in Ms Kings's article are sensible and practical - and the need is now, Mr Rudd, not in a couple of years' time.
V.A.H....
Holland Park West

[small correction: Vi is a mere 80 years old]

Support from the Courier Mail.

Madonna King, the ABC journalist and Courier Mail columnist has given over her Saturday column to our issue today.

Thankyou Madonna, for helping the general public understand the many issues underlying the imminent crisis in general practice.

Madonna's article can be read HERE.

Letter to the Editor.

The press coverage continues with the publication this week in the South East Advertiser of my letter to the editor.

Press powers GP crisis solution.

Dear Editor,

I would like to thank you for your recent articles in respect of the general practitioner shortage in Stones Corner and Greenslopes, in the Prime Minister’s electorate of Griffith. You have drawn attention in your newspaper to the imminent crisis in GP supply, and to the campaign started by a concerned local citizen with the aim of addressing the issue. I am the principal of one of the practices featured in your newspaper as being at risk of closing due to the shortage of GPs.

We believe that good general practice is the cornerstone of good primary care, and that everything possible must be done to ensure that it survives and thrives. Any further worsening of the GP workforce will have serious impact on health care in the community, and will put further pressure on the already over-burdened hospital system. We know that the situation is similar in other urban areas in Queensland as well as interstate, and we are determined to put the focus onto finding a solution to the problem, rather than eternally analysing it and complaining about it. We hope that our blog at needmoregps.com will help publicise the issue and act as a forum for ideas.

I would like to inform you and your readers that the local campaign has attracted interest from the broadcast media and the national press. This would not have happened without your enthusiastic support. You have provided a fine example of the power of the local press.

Dr Janet Clarkson,
Logan Road General Practice.

Yes, Minister.

Yesterday The Australian featured an article by former Labor senator John Black on the GP workforce issue as it is impacting on us here in the PM’s own electorate of Griffith. We are immensely grateful to him for generating interest in our little problem. The full article is HERE.

John drew an irresistible parallel with the Yes, Minister episode called The Compassionate Society (first screened in February 1981). In case you have forgotten, the story is centred around the new St Edward’s hospital which is staffed by 300 administrators but has no doctors, nurses, or – heaven forbid – patients.

Purely for your amusement, I offer the following snippets of dialogue from the episode.

Jim Hacker: "The National Health Service, Humphrey, is an advanced case of galloping bureaucracy."
Sir Humphrey: "Ooooh, certainly not galloping. A gentle canter at the most."

And …

Sir Humphrey: "Minister, you said you wanted the administration figures reduced, didn't you?"
Jim Hacker: "Yes."
Sir Humphrey: "So we reduced the figures."
Jim Hacker: "But only the figures, not the number of administrators."
Sir Humphrey: "Well of course not."
Jim Hacker: "Well that is not what I meant."
Sir Humphrey: "Well really Minister, one is not a mind-reader, is one? You said reduce the figures, so we reduced the figures."

Twenty-seven years down the track, and it still resonates ….

Letter to Medical Observer.

The Medical Observer featured my letter to the Editor in the edition of March 28. This is what I said:

Dear Editor,

The GP workforce issue has been recently reinforced with a vengeance for me, as you highlighted in your article last week. My practice is in a designated ‘Inner Metropolitan’ area of Mr. Rudd’s electorate of Griffith. Once upon a time this little shopping precinct had eight busy doctors, in a few weeks time there will be two. I am sixty years old and have no succession plan for my practice. I admit to completely giving up trying to find a solution to the problem two years ago.

I have been shaken out of my resigned, cynical sloth by the loyalty and support of patients and locals, who are enthusiastically researching the issue, coming up with ideas, and signing a petition.

We do not need any more statistics: any further government recourse to data-collecting is avoidance behaviour, pure and simple. We resent the patronising reassurances from government (and our own professional bodies) that ‘we understand the problem’. We would laugh at the proposed ‘solutions’ such as Super Clinics if they were not so fundamentally flawed as to be tragic.

We all want this problem solved. It will not be solved without a determinedly problem-solving attitude and genuinely open, vigorously creative debate in which we and our patients are involved. It will most certainly not be solved by bureaucrats. We want to get the debate going and the ideas flowing. To that end we now have a blog which we hope will provoke discussion and stimulate ideas. It is at http://needmoregps.blogspot.com/ , and we invite your comments and input.

Yours sincerely,

Dr Janet Clarkson,
Logan Road General Practice
Stones Corner
Brisbane 4120