Wait, who is the baby in the innovation bathwater?

As technology marches onward, Dr John Buckley fears GPs will lose the vital skill of communication.

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How traditional is Dr John Buckley? The Coochiemudlo GP is so traditional that it took him decades to start using newfangled suitcases with wheels.

It might not be a surprise, then, to learn that he is somewhat sceptical of claims that new technology will revolutionise practice.

“I understand we need to wash ourselves off from the past,” Dr Buckley told delegates at the RACGP conference on Friday.

“We need to clean our water and change our environment.

“But … I want to talk a little bit about what we risk losing and how we hold on to that.”

Instead of focusing on big leaps and “innovations”, the Dr Buckley philosophy is more about incremental changes.

Think less North Queensland Pharmacy Prescribing Pilot and more small, day-by-day adjustments to practice.

“Incrementalism – small changes that you can do in house, that are meaningful and done by the people on the ground, relevant to the work they do – is not talked about and is not respected,” Dr Buckley said.  

“Doing a good job every day, all day is not valued and rated the way it should be.”

He would argue that it is smaller-scale changes driven by the gradual accumulation of evidence that ultimately alter practice.

Beta blockers in heart failure, for instance, were initially thought to be contraindicated but are now part of normal therapy; the idea of helicobacter causing ulcers was once unthinkable.

“The point I have is that somehow all these changes, one at a time, have happened to you in the way you practice, and yet you practice as you do now,” the Queensland GP told delegates.

“In the training of our GPs and our medical students, one of the most valuable things we can teach them is how to adapt ourselves to the changing world.

“We can teach them all the information you like, but next week, next year, 10 years from now, what you’ve just taught them might be completely wrong.”

The core skills of general practice are not necessarily found in a textbook or clinical guideline and can’t be taught by an online module or set of protocol-based teachings, Dr Buckley said.

“We think about not the symptoms or the diagnosis, but the person in front of us and how they’re feeling and what is happening in their life. 

“And [we think about] what the symptoms, illness and treatments are doing to them.

“That’s GP thinking that we can’t afford to lose.”

On the opposite end of the innovation-embracement spectrum is Australian Digital Health Agency chief clinical adviser Dr Amandeep Hansra, who delivered a keynote on the importance of keeping pace with technology.

“The technology drive isn’t just coming from healthcare providers … it’s actually coming from patients,” she said.

“Our patients live in a digital world.”

Failing to meet patients where they are at serves to clear the way for alternative therapies like IV vitamin infusions and ice baths, Dr Hansra told delegates.

“The way that patients are being marketed this stuff is through social media and influencers who have no health experience or knowledge.

“We are working in a crowded market where we sit with a patient for 10 or 15 minutes and try and tell them about basics that they can get right.

“You can tell them about their diet, or tell them to get some sunshine and exercise, but they’ll look into these things before they do any of that, and that is something that we have to be aware of.

“It’s not happening in the future. It’s happening now.”

GP24 was held at the Perth Convention Centre between November 21 and 23.