Patients first in chronic illness management
EMBARGOED UNTIL 12.00 NOON SUNDAY 31 AUGUST 2003
Teams of multi-disciplined healthcare professionals, including but not solely comprised of doctors, is the way forward for the management of chronic illness, according to a report in the current issue of the Medical Journal of Australia.
While Australians enjoy an enviable average life expectancy of almost 85 years (second only to Japan), chronic illness, including depression, dementia, asthma, osteoarthritis, hearing loss and diabetes, is on the increase.
"Healthcare workforce shortfalls require a rethinking of models for delivering care to people with chronic disease," said Dr Peter Brooks, Executive Dean of the Faculty in Health Sciences at the University of Queensland.
Dr Brooks said medical graduates should have a major role in diagnosis and initial assessment of patients, but management can and should be shared by other healthcare professionals.
"The health system is predominantly geared for healthcare professionals, rather than for patients, and for episodes of acute care rather than for chronic care," he said.
He said the delivery of healthcare is currently very compartmentalised and that it's important to break through the barriers between these 'silos'.
Dr Brooks stress the importance of communication between specialists and primary care teams for the good of patients.
"Education at undergraduate, graduate and postgraduate levels needs to prepare healthcare professionals for this new paradigm. Future healthcare professionals will need skills in health promotion, patient advocacy and patient empowerment."
Dr Brooks discussed the possible future role of 'generic' healthcare professionals, or advanced practice nurses, who have a defined range of allied health skills such as physiotherapy, occupational therapy and nursing, but not necessarily the specialty expertise of any one discipline.
"These healthcare professionals could use technologies such as video or computer to link with specialists, medical or other, in urban centres," he said.
"Some tasks currently seen only as part of a doctor's purview could be performed by other trained professionals to allow doctors to concentrate on more appropriate activities.
"We need to explore new collaborations to deliver multidisciplinary health care for chronic disease and evaluate these for patient outcomes and cost effectiveness, Dr Brooks said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Dr Peter Brooks, 0411 408 581
Judith Tokley, AMA, 0408 824 306