Category Archives:Uncategorized

When Patients and Their Families Feel Like Hostages to Health Care

When Patients and Their Families Feel Like Hostages to Health Care

People as consumers are often assertive in ensuring they get what they want. However people as patients are often reluctant to speak up. They understate their concerns, or ask for what is less than desired to needed, or remain silent against their own better judgement. Often they will be confused about the choices available to […]

Are we having fun yet? Understanding pressures in UK General Practice

We know that ‘the good GP’, partnering with a patient and their family, is the cornerstone of an effective health system. This is known and proven – the evidence is well established and growing. But where is the evidence that the government (or our representative bodies) are prepared to walk the talk? Recognition and support […]

The five principles behind the world’s most efficient health systems

The five principles behind the world’s most efficient health systems

Some nations pay half what others do for healthcare and yet get the same or better outcomes. How? Dr Mark Britnell has worked in more than 60 countries, and has seen crucial patterns in the way that healthcare is managed, delivered and funded He is head of healthcare, UK and Europe, at KPMG, and is […]

Identifying Most Valuable Care

Identifying Most Valuable Care

What do the top performing family practices do better than the rest? The Peterson Center on Healthcare identified 11 ‘bright spot’ primary care practices across the US – teams that deliver high quality care at a much lower than average cost. (Article is here) They identified 10 features that these high performing sites had in […]

I work for the Canterbury Health System

We aspire to have a health system that works ‘as one’. I was told last week that GPs, allied health and specialist doctors in Canterbury, NZ, may all well say “Hello, I work for the Canterbury Health System”. This would imply that they do feel that their care is joined up. Does this happen in […]

Innovation as Usual

We are all keen to engage our team in their second job – improving their work. We would love them to come up with innovative and creative solutions that benefit our practice and our patients. Somewhat paradoxically, rather than encouraging our team to adopt a ‘blue sky’ approach, we would get better results if we […]

Shared Decision Making – 30 Years On, What’s Changed? What’s Next?

Shared Decision Making has three main objectives : patients who are, to the extent they desire, well-informed about options relevant to the decision they are making, helped in clarifying what matters most to them about the decision, and involved in the process of decision making. The Evidence Communication Innovation Collaborative (ECIC)’ of the Institute of […]

Is General Practice good value for money?

Last year taxpayers spent A$6.3 billion on GP services through Medicare, about 6% of the total government health expenditure. The authors of the Bettering the Evaluation and Care of Health (BEACH) program published in the Conversation their assessment of whether this represented good value for money. Their conclusion, as outlined in the infographic above, is […]

The Art of Deprescribing

The Art of Deprescribing

First do no harm: a real need to deprescribe in older patients | MJA Online Sept 22nd (1) The benefits and harms of deprescribing | MJA Online Sept 22nd (2) Emperor Joseph II: My dear young man, don’t take it too hard. Your work is ingenious. It’s quality work. And there are simply too many […]

Cholesterol Tests – non fasting is OK

Tools for Practice this week confirmed that it is unnecessary (? and cruel) to make our patient fast for a cholesterol test. The differences between fasting and non fasting levels are not clinically significant. Bottom-line: Minimal differences exist between fasting and non-fasting HDL, LDL, and total cholesterol (TC). Also, non-fasting HDL and non-HDL levels correlate […]