GP or not GP?

14 February 2012

Best estimates suggest that a confluence of fertility rate and migration will lead to the UK population doubling in 75 years.

The number of registered GPs in the UK is 2/3rds what it was just 7 years ago and the full impact of contractions due to the economic downturn has not yet been felt.
This diverging trend in the ratio of GP to patient is clear.

But it is not just about the number of GPs. The model of one-to-one consultations does not scale.

The GP has always been a bottleneck on getting access to advice and specialist services – a symptom of the relatively inefficient one-to-one consultation which is too infrequent to build up an adequate profile of patients, and too short to conduct an in-depth review of the current state of the patient – leaving the GP and patient both nursing a sense of dissatisfaction. Recent moves to offload this work onto other healthcare professionals simply passes the problem around.

In a final nail in the coffin, our approach to healthcare focusses on an expensive reactive approach to sickness rather than what might be a cheaply dispensed nudge towards health. In the US studies have shown that the medical cost of obesity is over $1,400/year and the productivity cost of inactivity is nearly $2,500/year (see RTI and Centers for Disease Control).

A self-administered cure

We are convinced that there will be a general trend to move away from relying on a large institution to hold our data and respond to our illness, towards collating personal health data and using it to manage our own ‘wellness’.

This approach could potentially save us the vast resources poured into the GP-centric model, and release all the cash currently spent treating the symptoms of poor health deriving from poor lifestyle choices.

That money could be used to deal with the inevitable problems arising from paradigm shift, as well as ensuring the specialist medical services can be expanded and improved.

Effectively we are stating what many healthcare professionals already know: the largest untapped resource in the NHS is the patient.

Digital health provision

Combined with irresistible trends in the use of mobile technology to collate data, apps to deliver services and social networks to share experiences the scene is set for a healthcare revolution.

Social networks have vastly improved the ability for staggering numbers of geographically dispersed individuals to share ideas and pool their knowledge.
Crowd sourcing experience has proven itself capable of solving problems faster and better than long-standing institutions and expert systems.
The vast numbers of recipients of services are best placed to assess the quality of service providers.
Initiatives like ePatient Dave demonstrate that patients can leverage these facilities and when armed with their own data can solve their own problems.

Barriers preventing patients accessing their own data are being overcome, not by solving technical and legal issues within the NHS, but by patients entirely sidestepping this problem by building their own patient record, their health graph, using simple apps on sophisticated personal computers – their phones.

Put together we can see that we have the building blocks for a new approach to health whereby users collate their own data; connect to apps to access services of their choosing; collaborate and share information with each other; collectively rate and approve health services in a more competitive market; and are nudged by smart devices into patterns of behaviour that are preventative rather than reactive.

Please complete the following form, providing as much details as possible:

Should the NHS support the public’s drive to monitor and manage their own wellness in any way they can?
_Obviously_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Does the NHS need to solve the problem of having to hold our data securely whilst also trying to make it readily available to us and all its disparate departments?
_Not for most of my data, no_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Could we instead build and hold our own patient records?
_In progress_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Should the NHS compete to provide competitive services to add value to the data we make available?
_If they don’t they someone else will provide them to me_ _ _ _ _ _ _ _ _ _ _ _ _

As a society are we prepared to retire the GP and spend a portion of the money we’ll save to solve the new problems this might introduce into the community?
_Big breath – OK, I’m in_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Could the NHS invest our pooled resources purely into specialist equipment, the development of new medicines, and to train experts to carry out difficult procedures?
_I think they should_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _




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