The freedom afforded to PHNs is not being wielded effectively and should prompt a broader conversation on their goals, according to one NSW doc.
Hunter New England and Central Coast Primary Health Network has chosen “stocking filler” and is short-changing general practice in the process, says one local GP.
In its most recent newsletter, Hunter New England and Central Coast PHN promoted a collaboration between Australasian Society of Lifestyle Medicine and Hunter Health, a “platform dedicated to connecting patients with practitioners specialising in preventive health”.
While on the face of it, a service helping patients find suitable preventative care providers is a niche worth filling, the website’s list of “leading preventative health care providers” – which does not include traditional general practitioners – has raised some eyebrows.
Speaking to The Medical Republic, central coast GP and practice owner Dr Max Mollenkopf said he was “baffled” by the choice of promotion.
“In many ways, [it seems] they’re looking for stocking fillers for their newsletters and by doing so they are working against local general practices by directing patients in an alternative direction,” he said.
“If they’re looking for stocking fillers for their newsletters, perhaps they should reassess what their purpose is in the region and who they are actually helping to link [patients to].
“My understanding, as a local GP, is that the PHN is there to help to promote our primary care services within the region.
“I don’t feel personally like they provide a lot of support to me as a practice in the area.”
Hunter Health’s website promises to connect patients with “leading preventative health care providers, including integrative doctors, lifestyle medicine experts, and dedicated health coaches, who are committed to helping you proactively manage your well-being”.
“My understanding of integrative GPs has typically been that they cross different parts of the health system and they will often take an approach that promotes more natural therapies and may be a little bit more fringe than what traditional GPs will typically provide,” Dr Mollenkopf told TMR.
“My beef with all this is why is the PHN promoting integrative GPs as the method of accessing preventative care and what is the PHN really doing in this space?
“Why are [PHNs] promoting a nationwide private company that, instead of helping patients to link with local GPs, promotes an alternative pathway of GPs to those that [PHNs] are there to promote.”
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While Dr Mollenkopf said he felt his local PHN had done little to bolster local general practice, he acknowledged that the efficacy of the PHN-general practice relationship was “highly variable” across the country.
“I look at some [PHNs] like WentWest … they have a really strong relationship with their local GPs,” he said.
“In the HNECC area, I don’t feel like there’s any real relationships with local general practitioners and my PHN.
“I see them as delivering on government grant programs, but I don’t really see much innovation otherwise.”
The “freedom” afforded to PHNs, in some cases, was not being wielded effectively to integrate with existing primary care services and general practice, added Dr Mollenkopf.
“I think sometimes the PHNs see [GPs] as an existing workforce that they work around rather than work with,” he said.
“Fancy database services is not delivering on core local priorities.”
According to Dr Mollenkopf, PHNs often foster services that compete with general practice, rather than support it.
“When we look at Medicare indexation, general practice received a lower percentage rise than specialists with the idea that some of that money would go towards PHNs,” he said.
“I don’t personally see the PHN delivering on that percentage rise that [GPs] have lost and I don’t see them coming back with that money and doing anything that really enhances [GP] care delivery within the region.
“Instead, I see them building out alternative services, I see them involved with Medicare urgent care but that doesn’t promote local general practice.
“That’s just promoting alternative, competitive services.”
Dr Mollenkopf said a broader conversation was needed around the point of PHNs and to ensure that traditional community general practice was part of the bigger conversation.
“[PHNs] have been running for a number of years now and if they haven’t got the message by now, well then it needs to be a top-down approach to say, ‘we will look at what the KPIs are for the PHNs and ask how they actually deliver for local general practice’.
“Not just make up their own their own criteria.”
Hunter New England and Central Coast PHN did not reply to TMR’s request for comment before deadline.
