Health Care Reform. When do we need it, and how?!

Burnout matchesFirst published in the European Medical Journal October 18 2017 I re-publish it here:

The buzz on the streets across the world is the need for healthcare reform. The costs of healthcare are exponentially skyrocketing globally and the rates of illness and disease are increasing, with mental health and chronic pain being in the top 5 causes of disease burden globally. Of the world’s population, 95% have some form of illness during the year; furthermore 81% of people with 5 or more health conditions are below the age of 65.1 The rising rates of chronic, non-communicable diseases across the planet are so rampant that the World Health Organisation (WHO) has labelled this as an epidemic.2

Globally, healthcare systems are struggling to cope with the burden of illness and disease they are faced with; the costs are expensive for healthcare organisations, governments, as well as consumers.

In today’s constrained financial times, the focus of healthcare reform has been on cost (including the cost of personnel) and how the cost will be sustained.

In the NHS, systems are stretched, with large numbers of staff leaving to work in lesser skilled roles for the same level of pay.3 The remaining staff are left in the tricky situation of coping with the high patient load with reduced numbers of colleagues.

In the USA, managed care has rationalised the delivery of healthcare with a focus on electronic health records for billable items, patient satisfaction, and business outcomes. This focus means professional autonomy has never been lower for healthcare professionals.

At the same time, the health and well-being of the medical professionals has reached an all-time low with burnout rates of more than 50%,rates of anxiety and high psychological distress greater than that of the general public,5 and suicide rates and suicidal ideation far higher than the general public.

The combination of these statistics highlights the potential difficulties associated with mental health faced by those in the medical profession and perhaps represents the tip of a growing iceberg.6 Continue reading

Why do we make education hard?

I spent a LOT of time in education. I have spent a LOT of time reading books trying to learn things. I studied medicine, which is lifelong and ongoing study. I’m still studying, all of the time in fact!

The language that is used in education is extremely complicated. We are taught with complex words delivered in complex and uninspiring ways. I have spent countless decades trying to survive, yes survive the most tedious and boring lectures and I know I am not alone here.

Who decided we needed to make learning boring and hard?

At what point does learning stop becoming fun and interesting and becomes some onerous boring chore of a task?

When we are small, we enjoy learning. It is a joy to learn new things about life and the world. Learning is made fun. We have fun learning new things, like…. walking, where the parks are, what animals are, and what our foot tastes like when we put it in our mouth…..

Adults do their best to support kids to learn. Toys are designed to make learning ‘fun’ for children. Things are kept simple.

But for adults? Is learning made fun? Even in high school?

At what age is it ‘right’ and decided to take the fun out of learning? Continue reading

Medicine in the age of technology. Does the personal matter?

There is much talk about ways we can reduce the costs of health care and to ‘streamline’ health care. There are some conversations that are happening about people putting symptoms into machines to generate diagnoses and then generate a treatment algorithm instead of seeing a doctor. This would of course make the cost of health care cheaper by eliminating the role of the physician, but is this really the best practice of medicine?

Can computers and algorithms really replace the role of doctor, or even nurse?

Even if it would reduce ‘costs’ by eliminating the personal contact in medicine, is this really the way forward in medicine?

Would it offer better patient ‘care’?

Would it even offer better patient ‘diagnosis’?

Many patients come to see me having put their symptoms in a symptom checker online only to be freaked out by the potential of multiple serious diagnoses, only to then find when they see me that they have something quite simple and nowhere near as severe as the symptom checkers had lead them to believe.

It takes skill, connection and experience to diagnose what is happening in a person as no two people have the same presentation of an illness and disease.
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The Silence of the Profession

Many of us in Australia will remember an ad for toothpaste in the 1990s where a man (with a great toned and tanned upper torso mind you) has his back to us whilst he is facing the mirror brushing his teeth. We are told they can’t show us his face, because he is a dentist. Apart from learning about this particular brand of toothpaste (?!) we learn from this that medical professionals are not allowed to be seen in public.

For me this is a great adage of the medical profession where there is some strange notion that we should be neither seen nor heard, and this extends to many in the profession who feel constrained to be seen as a person in public, or to have and voice their opinion in public for fear of being hauled before the medical board, or having their reputation as a doctor undermined or destroyed.

Many doctors will not be on social media, have blog sites or websites, and do not want to have themselves in the public eye, lest something ‘go wrong’ and their reputations be destroyed.

But lets consider this.

Does this even make sense?

Why is it that we would feel that being seen as the person that we are would possibly get in the way of people respecting us professionally. And why do we seek so much to separate the two? Are we really such a Jekkyl and Hyde? Are we one person at work and then some strange demonic being in our private lives that we would not want anyone to know about? Surely not… Continue reading

Why do we have laws?

When we consider ‘the legal system’ as people who are not trained in the law, we naturally consider that the policing and the legal system are there to uphold our rights as citizens, to keep us safe from harm. We consider that the legal system and the laws are founded on some notion of truth, keeping society safe and true to what we all innately know are universal human values, of truth, decency, and respect. We know that we need order in society and that order needs to be founded on these key values, as it is those key values that underpin the functioning of society.

Yet when we turn to the legal system when something goes wrong or we are harmed, do we find consistency clarity and true support and laws upholding truth? Or do we find confusion and at times the protection of the rights of abusers in society? Certainly when you turn to the law with respect to cyber abuse, you find that the ‘rights’ of people to abuse and lie about people online are well and truly protected, particularly in Australia at the moment. Anyone who has had dealings in property realises that contracts do not necessarily endorse that which is decent or true.

How can this be so?

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Are we really civilised?

At the moment in Australia and much of the West, we say that we are a civilised society. After all, we wear clothes, well, most of the time and go to work in offices, we have running water, toilets and live in houses which (usually) have roofs, walls and windows. We have television, electricity, cars, public transportation – of variable efficacy – we have family units, schools, education systems, the internet, hand held mobiles, small computers, big computers, shops, money and banks. We have ‘art’ and we have ‘music’. But are these the things that make us ‘civilised’? And to what are we comparing ourselves…

What is it that makes us civilised? Is it our ‘mod cons’ and the fact that perhaps we wear more clothes than what used to be termed so called ‘primitive savages’ ie the apes or early man? Is it because we have less body hair than the animal kingdom? Or is it because we have and live by certain values?

Surely it is the values that a society live and work on that are the foundation of a true society and surely a true civilisation is one where people live and work in harmony and love together? And thus is it not civilised to be loving and to treat people with decency and respect? Continue reading

Refugee – or Person?

There is a lot of talk in the news at the moment about ‘refugees’ and whether we should ‘take them’ or not, or intriguingly, whether perhaps we should only ‘take’ ‘Christian’ refugees…

But you can’t brand people.

People are people.

They are not a culture.

They are not a religion.

They are not a headscarf or fashion sense.

They are not a race.

They are not a country.

They are not a language.

They are not a ‘refugee’. They are a person.

We are all human beings.

We are all people, and the notion of putting boundaries, barriers and borders between us all is somewhat ludicrous. For starters, people do not actually own the land or Earth. Earth was not created with crazy outlines of borders between ‘states’ and ‘countries’ to be fought over. Earth itself is unified. Continue reading