Health care homes approach billed to star as major cure for health sector ailments - Jeff Lowe

Goodfellow Symposium

Health care homes approach billed to star as major cure for health sector ailments - Jeff Lowe

Jeff Lowe Goodfellow
GPNZ chair and Karori GP Jeff Lowe says the health care home approach is a must in finding a fit and sustainable primary care business model
Change is necessary to allow practices to evolve at pace and scale, and to restore the joy that has gone from general practice Health care homes


A slightly different way of approaching the work day? Yes.

A "major cure for health sector ailments"? Definitely not.

Ultimately these models aim at maximising a dwindling resource, i.e. the GP workforce.  As a GP working in a health care home for 2 years I definitely wouldn't say it's the promised land leading to an easier day, less stress & a decreased risk of GP burnout. If anything I'm busier. I am now a face to face GP and a Managemyhealth email GP at the same time. Sure my "output" has probably increased (therefore the NHC model delivers for the Government) but is my life more relaxed because of it? No. What I do see however is a means of General Practice somewhat readying itself for the likes of Babylon etc which is, like it or not, coming to a patient's phone near you...

I am aware of "mixed reports" of these models in papers overseas, mainly the UK. Also I am aware that there is a little disquiet among the GPs in Kaiser in the States facing up to 70-80 patient emails a day to answer in addition to their face-to-face consulting. This MUST be taken into account with timetabling but is not always easy and usually added onto the night time labs.

N.B. I'm not on the payroll to promote of bag NHC :-)

The Kaiser Permanente story is not the success it has been portrayed in NZ. They have pulled out or sold out of four money-losing regions including Texas, North Carolina and the Northeast division.  There have been many court cases regarding advertising fraud, racial profiling, long waiting times, limiting doctor visits, decreasing service accessibility and bonuses for providing inferior care, as has happened historically with Managed Care HMOs.  Of course this could never happen in NZ!  Have a look at this Managed Care Watch Web Site


Wow, that's fascinating Keith! Not the great saviour and messiah we've been lead to believe...

On nights and weekends I am managing email queries from the patient portal while urgent care patients are in our waiting room. I feel like my brain is split in half as I read an ecg from resus; sign off pediatric abs for another strep; wave away a baby from under my legs; and get an email regarding complex chronic multimorbidity eg " my aortic valve replacement has been postponed b/c of my recent MI"???? all of a Sunday. My response to this is to make myself scarce. I will do the patients in front of me but without time in my day to manage the portal; it can wait. Neither safe nor helpful. There is only so many thinesses we can be airly beaten to. "Like gold to airy thinness beat."