‘We need to get better at marketing primary care’

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The work of general practice is misunderstood and undervalued by politicians, the media and the public, according to leading general practice academic Professor Trish Greenhalgh.

 

Speaking at the WONCA World Conference in Sydney this week, the Professor of Primary Care Health Sciences at the University of Oxford said the profession needs to improve the way it is perceived – particularly the impact of the therapeutic relationship between GPs and their patients.

 

‘We in primary care need to get better at marketing ourselves,’ she said in response to a question from Host Organising Committee Chair and former RACGP President Adjunct Professor Karen Price.

 

Professor Greenhalgh gave the example of a former patient whom she had helped with regular homes visits when the woman was struggling with a very young baby.

 

‘If there had been no relationship-based care, that probably would have been a psychiatric admission, and probably some kind of issues with the mother–child relationship,’ Professor Greenhalgh said.  

 

‘We need to tell that kind of story to the politician and start … in crude financial terms [to calculate] what it would have cost if that had been a hospital admission.

 

‘I don’t think we do it very well to ourselves, let alone to the press and the public.’

 

She also cited one piece of research considering around 400 media articles, in which hospital doctors were represented in a more positive light than general practice.

 

The observation was part of a wide-ranging speech and Q&A Professor Greenhalgh made in front of thousands of family doctors from around the world.

 

Drawing on varied artistic, religious and literary references, she reflected on the suffering of general practice during the earlier stages of the COVID-19 pandemic.

 

‘I really worked my socks off, I got pretty burnt out … and I thought, “I’m not actually quite ready to move on from it”,’ she said.

 

Noting an ‘accelerating’ workforce crisis in primary care, Professor Greenhalgh said the contribution of GPs is typically not appreciated by those outside of the sector.

 

‘Our work is widely misunderstood and undervalued by politicians, by the press, by the public, and even sometimes by our secondary care colleagues,’ she said.

 

Consequently, the resources needed to do the job of general practice ‘are being squeezed year on year with no relief in sight’.

 

However, Professor Greenhalgh also looked to the future, saying she wished to plant the seeds of a few ideas for recovery.

 

‘I am not going to insult your intelligence by implying that there’s a quick fix here, you all know there isn’t,’ she said.

 

‘How can we move on in a positive way? How can we learn and grow from that suffering?

 

‘First and foremost, we need to reconnect with the core definition and values of primary healthcare.  

 

‘If we design and adapt our primary care systems to value and reward healing relationships, both we and our patients can begin to recover from a system that’s become perverse and inhumane.’

 

The British academic also sounded a sceptical note about over-using technology at the expense of time with patients.

 

‘The more frantically you … pursue technical solutions, the less time we have for meaningful contact with our patients, and the more exhausted we become,’ she said.

 

While stating that digital technologies have ‘an important place’ in healthcare – saying the use of technology ‘within the context of a therapeutic relationship’, can work ‘pretty well’ – Professor Greenhalgh described the rush to monetise patient data as ‘like the Wild West right now’.

 

‘It needs to be controlled and regulated,’ she said.

 

The power of that therapeutic alliance between GPs and their patients remained the dominant theme of the speech.

 

‘As healthcare becomes ever more complex and fragmented, communication and coordination becomes increasingly important,’ Professor Greenhalgh said.

 

‘And these functions depend crucially on the quality of human relationships.’

 

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funding primary care Professor Trish Greenhalgh