I want to begin by thanking everyone for working in the healthcare sector and for their hard work. People are working under challenging conditions doing their best to deliver high-quality care for their patients. The world we are in is volatile, uncertain, ambiguous, and complex (VUCA), which makes us feel unsettled whether we are doctors, nurses, therapists, managers, or patients. However, this also presents opportunities that must be seized. After all, no one can be happy with the quality of care at the current time: citizens, payers, or physicians.
Some nations have a fractured healthcare system with variable quality and rising costs. There are systemic issues with increasing demand from a tsunami of long-term conditions, an ageing population, rising costs, and the requirement for better value. Moreover, there is a rise in consumerism with discerning and empowered patients whose legitimate needs need to be met.
Moreover, there are significant patient safety issues, such as antimicrobial resistance. The scourge of modern medicine is over-diagnosis, over-investigation, lifestyle diseases such as obesity and polypharmacy. There is a reliance on super-specialisation, which, while providing brilliant care for individual patients with single conditions, does not meet the holistic needs of people or the public health challenges of global non-communicable diseases and multimorbidity. The medical profession itself is changing, wanting more autonomy, flexible working, and control of workload to deal with the damaging effects of burnout
Medicine is an unhappy place right now. So how does healthcare evolve to meet the legitimate needs of citizens? Solutions are available with new models of care that allow generalists and specialists to work together to provide high quality and safe, integrated care. Critical to this is an engaged and confident workforce that can lead and shape future health and care with a focus on wellbeing.
There are no simple answers but change and improvement are distinctly possible! It is possible to ‘bend the curve.’ The secret to success is leadership from doctors to drive forward transformation by pursuing a progressive, innovative patient-centered agenda. Conferences like Arab Health allow us to reimagine healthcare.
There are five critical components of reimagined healthcare, which I am calling the new frontiers that must be embraced. Firstly, the systematic and disruptive introduction of technology and artificial intelligence to support – not replace – doctors and nurses, especially in light of the global workforce shortage. Second, a big- data approach – including genomics to help predictive and personalised medicine. Thirdly to reverse the power balance in medicine from doctors to patients – the concept of empowered activated patients’ experts in self-care and self-management – ‘the patient will see you now doctor’! Fourthly, a relentless focus on universal primary healthcare, including the wider social determinants of health. Finally, a joined-up, connected system of healthcare where generalists and specialists’ providers work together seamlessly to focus on clinical excellence and outcomes – the focus being on teams and systems rather than individuals.
Research has clearly shown that countries with well-developed primary care healthcare systems have much better outcomes and patient satisfaction. Being a GP/family doctor is probably the hardest specialism in medicine. It is not an easy role, e.g., differentiating a viral illness from meningitis or migraine from a brain tumour or panic attacks from pulmonary disease. This requires formal training to build confidence in being a family doctor.
The WHO Alma Ata Declaration in 1978 committed to the adoption of universal primary healthcare and the importance of the social determinants of health such as sanitation, housing, education, and employment. The challenge still holds and was reconfirmed in the Almaty declaration of 2018. Underpinning all five components is the need for good governance, ethics, and collaboration. We can only earn the trust of people, patients, society, and governments by demonstrating high standards of practice with accountability. And by being kind, compassionate, and courageous.
I am confident about the future. Positive change is already happening in many parts of the world. We are in an age of progress with the advent of digital and genomic innovation and people-power. I have met many inspirational medical leaders and managers who have a vision for better sustainable healthcare. But we can all do something to help and play our part. Lots of small changes can lead to significant improvements in outcomes.
Please follow my three-point plan: Be the best doctor you can be; be on the side of patients; be a leader by shaping the future. In this way, we can get Happy Doctors, Happy Patients.