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A New Healthcare System – by Dr Glen Davis

A New Healthcare System

How To Create and demonstrate a new version of the healthcare system?

Based on the values of:

  • Service
  • First do no harm 
  • Informed consent
  • Evidence influenced medicine
  • The Coach Approach
  • Holistic Medicine, emphasising nutrition, lifestyle and prevention
  • Sustainability
  • Self-care

Over 2020 and 2021 I have seen the dramatic flaws in the health care system. These problems are not new but have been exposed by the pressures created by the responses to the Covid 19 Pandemic. With the problems so dramatically demonstrated, it has been far easier to see the solutions, or at least one version of a better system.

At the core of the problem is the influence of the pharmaceutical industry. This cartel is not in itself evil. It’s motivation just needs to be understood. The pharmaceutical companies have one clear objective. This is to return a profit to their shareholders. They have large and widespread influence, expressed in their control of university curriculum, influence over what and how trials are published. Today’s medicine is pharmaceutical medicine. We have a reductionist model where each doctor is asking herself “what medication will I prescribe at the end of this consultation”.

This is not the solution. This is a solution. We will need many options, from which we can chose aspects to create a solution that is fit for purpose.

A SOLUTION:

  • Time
    I will offer 30 minutes as the minimum appointment time. This will create space for listening, hearing, expression, sharing and discussion. This will allow time to consider options other than just those written on a prescription pad.
  • The hui method
    Time for relationships to build. Time for the client to express who they are and what matters to them but also time for the health professional to express who they are.
  • History
    The answer is 90% of the time in the history. Comprehensive and careful history taking must lead to better diagnoses.

    The determinants of Health.

    If the doctor has not asked “Why”, 7 times he has not considered the cause of the cause. The up-stream determinants are always essential to understand. Without addressing these we are treating the symptoms of illness and never the cause.

  • Diagnosis
    Meaningful diagnoses, rather than labels to make communication between doctors easier. The diagnosis needs to reflect the cause. Diagnoses like “Inflammation”, Insulin resistance” and “Mitochondrial dysfunction” will direct the health professional to more useful solutions.

  • More tools in the toolbox
    We can no longer be mainstream doctors, integrative doctors, lifestyle medicine doctors, naturopaths and herbalists. We need to understand a broader range of options. The toolbox needs to be overflowing with options.

  • The coach approach
    The paternalistic attitude of the doctor who knows best and prescriptions that are imparted, even bullied, must stop. The client is the expert in their own health. Treatments will reflect this shared knowledge. Readiness to change/adopt, must be central to prescription.
  • Follow up
    Change is a process. Support needs to extend beyond the payment at reception on the way out.

  • Evidence
    We have seen evidence being ignored and suppressed. We need the courage to change practice and even say we have been wrong when the evidence informs us so. Evidence based medicine only works if we change our practice when the evidence informs us so.

  • Team
    Often the Doctor is not the best therapist. The bigger the team the more the option. I think health coaches need to be in every team as behavioural change requires support. The team needs to collaborate within the organisation and outside.
  • Tech
    Apps, monitors, bio feedback. This gives the power to the clients and data is king.

    Telemed.

    Video and phone consults allow reach and options. Avoiding travel creates efficiencies and reduces emissions.

  • Environment
    Our clinic will reflect the principles of Te Whare Tapa Wha. The individual and the whanau cannot flourish by hoarding resources. The clinic will enhance the environment and be self-sustaining for energy and water. We will utilise electric vehicles and be as self-sustaining for food water and energy as possible.

  • Schedules
    If the health professional is stressed, they can not give their best to their clients. Doctors need to create their own health. They need time to study and learn.
  • Partnerships
    The new Health Authority and the Māori Health Authority creates an opportunity for innovation in funding and delivery. Māori Trust, Insurance companies and Employers offer different funding options.

    Doctors need to demonstrate values, including integrity and courage to advocate for the needs of our clients.

Glen Davies 9/5/202

This Post Has 7 Comments

  1. Caroline McGirr

    Wonderfully put . Inspirational !

  2. Latara

    Goodmorning Dr Davies. Its Latara Nicoll here. I am so amazed that you still find time In your day to make things much better for everyone’s health. I just want thank u for everything and all the kaha and mana u put into the people of taupo not only taupo, Aotearoa itself. I wish the people could see what u see, what we see. The visions I have just read I am so friken keen to support. Our whare tapa wha is so sacred and is so important for oneself. Spiritual work. I’m willing to support. Ild love to donate a taonga to you if I am able to. Keep up the gangsta Mahi Dr Davies. You will always be Taupo Best Doctor ever.

    1. admin

      Kia Ora Latara, Thank you so so much for your message of support. I know we can create a better version of the health care system. As you say it must be more holistic. Te whare tapa wha challenges us to acknowledge that we are connected and complex beings with a spiritual aspect. We can not thrive if one of the ‘posts’ is weak. We can not thrive if we are not supported by whanau and community. We can not thrive if our environment is unhealthy. These are not complicated concepts but are not represented by the current reductionist pharmaceutical model of medicine. Together we can do so much better. I am just doing my small part to demonstrate another way, hopefully a better way.
      Nga mihi and with aroha and appreciation of you support. Nga mihi, Glen Davies

  3. Rowan Boyle

    I’m a practice nurse working in Tauranga. It was an absolute pleasure to meet you at the GP conference recently. You have inspired me to take control of my health again, and am back doing vegan keto and once I have reached my goals, will be adopting a low carb lifestyle permanently. I feeling amazing again! I wish there was more doctors out there like yourself. Your approach just makes so much sense to me, I wish you had a clinic in Tauranga. Id apply for a job in a heartbeat! Thanks again for imparting your wisdom to us all at the confrence.- Rowan Boyle

    1. admin

      Thank you so much Rowan for your endorsement. Congratulations for taking control of your own health again. Great to hear you are feeling well again. I think we need many new versions of the health care system, however I think any successful new option will have whole food nutrition knowledge at its core. It will be client focused using Health coaching principles. Health care professionals need more tools in their tool box. Lifestyle medicine offers him/her powerful and potent tools that actually work. There will be a place for medications, but just as one of the options. I hope to meet again soon and who knows there may be a Reversal NZ clinic in Tauranga at some time soon so we may be discussing that job offer!!
      Nga mihi, Glen Davies

      1. Rowan Boyle

        Thanks Glen. I was wondering if you could point me in the direction of any education/courses that I could enrol in to give me the knowledge, confidence confidence and resources to coach the prediabetic patients I work with in my IGT clinic about how to switch to Keto or low carb, backed by evidence based science and research. I’m confident doing it for myself as I dont have any medical conditions to consider and if anything goes wrong, its all on me. I am acutely mindful that many people I look after may have multiple co-morbidities, medications such as diuretics that may require specific monitoring and I dont want to give anyone incorrect or dangerous advice. I’m just not sure where to start looking for such courses or educational opportunities, hoping you may be able to help – only if you can spare the time ofcourse!Nga Mihi
        Rowan Boyle

        1. admin

          Thank you Rowan, By far the best training is via PreKure (Louise and Grant Schofield) in Auckland. If you are looking for support with your more challenging clients, especially with deprescribing then we can support your clients at Reversal NZ. If you are looking for resources, have a look in our resource section. But basically as long as clients on medication are monitoring BP and blood sugar and are happy to reduce meds as their markers improve there is virtually no risk. Nga mihi, Dr Glen Davies

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