When you ask someone, what is wrong with the state of health care today, you will get a couple of answers. Interestingly these answers will most often have two central themes, patient care and money (a perceived lack of money).

When I ask health professionals what is missing for them in the health care industry, they speak of lack of genuine care for the clinician, and a perceived lack of money.

When I ask employers of health professionals in public and private, large and small health care businesses what their biggest frustrations and challenges for them they speak of finding and keeping great talent, and a perceived lack of money.

Everywhere we turn in the provision of health care we are faced with two common and central themes:

1. The people. Both those who do the treating and those who participate in treatment.
2. Perceived lack of funding or money.

Most of us as clinicians did not enter a health care discipline for the money.  No, we entered these professions to make a difference, to help, to bring about change for people who need it.  Our intentions have always been noble, our desire has always been one of care, however when the rubber hits the road, we too need to ensure we have a roof over our heads and food on the table.  We need to be able to pay back of student loans and make sure our children have opportunities that we want for them… oh and a work-life that allows us to be taken care of.

We have alarming rates of churn and burn across health businesses; we have increasing rates of people living with chronic health conditions and with disabilities, who will need increasing levels of health and associated health care support as they age. We have a tightening of public spending. In short, we have an ever increasing need and a decreasing capacity to fulfill the need.

Burnout amongst health professionals is at epidemic rates. Burnout leads to lack of engagement which leads to poorer patient outcomes.   This isn’t something that you and I might just think is an issue, there is actually research that supports this as a truth.

Burnout leads to mistakes which leads to harm of people in our care.

Burnout leaves us as health professionals feeling less than because we entered into the system to make a difference – and we are faced with an insurmountable mountain.   How will the people who need care actually get it?

Some of us create health care businesses to help meet this need to be faced with what feels like an endless revolving door of talent acquisition.  We recruit, onboard, train, develop team members who then leave.  We need our new talent to be ready to earn for us, ready to treat the people who come to us.  The need is so great, the cost of business is increasing, the demands of compliance is increasing and the capacity to train and develop comprehensively, thoroughly and appropriately is lessening.

Health professionals, please understand this is not your fault.

Traditionally we as clinicians are taught how to implement a set of clinical skills to a cohort, or diagnosis to provide a pathway to recovery.   We have traditionally housed ourselves inside of clinics or centers or practices, and we have expected patients to turn up and have treatment done to them.

This is what is known as a medical model of treatment.  We know it is excellent in a crises or health emergency, but when it comes to helping our client’s live with long term, chronic or complex issues that impact not just one part of their life, but all domains of their life – well the medical model is very limited.

How do we know – well research has been telling us for at least 20 years that the medical model is limited. Yet we have health care systems that are based upon this model.  We see it all the time, someone turns up to hospital and is admitted, they are discharged when they are safe to be discharged, they are discharged into the community care, that is also under resourced, so they receive limited, short term care, that keeps them safe for the moment;  then they are discharged, then they have some type of health crises, end up being admitted to hospital again, where they are essentially patched up so that the “bed” can be released, back to the under resourced community where they continue on this cycle of crises management and we call it health care.

Health professionals, please understand this is not your fault.

When I ask health professionals what they think is wrong with heath care and what types of change they would like to see I rarely get responses about changing the model of delivery, or of client expectations of the clinician.

The responses I so very often get is that governments need to make available more money to fund more clinicians to provide more services for free.

 And while I do think that Government has a role to play in health care, I also believe that we as individual clinicians have a much bigger role to play in bringing about the change that many of so desperately want to see.

Imagine a health care system where people get ALL of the treatment for their conditions.  Not some short term Band-aided solution, but they get the care they need.  Imagine a health system where, you go and ask for advice about an orthopedic joint disease, and the person helping you actually asks about how you get to and from work; how you cope at home; how on earth will you manage caring for 3 children under the age of 6 while being unable to weight bear through your right leg.

Imagine a health care system where mental health is no different to health. Where there is no distinction, it’s just health.  Now imagine a culture of health where people expect to be treated for depression and expect to regain their health after a depressive episode.  No fear of stigma, or black marks against your HR record with an employer questioning your ability to cope at work.

We all like to think we are contributing to this image of health care and health services, but what are we actually doing to bring it to life?

If we, as the laid back, risk adverse clinicians of 2018 remain committed to perpetuating passive medical models of health care then we really have no one else to blame but ourselves when clients argue about paying our full fee; patients self-discharge because they are not engaged; or when they refused to take personal responsibility for their own recovery.

It’s all well and good to say government and the Big end of town need to change.  However, they won’t.  And if they do it will be at glacial speed.  How do I know – well the medical model of health care was debunked as the model of chronic disease management after the FIRST world war. Yes people the FIRST world war say 1920.  So, what’s that, only 100 years of a lot of rhetoric and not a lot of change.

 If we as the clinicians working in the health sector do NOTHING, then we are contributing to the problem.  That’s completely unacceptable.

What I also know, is that in 2018 we have a culture of change that is brought about by grass roots movements.  It is in the raising of awareness and being committed to act differently that brings about change.  So, dear health professional are you ready to explore your role in creating the change in health care?

Are you ready to learn how you can help create a culture of change?   To imagine a health care system where every clinician is financially rewarded for the value they bring to the lives they change? To imagine a health system where clinicians want to stay working because the work is good for them, its fulfilling and it engages us to stay working as clinicians.  To imagine a health care system where client’s take responsibility and ownership for their own recovery, health and wellness and where they are resourced to do so.

No, we don’t need an open cheque book.  Come on that’s not an answer.  This is not about having unlimited funding for everyone with everything.  This is about a fundamental shift in the way clinicians allow themselves to be accessed, to be treated and to be valued.

So, in the end its up to us.

Its up to us who have been around for a while to create a culture where is OK for the newly credentialed and licensed to think about these issues and to bring about new solutions to the problems that we haven’t solved.

Are you ready to be a part of the change that we need to see?

I really hope so – because I am!

Here’s to making change happen.

Jo