A GP's Patient Centered Care Approach, Works Alongside Consumer Directed Care; To Allow Ageing in Place in the Community

Every general practitioner has a duty of care to their patients and there must be a relationship between GP and patient in order for the GP’s care to be effective. Patients have learned to expect more from any healthcare system or healthcare provider, which has an implication on the relationship between the GP and the patient. Gone are the days when patients were processed as in a factory, going through the assembly line without any say in the matter. They now want to have a say in how they are given care since they pay for it either directly or as a tax payer. GPs, the primary health care givers, must therefore change in the way they relate to patients. The ideal relationship between the GP and any patient is one in which there is trust between the two and the patient is open and receptive to the GP’s advice and the GP honors the patient’s right to make decisions. Such an ideal situation is the idea behind the Patient Centered Care (PCC) approach.

Patient centered care exists when healthcare organizations, healthcare service providers and policy makers actively work with health care consumers to ensure that information and services meet consumer needs. The needs of individuals differ. Some prefer more attention, while others are happy to look after themselves with professional guidance. Some prefer to go to the doctor’s office and yet others are happy utilizing technology. All the personal preferences are taken into account, and care is designed taking the preferences into consideration. Information is made available to the consumers and their communities to make sure they know as much as possible about the conditions that affect the patient, and how to improve health.

As a result consumers are treated with dignity and respect, information is shared with them and their participation and collaboration is encouraged. Consumers are no longer at the mercy of the system. There is evidence that PCC can lead to improvements in quality, cost effectiveness and safety of health care and improvements in patient and caregivers’ satisfaction.

GPs in Australia can use the patient centered approach to provide long term care to the aged in Australia. Luckily, My Aged Care allows Consumer Directed Care (CDC) in which the aged people, or their family members, determine what health care services and supplies they want. The aged people or their families select, retain and manage care providers and payment of those care providers within a pre-agreed budget. So the GPs will not dictate what care is required, who provides that care and when it is delivered. The role of the GP is to inform and guide. It is hoped that because the aged people are in charge of their own care, they receive higher quality care that is customized to their needs, and they can enjoy more flexibility, control and satisfaction from that care. Hopefully consumer directed care will save the states the cost of care since they do not have to provide that care and they do not have to continue building requisite infrastructure.

With patient centred care together with Consumer Directed Care, the aged Australians can receive the best of care that will keep them healthy and independent longer. In fact they can improve their health, or at least maintain it, and happily age at home, within their community, close to their families and friends. The power to make their own decisions and control their budgets will give them confidence. As has been discussed in this article, keeping the aged at home with assistance is more beneficial than confining them in a nursing home because they have the love and assistance of their friends, families and neighbors.

My Aged Care embraces the principles of Consumer Directed Care, giving the aged person control over the budget and control over who provides services. It creates an open market for service providers who have to prove themselves in terms of the way they provide services, the level of their charges and the way they market themselves. Only those service providers who change in order to become attractive to the aged Australians will benefit from the program. Read more here.

However, aged people face a lot of challenges like mobility, lack of money, chronic diseases, and disability. They need help from a variety of service providers, not just health professionals. Their care requires better integration between health care, social services and human services to provide cost effective care. In fact, real merging of the Australian Department of Human Services, Department of Social Services and Department of Health would be a welcome move in which consumers can find all the help they need in one place. Read more here. Merging the three departments will reduce duplication of services which exists at the present moment in the departments. It will allow programs like Health Care Homes to better utilize community based resources and to fill capacity gaps that exist right now in the programs and to remove any barriers. Read more....

As the population of Australia continues to age and more aged people develop chronic diseases and disabilities, Patient Centered Care and Consumer Directed Care become more useful as approaches to care. Each person is unique in his or her needs. There is no one size fits all type of care. That is why Patient Centered Care makes sense. In PCC the patient and the GP develop a relationship of trust, the needs of the patient are identified and then the GP and the patient together plan the type of care that is ideal for the patient. At the same time the patient, exercising CDC, decides who provides all the services that he/she needs, when and for how much.

The elderly people who are ageing in place, and have challenges like chronic diseases and disability need a lot of care. If they have to visit all the service providers they would spend a lot of time seeking help, needing transportation to service providers’ offices. That would put a lot of pressure on family and friends who must take time off from work to take the elderly to visit service providers. Thankfully technology can lighten that burden. Telehealth can be implemented whenever possible. The elderly people can have access to the internet and most visits to service providers can be done through video conferencing. They can have a range of monitoring devices for blood sugar, temperature, blood pressure, pulse, etc., and log into the telehealth system to keep a record of the vital signs. The doctors and nurses at the health care center can monitor the vital signs and if a reading indicates a problem, they call the patient and discuss the problem. When necessary they can send a prescription by email and the pharmacy can deliver the medicines. Read more This saves time for both patient and the service providers and the patient is never alone.

At the center of PCC and CDC is the GP who directs everything while involving the patient. The GP plays a critical role in making sure that the patient receives a sufficient amount of the right information. With the right information the patient is guided to make the best choices of the services that he/she needs and the service providers that he/she prefers. The GP then coordinates the holistic care that the patient receives. If any physical changes are required at home to make moving around easier, the changes are made. If the GP implements telehealth as part of the service, he can keep watch on the patient through technology, making it easy to provide care at home and unnecessary for the elderly person to travel for appointments. When something goes wrong the GP can alert the relevant specialists.

With PCC and CDC properly implemented and through integration of goverment services, patients receive the best of care, retain control over their health, learn a lot about their health and become more confident, more independent and happier. With holistic approach to their care, they are satisfied and can easily age gracefully in place, happy to be among their friends and families. The families have less stress concerning their ageing relatives whose presence they can enjoy. At the same time, ageing in place saves the nation money that would otherwise be spent on increasing infrastructure for the aged.