health care

On networks and silos

A brief comment this morning, as I’m struggling with sinus problems and hayfever (oh the joys of spring!).

I was thinking about the need to develop networks between groups of health providers working in different settings and different systems.  It seems sensible to me at least that we should be aware of what other providers have available within our communities – at least so we know the options for the people we are working with, even if we can’t directly refer to those providers because of funding issues.  But this is a vexed question because I work in a public facility, and traditionally the relationships between public and private facilities in New Zealand have been at arms-length.

The managers of public facilities seem to view private practices as places of lush finances where money is no object and therefore somewhat suspect.  At the same time, private facilities look at public clinics as places where efficiency isn’t necessary because there is a steady flow of money coming in from Government… (more…)

Two strikes and you’re out – referrals and readiness

I’m in a bit of a dilemma. As you know, health resources are scarce and it’s not easy to get an appointment for treatment of a chronic condition. There’s something to be said for making sure that our precious health care time isn’t wasted by people who would rather not be there.
On the other hand, there is also something to be said for people being in the right headspace, or in more technical terms, the right stage of readiness to engage in therapy. If the person is referred for treatment before they’re ready, it’s going to be difficult for them to engage – and they may very well do the resistance thing that we see so often ‘yes, but’, ‘OK but’ or not actually do what we’ve suggested they do to help manage their condition.

The discussion that has raised this in my mind happened on Monday. (more…)