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Independents' Day

General practice must embrace the latest technology to survive

Dr Jonathan Simon argues that GPs must embrace digital innovations and models of care to secure their future

dr jonathan simon

I began my GP career in Oxford before spending 35 years practising in New Zealand. I believe there are some common strategic challenges facing the profession in each country.

We know morale in general practice here in the UK is low. There are problems with recruitment and retention, the workload is becoming unmanageable and time spent on administrative tasks is increasing and reducing the satisfaction of being a GP. There is pressure to delegate to nurse practitioners, practice nurses, pharmacists, physicians’ assistants and health coaches, yet many questions remain about what GPs’ role will be in the future.

If this were not enough, the whole model of medical practice is being disrupted by the digital revolution, something I believe will determine the future of general practice both in the UK and in other developed countries. As knowledge moves into the community, so does power and the capacity for patients to make their own choices about which services they want and how they have them delivered.

So how can general practice respond?

GPs need to be proactive and incorporate ‘smart technologies’ into their practice, using the technology to support high quality real time and virtual access to services. The big players in health, Amazon, Apple and Google, have yet to truly make their presence felt but they will offer alternatives to existing models of care and will have totally new infrastructure. This will make them difficult to compete with, unless general practice in the UK and other countries are aggressive and proactive with innovation.

GPs with special interests could take over inpatient management

The experience so far with ‘GP at Hand’ in London has demonstrated there is a large demographic that wants access to highly responsive medical advice. As Professor Helen Stokes-Lampard suggests, all practices need to be able to incorporate this offering, so that it no longer becomes a threat but is just another solution for patient access.

New technology assisted models of care are also going to have a huge impact. In Canada, GPs can admit patients to hospital and care for them during their admission, with consultants supporting with more complex cases. Some GPs manage across the primary/secondary care boundary, while others choose to work exclusively in hospitals and are called ‘hospitalists’. Here in the UK, GPs with special interests could morph into GP-based hospitalists and take over inpatient management. They would have consultants, AI and technology to support their practice. Hospitals with better use of workforce and new models of care will become more efficient and effective.

Furthermore, I believe GPs need to acknowledge the new specialty emerging called ‘functional medicine’, which essentially ties in systems biology, genomics, nutrition and role of the microbiome. Lifestyle medicine guru Dr Ranjan Chatterjee, from the BBC’s ‘Doctor in the House’ series, is an excellent example of functional medicine in action. It is an exciting and satisfying place for a medical generalist to be and offers a real option for the future. GPs working in this way can really alter the health trajectory of a person’s life.

I also believe it is in this space that GPs can offer continuity, convenience and empathy and have a more satisfying and fulfilling professional life.

Dr Jonathan Simon is a retired GP in ­­west Sussex and former honorary secretary of the Royal New Zealand College of GPs



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Readers' comments (3)

  • Vinci Ho

    As I wrote , I would like to keep an open mind about this . But I also believe everything has its advantages as well as disadvantages. Well , at least that is how I was taught during my vocational training on developing good doctor-patient relationship 24 years ago . We know very well the strengths and weaknesses of the ‘old’ (still current) model of doctor-patient communication skill simply because of long time of practising this model.
    We are yet to learn the same about this new AI-algorithm-smart GP consultation model . As veterans , we are easily labelled as anti-revolution. Equally , the younger colleagues can be criticised as insouciant. I am reminding myself this everyday.
    One size certainly cannot fit all . The current climate of pushing AI by all these tech companies like Google , Amazon , Facebook etc is NOT healthy , at least , politically . We have already seen the goods as well evils of the over-indulgences of Internet and more specifically social media . The way they can influence ‘outcomes’ has arguably crossed the red line of morality in various arenas.
    Until I have seen objective evidence about the real merits of this kind of model of consultation which is to be driven by the tech industry fast and furious , my scepticism always remains.
    Another big issue is confidentiality, the collection of ‘big data’ by these tech giants(hence , further usage )is estranged to our principle of defending patient confidentiality. Clearly , I don’t believe the IT system of NHS will be strong enough to deter the misdemeanour of these tech firms .
    Once again , like I quoted Lincoln in my long comment yesterday :
    One can fool everybody some time and some people all the time . But not everybody all the time.
    The reason I always believe we are Jedi is because we have a code and morality to serve for, that’s why we are different from them.........

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  • How do you solve a problem like GIGO??? Hum!
    The input to medical AI algorithms is almost totally subjective and often based on appalling misunderstanding of medical science!

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  • Argil

    I can just subscribe Vinci Ho comment.

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