Primary care done differently?

There are 2 health-related stories in the news today, firstly the confirmation that dietary management can be more beneficial than pharmacological treatment for primary prevention in cardiovascular disease. There has also been a gamut of recent evidence showing the effectiveness of dietary (in excess of exercise) and lifestyle change for obesity, diabetes and broader health.

The second story relates to the call by GPs for more time with patients to manage chronic disease and multi-morbidity and a suggestion that GPs should be expected to deal with no more than 25 patients per day.

On first inspection these two stories would appear unrelated but I strongly believe that the ‘art’ of general practice is the amalgam of clinical effectiveness and management efficiency and this presents an opportunity to deliver both needs more effectively.

Lifestyle interventions and behavioural change, by their very nature, often require more time than is available in a typical 10 minute consultation. An alternative approach could be the adoption of GP-delivered group-based lifestyle education, support and ‘treatment’. How?

Providing a minimum of 6 patients per hour are seen the model is at worst cost-neutral but delivery of group-based lifestyle services to more than 6 patients per hour represents a opportunity for cost and efficiency saving (generating more free consultations, hence more capacity) for practices whilst providing individual patients with more ‘face time’ thereby enhancing the quality of lifestyle intervention and improving the chances of success. If the cost-savings of reduced pharmaceutical prescription and potential improved disease profiles are considered then this alternative approach represents a large potential saving at both practice and national level.

Surely it’s worth a try?

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