MD and Chef Team - The Show!

Can Healthcare Change Really Happen?

July 19, 2021 Dr. Isabel MD & Culinary Nutrition Expert Chef Michael Season 2 Episode 19
MD and Chef Team - The Show!
Can Healthcare Change Really Happen?
Show Notes Transcript

✅  Let's listen in on the chat with Mel Jeur from Change Jam;

🔵  "I got the opportunity to start working in consultancy around customer relationship management and then moved into the health and social care sector through the e-government initiative in the UK, which was coming about. And the government at the time was being quite forward thinking, and that's a good 20 years ago.

🔵  So things have changed, but that was what brought me together with technology, the health sector and health and social care, really people, process and technology as well as the consultancy side.

And you know, I was here  in New Zealand, not in England anymore.

🔵  As I moved into health and social care, it has been kind of project and change management all along and in the last two years, I actually picked up an operational management role of two medical centers. So I manage two medical centers, lock stock, and barrel staff, profit and loss, everything, clinical quality patient incidents. So I manage two medical centers, 12,000 patients and 30 staff.

🔵  And because I've done so many years of change and improvement, and I also still have the energy to change the world, three or four years ago, I worked with a wonderful woman called Joe and I worked on changing general practice. And we can talk a bit about that in a bit. We worked, Joe's got a huge amount of experience, and we worked with 12 general practices across Northland to deliver an integrated, more proactive, more technology savvy, general practice offering.

To hear the insights about change and transformation in healthcare ...

➥ Download & Listen for the Rest of the Story!

🔗 
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Speaker 0 (0s): Coming up on this episode of the MD and chef team show. 

Speaker 1 (8s): The opposite of that is a permanent ongoing relationship between health practitioners and other people and yourself and data and ownership of everything where it's not episodic, it's based on it's how you live. And it's also in the staying well space, not being sick space. You know? So it's a wellness system, not a healthcare model. 

Speaker 2 (38s): Well, it's going to the show from the MDs shop team. I'm Dr. Isabel medical doctor here at the MD and chef team. And who are you? I'm chef Michael Coleman nutrition expert. I'm the chef, the kid. And what are we going to talk about bed? Now? I can say that because he's my husband. Well, then we'll be talking about marriage relationships, parenting intimacy. Talk about mine, tests, success, overcoming depression, anxiety. I'll be getting into functional nutrition, recipes and tips from the kitchen. 

And we're going to both get into how to live a long, healthy, vibrant life. Yes, I love it. Our mission is to help you prevent and reverse the disease and give you both in the process. Oh yeah. We might have to have some, let us get on with the show. 

Speaker 3 (1m 32s): Hi, I'm Val, how are you doing Isabel Cura. 

Speaker 1 (1m 36s): Lovely to see you virtually 

Speaker 3 (1m 38s): How very good. So called I'm in the mood now I'm in Hawke's bay and you're where are you now? North lead. Where 

Speaker 1 (1m 46s): We're actually <inaudible> but it was eight degrees this morning. Yeah, 

Speaker 3 (1m 50s): We're talking New Zealand, everybody. We're all talking to New Zealand. It's winter down here. I'm so ready for spring me to 

Speaker 1 (1m 59s): This in north end of course. By this time the sun has come out. So it's warm in the middle of the day. Yes, but the winter was, I mean, weekend was cats, raining, cats and dogs, howling gales, you know, proper rain. So yeah, we'll just have to hang out for a few months. 

Speaker 3 (2m 14s): Yes. But isn't it great to see the buds coming out on the trees. 

Speaker 1 (2m 20s): We're already starting to talk about weather. What about cows? We have two cows. One of them might be in calf, so we're not quite sure if it would be sort of late August, early September, but she doesn't show she's. She's a Friesian so she doesn't show well. 

Speaker 3 (2m 35s): And when do they, when do they give birth? October-ish October, November. Oh God. It's so sad to see the little baby lambs being born so early in the, in the winter when it's like, like last night, wasn't it freezing? 

Speaker 1 (2m 49s): Absolutely. Yeah. And it does, you know, we in general practice yesterday and it's a kind of sad, happy, sad story, but one of our receptionists was being really happy on the phone to a patient. She was like, I I'm so happy to hear that. And I said to her, you know, who was that? She said I was a patient we've had for many, many years. She said, she's just, she's been living in her car for six years and she has just got a heart. 

Speaker 3 (3m 14s): Oh, wow. Mel. Well, look, I love that. You just shared that story. How about if we introduce you to the listeners? Cause we've got everybody listening here. Well, I'd like to introduce to you everybody. Mel is her and she's in Northern the north part of New Zealand. And, and she's going to go ahead and tell a little bit about her story and then I'll just kind of start talking to her and I, we're going to just share the big vision about healthcare. Okay. So tell me a little bit about your story. 

I will 

Speaker 1 (3m 47s): Do it Isabelle. Great pleasure to meet you and all your listeners. Of course, we've already got to know each other. So I'm definitely a global citizen grew up in Namibia in a town called Swakopmund, which is actually Jew was German Southwest Africa at the time. So in the middle of a desert somewhere, the oldest deserts of the world lies a little German town with German architecture and coffee on cool Quinn and intense. I know it's amazing and a beautiful coastline. 

So I had a very free childhood running around with dogs on the beach, no TV, no computers. In those days, Africa, you know, you, you you're barefoot. And in the sunshine, it was a lovely way to grow up 

Speaker 3 (4m 31s): And are there giraffes and elephants? All of them. 

Speaker 1 (4m 34s): Exactly. So the deserty beaches desert, and then you go into where there are all those scam parks and a lot of conservation with Namibia is alongside Botswana. So they're particularly good game conservation lions, elephants hippopotamuses. My mum actually works in the game park industry. And even in the seventies would get on a four wheel drive and bugger off into the middle of nowhere on a dirt road. 

Speaker 3 (4m 59s): I love it. I love that. So great 

Speaker 1 (5m 3s): Childhood and then studied fine art in South Africa at the university of Cape town at a place called Makeda school of art in a time when Nelson Mandela was in prison. And so Africa was an apartheid torn, you know, war torn country. I got involved in anti-apartheid politics and you know, that's a whole other story was an activist, was one of the lefty, female activists, you know, Whitey activists in the eighties and then went to England in the Thatcher days. 

And in England started just, you know how these things are, cause you have some of this in your life too met my husband and between us, we plus a Kiwi guys started a software business, a CRM company, customer relationship management, which was like, nobody knew what that was 

Speaker 3 (5m 52s): Then back in the eighties and the nineties early nineties. Yeah. 

Speaker 1 (5m 58s): Did you know, kind of, you know, again, parallels for us pioneers. Sometimes they say pioneers die with arrows in their backs because you're so far ahead of everybody, 

Speaker 3 (6m 11s): Girl, I hear you. I hear you. It was what the hell it is, 

Speaker 1 (6m 21s): But it was, it was fun. And we, I got the opportunity through that to start working in consultancy around customer relationship management and then moved into the health and social care sector through the e-government initiative in the UK, which was, you know, coming about. And the government at the time was being quite forward thinking actually in what talk about some of that that's a good 20 years ago. So things have changed, but that was what brought me together with technology, the health sector and health and social care, really people process and technology as well as the consultancy side. 

And you know, I was here and I still am. Although I'm in New Zealand, not in England 

Speaker 3 (7m 3s): Anymore with your husband, with my 

Speaker 1 (7m 6s): Husband and my children have all grown and got away. You know, they, they came with us and we have a son in London still in his thirties and then two more here in the UK, in New Zealand, but they've done their unis and getting on with their lives. So that's amazing. 

Speaker 3 (7m 23s): And so now you and I are in our different, our next stage of life. Right? Absolutely. And I don't know about you, but I still want to help heal. Well, 

Speaker 1 (7m 34s): I'm glad you got the energy 

Speaker 3 (7m 38s): Till my last, till my last breath. I just, I you'll never be able to shake it out of me. There's so much that needs to happen. But yeah, so you tend to New Zealand and now you are a project matter. Well, 

Speaker 1 (7m 56s): I was, so my career when I moved into health and social care has been kind of project and change management all along and in the last two years, I actually picked up an operational management role of two medical centers. So I manage two medical centers, lock stock, and barrel staff, profit and loss, everything, clinical quality patient incidents, blah, blah, blah. So I'm kind of in your world really, or the world that you might've left behind, right. Because you're not exactly in that kind of GP clinic face-to-face world. So I manage two medical centers, 12,000 patients and 30 staff. 

And I also, because I've done so many years of change and improvement because I also still have the energy to change the world three or four years ago, three or four years ago, I worked with a wonderful woman called Johannsen and Joe and I worked on changing general practice. And we can talk a bit about that in a bit. We worked, Joe's got extreme, a huge amount of experience, but we worked with 12 general practices across north end to deliver an integrated, more proactive, more technology savvy, general practice offering. 

And so when I took off my operational role, I kind of missed that transformational side of it, but I also just miss Joe and Joe, and I can talk, we can talk the hind leg off a donkey. So we're like easy. Let's just do a podcast 

Speaker 3 (9m 23s): And hence the reason for <inaudible> exactly, you know, 

Speaker 1 (9m 28s): And also based on a principle that I'm now in this place where I know so much as the truth of Edison, as, as I'm sure you do, I have such a full kit bag, then I actually quite keen to share it and share it for nothing. And that's in some ways what podcasting is about and social media is just giving away. Right? That is actually what we do is change down, talk through all sorts of pithy problems or, and, or opportunities in life, because we're all at that age where we actually can draw on lots of experience and hopefully help other people, you know? 

Yeah. Yes, 

Speaker 3 (10m 2s): Absolutely. Absolutely. And when that's what I love about what we're doing. And so talk about, let's talk about transformational healthcare change, because when, when I had sent you a message on, Hey, would you come in and do a pod, you know, be with the MD and chef team podcast. And I said, would you just share with us what you see as the best best system for health care currently? 

Like what, just, just expand just you, you've got a huge table. We're not on any time restraint. What do you see? What's your vision? Well, 

Speaker 1 (10m 42s): You know, I mean, there's so much to say here and one can also talk about how to get there, you know, but I think let's just start with real visioning. I actually listened to a couple of years ago to a King's fund podcast about what might the future of healthcare look like? And King's King's fund in the UK had actually taken, they'd done some research, they've done some think tank work with a group of people in London. And what they'd said to them was don't dream up stuff that doesn't exist. 

Think of what you know now and future projected by about 20 years, you know, like go ahead. And what they talked about was sort of mindblowing and scary at the same time, but let's just go there, right? 

Speaker 3 (11m 30s): Let's chat. Let's just go there. 

Speaker 1 (11m 32s): So what they talked about was that there is an internet of things growing and for our listeners who maybe don't know what that means, and you can use the internet and you can use small devices in lots of ways. These days we have Alexa, we have lights to switch off and on. We can switch off free John. We can measure how much water is in our water tank. I have a robot and I've got a little app, I've got a robot vacuum cleaner. It's brilliant. So the internet of things is a growing thing. 

And whether you like it or not, your life is going to have all these devices around you. So that's one thing the other thing to think about is the growth of Fitbits and technology on your wrist, which measures your heart rate and knows your calorie output, and maybe can help you with macros and you know, knows how you sleep. And there's a whole wealth of material around mindfulness stuff and mental health. So the technology, if you forward that by 20 years is amazing. 

Wow. Okay. So there's a possibility that all of this could be used to give you ownership and understanding and control of what's going on in your body. And you might go as far as saying, there might be artificial intelligence or smart, big data, looking at your vibe vitals versus your genetic disease comparisons. You know? So there's also the ability to take readership from you and map it against data from the world. 

I hope I'm not losing people, but this is like, so it's going to be, there's a possibility that when you open your fridge for your fourth gen atonic, the fridge might say, you know, this is not a good idea. 

Speaker 3 (13m 18s): That would be a really good idea after the second after the second one. Right. You know? So 

Speaker 1 (13m 24s): On the other hand, I hope that I'm still in a position to make decisions and mistakes for myself, right? But there's, there's firstly, all this information and all this measuring of information. The second thing is that what that means for healthcare, which I think is fascinating is that if you look at healthcare today and you know, terribly well, it's even for a GP episodic, right? People, people come to you when things have gone wrong. Yes. Right. Then do they look for you to fix them or give it a name or MOSCOT they don't. 

Right. And they, you do that. And then they go away and then when things go wrong, maybe a bit more, 

Speaker 3 (14m 3s): They come back, 

Speaker 1 (14m 4s): Just fix it or mask it. So that's the opposite of that is a permanent ongoing relationship between health practitioners and other people and yourself add data and ownership of everything where it's not episodic, it's based on, you know, it's how you live. And it's also in the staying well space, not being sick space, you know? So it's a wellness system, not a healthcare 

Speaker 3 (14m 35s): Model, self care disease management, which is what we've got. We don't, we don't have, I always say we don't have health care. We've got disease management. 

Speaker 1 (14m 43s): That's right. Yeah. It's a sickness system. 

Speaker 3 (14m 45s): Yeah. It's a sickness system and I love, and that's what I'm doing for the rest of my life is just teaching people how be the CEO of their health. And that includes their brain. And that's exactly what we're talking about is teaching people, you have got the power, you just know, you just need to be taught what to do because you've never been taught what to do. And also, yeah, there's just so much that people don't realize that they're being tricked into thinking they don't have any power. This is just the way it is. 

Speaker 1 (15m 15s): And that's so interesting. Cause you know, what it also makes me think is these days, if you look at particularly younger generations, they can access any information and they do right. They're highly clued up because they can just do it. And the health care industry is still based on the fact was this premise that patients are stupid and doctors are very, very clever. And so doctors don't give, you know, they didn't tell you, I'm not a doctor. I want to know. And I want to know what I can do about it. You know, and I want access to resources and I want access to tools and techniques and that I can help myself. 

Thanks very much rather than I'm. 

Speaker 3 (15m 55s): And, and the way that, the way that the GP services are as doctors don't have time. No, that's exactly right. We're under such a time crunch, you know, that you're in that space, you see what doctors have to see. 

Speaker 1 (16m 10s): So I think that that is we, cause we've talked a bit about this really amazing vision out there, right? If we look at what's going on today and we can talk about that and it's the New Zealand context, but the UK is not much different, possibly worse is that the health system has not had financial investment for a very long time. 20 years. There was an article in the New Zealand doctor quite recently, which broke down the economies of the new budget, you know, figures and what they said, just, you know, and I'm like, oh, that's interesting. 

And I've not been in New Zealand since you know, that long. They said from firstly, if you go back to the year 2000 and you look at the rate of investment based on population. So you know, you and I both know you can look at an F first of all, index of that New Zealand was already low. It was lowish, right? In 2000, if you looked at it as a rate and then from 2000 to 2017, no, not even an inflationary increase, no increase was major primary care, nothing, zero. So it's gone backwards for 20 years, right? It started low. 

In the meantime, you know, this from a system point of view, older people, long-term conditions, inequities with Murray health, diabetes, cardiovascular is huge, right? Huge and secondary care has got harder and harder and harder to get to. So more and more and more complexity sits in primary care. It becomes a high utilizing chronic conditions system. We see it all the time. And the money you're given is for 15 minute consultations by GPS, not even by nurses or social workers or healthcare systems or dieticians by GPS. 

Yes. All they do is prescribed. 

Speaker 3 (17m 54s): That's all they've got time for. They don't have time to do anything. 

Speaker 1 (18m 1s): What you're saying is right. So I think it's important not to kind of denigrate an entire professional because I know lots of GPS who do an incredible job who really, really care, but it isn't. The system is for starters, a ambulance at the bottom of the tip system, the funding is for an old fashioned model. It doesn't think it says nothing health and social care about it. And it would not only need funding, you know, for a more preventative, more holistic, more multidisciplinary team investment, but it would need pump priming to become prevention, not cut your leg off because you've had diabetes. 

Right. Which is kind of what's going on right now. So you would need pump primary. It needs too much. 

Speaker 3 (18m 46s): Right. Right. So like how would you, I've always, I can't figure out how this is going to happen, but how do you get people invested in their health? You know, how do you get people to, to want to take better care of themselves? I just like the population that I work with. Yeah. The population I work with online, they, you know, that's what they want. But in health care, like how do people that are going to the GPS? 

How do you motivate people to take care of themselves? 

Speaker 1 (19m 24s): You know, I think there's motivation and also environment. And it's a hugely complex discussion is because there is the inequities, as you get into poverty and all the determined, social determinants of health. I mean, you know this stuff, right. But if, and let's just stick to the diabetes side of things and food just for a minute, oh, we have a health. Yeah. We have a health coach. Who's a dietician in our practice. She's amazing. You would love her. She loves the reversing diabetes words. 

Thanks very much. She's like, yes. Anyway, she came into our practice the other day and she was looking very miserable. She must have, what is it? And she went, ah, I just feel like I've just sometimes I'm up against this massive battle. And I said, what is it? She said, they've just opened up another pizza shop, 10 minutes outside of the school. And in the afternoon before three of those pizzas are a dollar, she said they are teaching and addiction. Oh yeah. She said, I will have lost those kids by the time they get to me. 

And they're 20 something, forget it it's past. So there it's serious. You know, there is a massive industry out there that sells fast, burning carbohydrates, dead cheap. And that messes your body up. Oh yeah. You know, and then ha that's not about motivation. That's about objections that exactly. So there's a big societal component to play. Then there's all the poverty stuff laid over it. If that's all you can afford and this, and they were saying to you and you're living in your car, let's say, blah, blah, blah. 

Right. Okay. So that's the food side of it. So I think when you're talking about people, who've got other things going on in their lives or other disadvantages or other massive challenges, you need to help them with the massive challenges first. And those people may well get through those challenges and go, that's amazing. I'm now ready to work on this. And we do have those patients that may do an incredible, that's amazing how, wow. Then there's maybe affluent people who have got lovely lives, who can be precious enough not to care about their health and in a way I'm almost, you know, and some of them are motivated enough to listen to people like you and all get up and want to live their best lives. 

You know? And sometimes in life it takes a big wake up call doesn't it 

Speaker 3 (21m 47s): Actually has to happen. Fortunately, that's usually how we learn best. We kind of like land on our face and go, okay, there's no other place to go. You can't go down any further. So now it's time, you know? And that's normally when you've been diagnosed with, with type two diabetes or a heart attack or stroke and, and I'm just like, well, you and I both know, we're like, don't go there. It's really ugly. But unfortunately that's human nature. And that's where we learn the best. That's where I learned my best lesson. 



Speaker 1 (22m 19s): Know what I'm talking about. Sort of just saying to people don't go there and also explaining what's going to go on. I'm sort of, I hold off saying the word health education. Cause I think it sounds very paternalistic, but we've in our practice. We've recently had some new roles. There's some roles that are being rolled out by the ministry of health, the hip and health codes bottle. So you get this role called a health improvement practitioner who does short term mental health stuff. And they get a health coach who is a community based person and can go out and actually see people and talk to them. 

Anyway, we've got our health coach recently, she's Marty with fluid. Tenao really amazing money in her local region. And she started picking up. She does what she calls, scratched the surface with our nurses, people with diabetes, who haven't come in for ages and their mental over the place, people who aren't getting immunized. And she said to me, less than a cup of sock, she said, yep. I had a look at that guy. He's in his thirties, he's really on a long-term trajectory. This is not going to go. Well, she said, so I called his mother, right. 

She said, and I said to his mother, this is not going to go, well, we're talking to losing legs here. We're talking massively dependent. By the time he's 40, you need to go and get that guy. And even if you tell him, you're just going to the shops, you need to bring him to the GB. I said to her, honestly, I could never have done that by myself. I would have pussy footing around it, but she was just in there and she's right. 

Speaker 3 (23m 46s): Yeah. And a passionate and passionate. Like I've always, I've always thought, okay, we'll give people a financial incentive. You know, you have your hemoglobin A1C. I don't even know what a pho pays per patient per year, but you know, okay, let's give that money to the people. If they keep their hemoglobin A1C at a certain level, they keep their waist circumference to a certain level. They keep their BMI to a certain level. 

Okay. Not maybe BMI, but body fat, you know that they keep those parameters under control. Okay. You get those numbers to a certain level. Then you get paid at the end of the year, this amount of money. And then they can use that money for good food, you know, like the financial incentive. So we do do that because the reason, the reason I say that is because if we continue on this trajectory, then healthcare, New Zealand will be bankrupt financially because of the healthcare system. 

Speaker 1 (24m 48s): They, yeah. I mean, there's many points in that. Mostly the capitation is a really old fashioned system. There is some understanding and we've just recently got a smoking cessation contract with our pho that offers the patient a sign up $50 and quit $50. So if they successfully quit and they do a CO2 reading that there is an incentive and that does help. But I would say it's kind of dropping the ocean stuff really. You know, if you look at the really underlying reasons, and if I think of some of the patients we have, I mean, Hey, they've got multiple co-morbidities and they're on a string of meds like this 30 off, you know, like slip, Aw, how did you get here? 

So it's pretty bad. You know? So I think that's awful for them, but coming to the cost of ed, I, the health economics in the UK, when we did, there was some work around developing what they call an out of hospital model in terms of health system. And there was a lot of work done with a reablement model, which is like a recovery multidisciplinary model and some admission avoidance pieces of work. And there was longitudinal studies at the time. 

And it's not a big surprise for you and I to hear that where they offered it was older people, no holes, barred rehab for a six P six week period. So they didn't cap it. They just said, whatever you need, we're going to help you to get independent. 80% of those people got independent of back to where they were before they went to hospital, calling all of them, women, are 

Speaker 0 (26m 22s): You feeling depressed? Lack of energy, anxious, you're thinking is foggy, poor sleep, or maybe even hopeless. You know, there is a better you to present to this world. Hey, it's me, Dr. Isabel. And wow. If any of this sounds like you, hi, get you. I have been in this place and I've overcome those negative feelings. That's why I've created the free and private Facebook group called the bossy brain solution. 

Yeah. Would you like weekly coaching to help you become your best self come and see for yourself and be empowered by the other women who want to shine their best light in this world? The link is in the podcast description, or you could search for the bossy brain solution in Facebook groups, it's private and free. So come and join us today and know that there is hope. 

And I encourage you to remain on stoppable and now back to the podcast. 

Speaker 1 (27m 39s): So it's blindingly obvious that that is cheaper than putting all those people into residential homes for the rest of their lives. Blindingly obvious the business case stacks up enormously. And what I find so amazing is that the New Zealand government does not seem to understand that at all. It does not even, even this week's New Zealand doctor, they say it right in the editorial, what the fuck is going on? They didn't, they didn't actually say that pretty much. 

You know, the ministry of health has not. Doesn't seem to understand the primary care is a significant component of prevention. 

Speaker 3 (28m 21s): I know I'm just, you know, kinda, I remember, I don't know if this is the, the, the absolute figure, but I know that having somebody on dialysis per year is $70,000. Oh my gosh, take $35,000. You know, of that money and use it on people. The families, 

Speaker 1 (28m 43s): Yeah. Housing. We didn't eat it installation, 

Speaker 3 (28m 45s): You know? Well, no, but I'm talking about eating because eating is what causes well, yeah, eating causes diabetes. I mean, yeah, it's our genetics, but we don't have to express our genetics. Weak epigenetics teaches us that we don't have to express our genes. And I'm not talking about blue jeans. I'm talking about the genes in our DNA. Why not use that money to, for the family because teach one person in the family, that's got type two diabetes, how to reverse it. 

Then guess what? That person will be paying. We'll be buying food for the family. And they'll go on a journey to learn how to take care of it. And they're getting paid for it. Because if not, then we're not going to be able to take care of well, New Zealand, won't be able to take care of the financial stress that's coming within the next decade. And doctors, GPS, GPS, not becoming GPS. It's too much there to be. A GP is really not to be a GP. You're also an internal medicine doctor. 

You're a cardiologist, you're a nephrologist, you're a gatekeeper. You're a Jew. You know, you're a scientist, you're a psychiatrist. There's so much. And the renumeration is nothing compared to what all the other specialists or don't getting. And it's just so unfair. It's ugly. And we got to do something fast because it's crashing. 

Speaker 1 (30m 14s): I, I mean, I could not agree more. I see it in front of me every 

Speaker 3 (30m 18s): Day. I know 

Speaker 1 (30m 21s): Because we have a lovely registrar. Who's been working in our practice for six months, really fabulous doctor, beautiful with Kamani, just really cheerful, lovely together. And he said to me, you know what all the registrars are saying? And I said, what's that? He said, the secondary care doctors have no idea how hot primary care is. They do not have a bloody clue. It is so hard. We had no idea. I was like, yep. Well, what can you say? 

Yeah. So I think, you know, what we're talking about is it's too hard a job, actually. Even if you pay somebody, what secondary care specialists, a big paid, it's still too hard. And too, it's too hard. Maybe because of the way it's set up to sit in a little room and do 15 minute consultations or all the kinds of things you just talked about and not have much you can do other than diagnose and prescribe or refer to a secondary care system that doesn't have much space, 

Speaker 3 (31m 25s): Right? Hot, you know, well, I have a solution. Good to go. So the solution is start teaching doctors in medicine, medical schools, and now how to do functional medicine, which is getting to the root cause of people's illnesses. And for them to understand it, because we're not taught this in medical training is for them to understand what causes high cholesterol instead of, oh, this is the pill you give for high cholesterol. 

Just take care of it at the root level. So that the weed doesn't come up learning and teaching the doctors how to do that really will empower the doctors because doctors now are just like, what's the point? Here's a drug. And then when patients don't take their drugs, the doctors get upset. We get frustrated because that's the only thing we've got in our back pocket. So I think that that would be step number one is, is develop time so that doctors can learn functional medicine, integrative medicine, and, and learn the best of both worlds. 

Speaker 1 (32m 35s): So I completely agree. And what I there's, for me, there's an interpretation that ethos, right? Cause you said, you said functional medicine. And it also said integrative medicine and the integrative part in our practice and the future New Zealand health system aspirations certainly are an integrated set of care providers who have some specialist skills like dietician, life, coach, counselor, navigator of complex, let's say quite often older people when they need some occupational, you know, equipment aides and awesome home care. 

It's very, very difficult to get it. Shouldn't be difficult. It should be easy to get. But right now it's really difficult to get. So where I'm going is we have a number of different roles who work with the GP and our GPS know and understand. We also have a pharmacist in house, you know, know and understand those people really well. And our model is set up that they can easily refer to Allie, our health coach or to, you know, our pharmacist. If there's something complex there maybe to also work with the patient as to how to make this easiest for them, how to set things up in a way that they can be on top of what's going on for them it's integrative medicine with more than one person doing it, I guess. 

Yes, 

Speaker 3 (33m 56s): Absolutely. Absolutely. And I know in America I used, I, I couldn't practice medicine if I didn't have my physician assistance. And I think that that's so needs to be incorporated here in New Zealand. Yeah. And it 

Speaker 1 (34m 11s): Is, you know, slowly it's happening. We have to that's right. It is slow, but that that's the direction of travel. And then that brings you together from where you are now and where the GP is now into this place where there's a huge growing role, particularly for nurses around diabetes management, cardiovascular exercise, and et cetera, which is, and they tend to have more time or it should be designed such that they have more time and sometimes are maybe the better workforce to make that kind of heart connection. 

Absolutely. That's kind of one of the needs, you know, not, not just treadmill, cookie cutter medicine. 

Speaker 3 (34m 56s): Yeah. Heart so important people, people can pick up right away without you even saying anything, whether you love them or you don't love them, whether you care about them or whether you don't care about them. And eye doctors are so run off their feet, you know, that they just don't have time to be asking questions. They can just listen to a couple of things and then go, boom, okay, this is what you need because we're taught to fix, right. 

We're taught to fix them 15 minutes. I like, I like here at your practice, what you've got there, that you've got such a multi-disciplinary group of people. I feel that that would be a big advantage for more practices in New Zealand and just teaching people. What do you think about just teaching people that, Hey, anybody that wants to learn how to come off their medications, then this is, this is the doctor you want to be working with. Or this is the group of, of, of health coaches. 

You want to be working with them. 

Speaker 1 (35m 58s): Yeah. We're not all the way there yet, but that's exactly right. We would love to do that. And I think there's some of this is about meeting the challenges of the resistors. You know, in any practice, you'll have a range of real old people. Who've become from, you know, this study a long time ago and they practice in a more old fashioned way. And then as we bring in our locums from overseas, particularly from the UK, they're all up for it. Absolutely. I mean, we work with this nurse that we do that proactive care there. Let's do this over here. So it's the same old change stuff. 

Isn't it. It's working with the willing showing and demonstrating why that's good and more and more patients going, wow, that's great for them, their experience with the practice. Isn't just the GP. It's all the people, the receptionist who knows them. And that they've been there for five years and parts 

Speaker 3 (36m 49s): People get off, we'll get healed. The moment they start walking into the practice with heart, you know, with I'm cared for here, this is a safe place, 

Speaker 1 (36m 59s): But there is a thing we haven't talked about. And it's your subject. You're, you're, you're a subject matter expert at this more than I am. But another part of future of medicine or where the word wellness, the wellness support that you can get from the amazing people out there like you and others is also having it virtually. So for like in north Ireland, it's difficult for us to attract doctors. And some of the issues are, there's not that many schools for their kids. It's far away. It's very rural. 

So why the hell? Why can't we just offer a completely seamless experience online? It's 100% doable. You can, you can feel love over the bloody internet 

Speaker 3 (37m 43s): Possible. That's in its infancy. Isn't it, you know, been doing it for the last six years. And it's the only way I practice medicine now is telemedicine. I mean, COVID has actually broken down the wall so that, so that the medical system sees it as an advantage, like, wow, I can take care of anybody. They don't have to come to me. They don't have to spend money and time to leave their work. They can see me, you know, on their lunch hour stuff. 

So yeah, like you, like you said, you know, people that are ahead of their times usually have swords in their bag, but I don't care. I'm just doing what I know is right, because the world needs to be healed. And I've been thinking about this ever since 1985, when I went into pre-med owes being in medical training, I was like, pre-med yet just going, no, we got to change something. This is just not right. So I'll wait and it's really not. Right. 

Speaker 1 (38m 45s): And there is also, we haven't really talked at all about, but on a personal note, I use homeopathy and have done for 25 years, you know, and for me, if I have something small going on right now, I've got a little skin thing going on. I know that's my body telling me something. And that's what I would work with with my homeopath in a holistic way. Probably partly stressed. And you know, rather than give me some steroid creams, which is probably what a GP would do. So I'm like down that road. 

Speaker 3 (39m 16s): Yeah, yeah, yeah. And also skin, like, I always like to first go into the BrainHealth well, who's getting under your skin, you know, just who's bothering you, that it's coming out of your skin and then also gut health. I mean, your gut is so important. It just, it just talks through your skin. So those would be the two areas I know you didn't ask, but if you did, that's what I would say. I was going to say, thank you, doctor. That's very good. 

It's I am grateful 

Speaker 1 (39m 48s): For your skill advice. And funnily enough, because I did see a GP and I had done a bit of my own doctor Googling and I went to see this GP and I said, oh, my theory is this, this and this. And I said, and because I'd had to take an antibiotic, I, what happened? I don't mind sharing this. This is not a particularly it's, it's a funny story. Almost. We've got a hot tub, a Cedar wood, hot tub at Christmas time, which doesn't have a filtration system. And I, we were stupid. We didn't clean the water. We were naive. And I got a pseudomonas infection, a skin infection, hot tub, flicking lighters. 

I know. And I had to take an antibiotic. I hadn't taken one for 10 years and quite a hard hitting one. And so I ha you know, I took this antibiotic and then my skin was so sensitive. It just started, you know, not coping really. So where I'm going with this is that there's some science there, but as you say, I think there's also some emotion involved. And when I was Dr. Googling, I saw the connection between gut health and skin. 

You know, if you look hot enough that said, oh yeah, there's been recent research. And I actually said that to my GP when I went, I said, oh, I think I'll take a probiotic because I'd taken an antibiotic. And I think this is related to gut health. And the GP just looked at me. They were just like, 

Speaker 3 (41m 9s): Yeah, there, we're not trained in that. You know, that's not something you learn in, in medical school. Yeah. And I 

Speaker 1 (41m 15s): Think there's still lots. That's not under this. Isn't there, you know, about the gut and even things like the Vegas nerve and that sort of stuff 

Speaker 3 (41m 22s): So much, so much take care of your gut and it will take good care of you. Well, Belle, I'm going to go ahead and land this plane. Okay. Another metaphor could be, we're going to go ahead and dock this ship. I love that one. I've been working on my metaphors one time. I remember I said, okay, we're going to dock this plate. And I was like, that's the wrong metaphor? So that's just how I do it. 

Yeah. Before we go, I just, I would love for you to share with our listeners, the project that you're working on right now. 

Speaker 1 (42m 4s): So do you mean art project or change time project wise change, change job. Yeah. Hi. Yeah. Yes, of course. So for those who don't know, change jam is a podcast and you can just Google change. Dan, you can also Google DubDubDub change, jam.co dot N Z. We have a website and then you can subscribe there. And change jam is really a chat between two awesome women, just like you and me and sharing our wisdom. So we've Johansen, who's my podcast partner. 

And I have been delivering on change projects mainly in the health and social care space for about 25 years. So it's how to start change how to do a vision, how to deal with resistance, how to corral people along, how to stay true to what you're trying to do. Being cheerful is our next one coming up. Actually we've, we've, we've, we're just agreeing some new subjects and why, for example, being cheerful generally helps us, helps us mentally helps our teams. 

So that's what our next subject will be about and responding to people. Yeah. So DubDubDub changed after code and Zed is the place to see us and subscribe, and also really nice to, you know, talk to your listeners and find out more about your podcast. And I have been listening, it's teaching me some stuff, so, 

Speaker 3 (43m 32s): And just so all the listeners know we will have, the lady is in the show notes on this. Okay. So don't worry. You don't have to remember memorize that. Okay. All right. Melville, stay warm. Spring is coming in about a month and a half. I can't wait. All right. Thank you so much for your time. I appreciate it. And remain on stoppable. Okay. I will do. It's such a pleasure. Nice to talk. 

Speaker 4 (44m 3s): Hello, chef Michael here. If you enjoyed today's episode, we would love it. If you subscribe to the podcast and left us a review.