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The view from Australia: building better healthcare systems

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Kerryn Phelps, Bangalore, integrative health, Australia

 

kerrynphelpsKerryn Phelps is a former President of the Australian Medical Association and a strong supporter of integrative medicine.  She attended our conference on global health futures in Bangalore in the autumn, where we caught up with her

Could you tell me a bit about the work that you’re involved and the difference it is making to the people you see?

I’ve been actively involved in integrative medicine in Australia for quite some years now and I’ve certainly seen a shift in philosophy of the health system away from fairly conventional Western medical model through to a multi-disciplinary patient-centred integrative model.

This type of model is being supported by Medicare which signals that there’s a shift also in government philosophy to funding some so called complementary medicines and allied health services. The GP is considered to be the navigator who guides patients towards the services that they consider will be most appropriate for them, with the patients input.

The patient and the doctor will have a conversation about their condition and who is looking after their health needs, who is giving them advice and who they would like to include in their health care team. It might be a medical specialist, a surgical specialist, a cancer specialist, a physiotherapist, and it may also include other practitioners like chiropractor, osteopathy, psychology, acupuncture and a number of others and Medicare will then subsidise in one year five visits to one of these allied or complementary practitioners.

There are some complementary practitioners working within the Australian health system who don’t have Medicare support, but they might be privately funded by patients out of pocket. So were seeing a process of evolution towards a more integrated system of all different types of disciplines that are in the best interest of patient care.

In my clinic in Sydney we have a multi-disciplinary team of 15 practitioners and we cover a range of disciplines from general practice to psychology, Western herbal medicine, traditional Chinese medicine, shiatsu, yoga therapy and dietetics. We’ve spent 8 years building that team and building that concept and fine tuning it and bringing it to a position of strength now within the system and I would like to see that as a template for other clinics to be established and certainly learn from our experience.

And what’s the most positive idea or connection you’ve got from attending the conference?

I think the conference is a very strong reminder that the burden of chronic disease is a global phenomenon. It may have its unique social and cultural context from country to country and from area to area, but I think that overall our goals are the same. And that is to identify and reduce the burden of chronic disease, and to look at what therapies are available for patients in a cost effective way, in an accessible way, that are going to be in their best interests and do the least harm.  These should be integrated into a comprehensive management plan for patients where the focus is on the patients needs and preferences.

We have to keep in mind that patients or individuals themselves are ultimately responsible for lifestyle factors and we have to give people every opportunity to be able to live healthy lifestyles in terms of nutrition information and the availability of fresh wholesome foods, built environments that encourage activity, workplaces that encourage healthy lifestyles, environmental issues.

I really think we need to take a whole of environment, whole of system, whole of person, whole of life approach and I think that one of the things this conference has done has been to bring people together with different perspectives on that problem from different cultures so that we can all apply that knowledge to our own home context.

Biography

Professor Kerryn Phelps is Adjunct Professor at Sydney Medical School in the Schools of Public Health and General Practice and Conjoint Professor at the University of New South Wales.

She is a Past President of the Australian Medical Association and is also extremely involved in integrative health as Past President of the Australasian Integrative Medicine Association. Professor Phelps has worked as a principal in general practice in Sydney for three decades. In 2006 she established a state of the art multi-disciplinary integrative health clinic in Sydney’s Surry Hills called Uclinic. In 2011 she was made a member of the Order of Australia for service to medicine.