It's been sometime since I did anything to develop the model I presented in my first post in this blog. The most recent post is presented as an account of an actual consultation and how it left the patient (and her supporter) feeling. It is thus part of the body of evidence I am drawing on.
Anne Marie and I have had a vigorous private debate over on Wave which had two components:
- I was trying to use my own experiences within the NHS to demonstrate that medicine used to be much more paternalistic than it is now but that it is not yet where we would want it to be.
- We were to trying to understand where each other is coming from and how that affects the way we regard medical practice.
Anne Marie concluded that I am effectively an engineer and thus look for clear cut solutions. I am also sightly older than the NHS so my initial impression of medical practice were more "old-school" than Anne Marie's; what's more she is an educator and thus pretty much at the leading edge of establishing best practice in modern medicine.
I need to explain the philosophy behind defining the kinds of models that I have been using. The techniques come from my background in Business Analysis and are meant as tools to understand where an organisation has come from, where it wants to be sometime in the future and where it is now. It is then possible to articulate a set of well constructed goals and objectives, projects etc... that will move the organisation towards the desired end point. This is a purely intellectual process; the skill comes in communicating the strategy to the people who are going to be affected by and effecting the change. More often than not in the commercial world this where management fails (The Post Office and British Airways are probably cases in point.)
I hope that Anne Marie and I agree that medicine is more collaborative than it used to be but not as collaborative as we would like. Anne Maria is doing her bit to educate new practitioners t work more closely with the people they see and help them manage their health. However, there are risks that this model will not be universally applied nor accessed by all people who need it. South Wales in particular has a significantly large group of people who are disadvantaged by generational unemployment, poor education and digital poverty (lack of access to high speed internet connection and the ability to find and evaluate information about their health needs and opportunities).
So I've decided that rather than faff about trying to define a Nirvana I simply need to help build it. There is sufficient consensus of what the future should be amongst "forward-thinkers" that we should get on and do.
So Anne Marie, what can I do to help the patients in your GP practice to become better empowered?