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Australian Health Care Roundtable

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Australian Health Care Roundtable

Here we chat with four health experts about the current state and future direction of Australian health care. What will the scene look like in 10 years?

Our Roundtable Experts

Dr. David Rosengren
Emergency Medicine Physician & Chair of the Queensland Clinical Senate

Dr. Claire Hooker
Senior Lecturer, Medical Humanities, Centre for Values, Ethics & the Law in Medicine, Faculty of Medicine

Amanda Griffiths
Founder of My Health Career & Optometrist

Dr. Phil Goebel
CEO of Quanticare Technologies

What changes do you predict for Australian medicine in the coming 10 years?

Rosengren: The health system is evolving rapidly, so you might think in 10 years things will have changed dramatically. But if we go back 10 years, not much has changed. We still see patients the same way. We still treat patients with the same approaches. The way we practice medicine hasn’t changed. We’ve seen some changes in technology and these will continue to have an influence.

We have an ageing population and therefore, an ageing workforce. So there needs to be changes to how we allocate roles within the workforce. Tasks that may traditionally be the role of doctors could become the role of other substitute providers, like nurses.

Already, in regional Australia, we have extended different tasks to nurses; these were tasks once only performed by doctors. This will continue to evolve. And there will be a slow but definite change in the way we use our workforce to deliver health services.

Medical Services Sign

Hooker: Specialists will notice the differences more, because they’ll be able to offer much more finely judged prognoses and a more tailored set of therapies for many of their cancer patients, for example. But from the point of view of the cancer patient, not much will change. Having cancer will still be awful and frightening. There will still be unpleasant side effects from the medication, and a lot of the time, prognosis will differ very little.

Not only will fewer people be able to afford that kind of health care, studies show that in countries with a bigger gap between rich and poor, everyone has worse average health outcomes including the wealthy.

From the perspective of a patient, one of the most important things — which is how you feel you are treated by the health system — looks likely to stay pretty much the same or get worse. It’s possible that the lucky few (the very wealthy who can pay for it) will find their course of treatment and care vastly improved.

Not only will fewer people be able to afford that kind of health care, studies show that in countries with a bigger gap between rich and poor, everyone has worse average health outcomes including the wealthy.

Since our economic policies at present are aimed at widening the gap between rich and poor, we can expect that our actual experience of medicine in 10 years’ time may actually be more miserable and with a higher chance of dying than it is at present.

Australian Health Care (1)

Griffiths: I would like to see more of a focus on wellness rather than sickness. I hope consumers will be better informed and have more regular check-ups. I would also like to see more structure and guidelines for interdisciplinary care out of the hospital system, as well as better communications between health-care professionals.

Goebel: I see health care moving to a much more proactive and predictive system. Right now, the current standard of care is reacting to health conditions that patients present.

With the explosion of information technology coming into health care, there are a lot of opportunities to build predictive analytics and then to re-imagine how we deliver health care with a more preventive and proactive approach.

With the explosion of information technology coming into health care, there are a lot of opportunities to build predictive analytics and then to re-imagine how we deliver health care with a more preventive and proactive approach — especially in the area of chronic disease management.

It’s a movement from the current paradigm, which is very much a patient-events-driven system, to a more health-provider data-driven system.

More Information
Read the Budget Direct article Sci-Fi or Real Life? Gadgets For Health Care, which talks about the advancements in medical technology.

What is the most intriguing advancement in health care right now?

Rosengren: I think the big future that’s going to transform medicine is gene technology: the ability to manipulate genetic makeup to eradicate disease or to select certain genetic traits. Gene technology has multiple facets in multiple different directions. Globally it’s where the greatest promise for transformation in health care comes from (the ability to modify genetic composition to get rid of diseases).

As science and technology becomes more detailed, the complexity of how we use it becomes more troublesome. The greatest opportunity and challenge is the ability to tinker with people’s DNA.

Hooker: Cutting-edge research is providing revolutionary new directions for technical specialist medicine. The therapeutical potential of gene therapies, targeted (to genes) therapies and personalised medicine is already allowing us to make much more individually tailored and finely judged therapeutic decisions.

This greatly reduces the frequency and severity of side effects and at the same time increases the efficacy of receiving technical therapies, like chemotherapy for cancer.

At the same time, work in bioengineering (including with 3D printing) and nanotechnologies have opened up transformative possibilities for everything from recovering vision loss to making enhanced humans a real possibility.

Australian Health Care (5)

Griffiths: The role of social media in health will continue to grow. There’s a lot of power in having local hospital services as well as health practitioners on social media. We have the possibility of educating the general public in the hope that people will listen to those organisations rather than people who are in the media but have no qualifications.

Goebel: The most exciting stuff that’s going on now is the explosion of data and access to personal informatics, including clinical informatics and genetic information. And integrating all this data and building predictive models on it, using that data for real actionable insights to re-imagine how we deliver health care.

More Information
Read the Budget Direct article Design a Generation: Advancements in Genetics, which discusses about how the understanding of human DNA is influencing medical science.

How would you like to see our health-care system change?

Rosengren: One of the greatest negatives around the health system in the last 10 years has been the move towards specialist services within the health system.

We need to find strategies to move patients back to a central area so they get better health care.

We are moving to an era with a huge burden of chronic, complex disease. We need to find strategies to move patients back to a central area so they get better health care. Over the next decade there needs to be a significant reinvestment in general practitioners who provide a holistic approach to care for patients.

We’ve raised a generation that expects cure. There needs to be a rationalisation about what medicine can do, what it’s about. There are many conditions we can’t cure. We need to reset that balance and become far more accepting of what medicine can do and what it does do. These conversations will become more important.

syringe and needle and nurse

Hooker: There was an article published in The Lancet a few years ago that recommended that we devote 1 percent of the health budget to art. I find this to be an incredibly intriguing development and I would like to see this happen over the next 10 years. Art is not gene therapy or chemotherapy and it can’t achieve what a dialysis machine or a heart transplant can achieve.

But it can, nonetheless, be just as transformative in a patient’s experience, in a greater range of situations than we see. That is ultimately what matters.

Griffiths: The shortfall of vocational training places needs to be addressed. Right now we’re taking in more students than we can train. The number of medical students has doubled since the year 2000, but the number of vocational training places has not. The government needs to make more training available.

There’s not a lot of data about what happens to those students who don’t do vocational training so we don’t know what happens to them. That’s the big system change I’d like to see.

We need to think of ways we can build fee-for-value systems and pay for performance and better outcomes, rather than a fee-for-service model.

Goebel: On a systemic level, we need to question how we pay for health care. We need to think of ways we can build fee-for-value systems and pay for performance and better outcomes, rather than a fee-for-service model.

When we can start to build those systems, we’ll see an explosion of adoption and prevalence of more preventive and proactive approaches to health care, with incentives for health providers to really provide those services and ways for the health care system to help individuals pay for them as well.

Further Information & Articles

Keep following Budget Direct blog as we present more news and updates on health care in Australia. If you found this article interesting, read ‘Public versus Private Health Care in Australia‘.

 

http://www.goldcoast.health.qld.gov.au/clinical-practice/engagement/clinical-senate/membership/executive/default.asp

http://sydney.edu.au/medicine/people/academics/profiles/claire.hooker.php

http://www.myhealthcareer.com.au/founder-amanda-griffiths/

http://quanticaretechnologies.com/

Survey Stats: Survey was conducted by Budget Direct in the month of April 2015 with a random selection of 1,000 people.

Michelle Guillemard

Michelle Guillemard

Michelle Guillemard is a professional health & medical writer based in Sydney, Australia. She is the founder and editor of Health Writer Hub, a community for writers from all over the world who specialise in health and medicine.