Capitalist principles have no place in the vision of healthcare I trained for, and I refuse to allow economists, public servants or Trent Twomey to tell me that his vision of healthcare is acceptable.
I’m working on a CPD series about values, and it got me thinking about why I feel deeply uneasy about the direction healthcare is taking.
Pharmacy prescribing got weirder this week, when the Guild announced that it would break new ground by introducing AI into pharmacy.
AI apparently will teach and assess interpersonal competence in training providing “feedback on the quality of the student to AI interaction”.
Iona Heath, a GP, wrote that “it’s hard not to see the advances in AI less driven by technological breakthroughs as by a society that has become normalised [to] both loneliness and theft, such that a sputtering algorithm badly trained on the stolen work of real human beings might be celebrated with a straight face as something approaching humanness”.
Governments obviously believe algorithm-based care with minimal diagnostic training in a retail environment has value.
But that will never be what good GPs stand for. We believe:
- conflicts of interest have no place in healthcare. Patients should know that their doctor is not influenced by pharmaceutical marketing. We learned from the oxycontin disaster. Patients shouldn’t have to navigate their way through product displays to get the healthcare they deserve;
- the consultation room should be kept private – a safe space for people who are worried, sick or ashamed. Our rooms should hold the dignity of confidentiality and sufficient time for people to be seen, relationships to build, and negotiated care managed;
- there should be no testimonials on my walls, not even a government logo with a helpful photo of me with the Prime Minister. It looks like an endorsement, and that is not okay. Looking through a cartoon uterus is demeaning for me and the women I serve;
- there is an ethic in competence. If I can’t examine it, I shouldn’t be treating it. Every women’s health guideline insists on careful examination, to ensure women are treated safely and well. Healthcare is not pattern matching, protocol following and treatment selling;
- I shouldn’t have to spend $110,000 to have a slice of birthday cake with the Prime Minister to earn the right to care for my patients. I shouldn’t have to dance with a Medicare card, or brand my clinic with government posters in order to practice. My clinic is not a political corflute.
My profession has a rich and proud history.
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It may well be that governments are content with a pale shadow of primary care existing where training is dumbed down to half its length, and the only value I hold is in my ability to adhere to a bulk-billing mandate.
Perhaps, as Mark Butler so evocatively claimed at our conference last year if I don’t respond to a carrot, he’ll have to use a stick to get me to behave. Difficult women GPs are like that.
Capitalist principles have no place in the vision of healthcare I trained for, and I refuse to allow economists, public servants or Trent Twomey to tell me that his vision of healthcare is acceptable.
Australians deserve better.
Professor Louise Stone is a GP in Canberra and an academic at Adelaide University. A collection of her research, policy and teaching materials can be found at drlouisestone.com.
