The "big picture" of healthcare in the capital calls for more than just attracting and retaining doctors, according to Dr Kerrie Aust, who will begin her new role as president of the ACT Australian Medical Association on Wednesday.
She plans to devote her two-year term to tackling the fragmentation of patient care within Canberra's health system which could help address issues including workforce shortages and shortcomings in digital records.
"Patients deserve quality and efficient healthcare in the ACT and there's absolutely no reason why in a jurisdiction as small as this one that we shouldn't be able to achieve it," Dr Aust told The Canberra Times.
She said there were alternative models of care being introduced in the ACT which were not necessarily more efficient.
"If a patient sees four or five clinicians that increases risk, [but] if they see their [doctor] who is coordinating their care with other specialties then we're more likely to have safe outcomes for patients," Dr Aust said.
Prevention is better than cure
Dr Aust said quality care started with integrated primary health, something outgoing president Dr Walter Abhayaratna also supported.
Canberra-born-and-bred doctor visualised a health system similar to Denmark's general practice-centred system.
"[Denmark] actually closed a lot of hospitals because the primary care is so strong in terms of preventative medicine," she said.
Dr Aust is referring to gradual changes in the Danish health system which included extensive digitisation of patient records and integrated primary care which did not need hospitalisation.
As a result, more than of half of Denmark's hospitals closed over two decades while new and remaining hospitals serve as centres for specialist-only treatments.
Dr Aust said modeling health systems like ACT's nurse-led walk-in centres after the National Health Service in the UK increased fragmentation.
She claimed this led to long wait times at public hospitals, moved jobs into other areas and created shortages of GPs and non-GP specialists (like urologists, psychiatrists, and pediatricians) in the region.
Dr Aust said she would advocate for evidence-based care, professional "fulfillment", transparency and seamless integration between public, private and allied health systems.
"If I refer a patient to the public system, how long are they going to have to wait? Is it safe for me to leave them on a waitlist? Or do I need to refer them interstate?," she said.
"At the moment, we just don't know."
Kindness in a 'stretched' health system
Dr Aust is a GP at Garran's Ochre Medical Centre. She graduated from ANU Medical School and continues as a clinical senior lecturer there.
She was also the medical director of Drs4Drs (a call service for doctors to access healthcare and support) where she is still a volunteer.
In her experience, GPs, specialists, nurses, pharmacists and other health professionals regularly contacted each other seeking and giving advice (for free) about managing patients.
"We don't talk enough about the generosity ... within our community," she said.
"Patient care in the ACT is often held up by goodwill."
In her view, a good system allowed health workers to access and share information easily. Such a system also ensured patients' access to transport, housing and activities that prevent chronic disease.
"When systems are stretched ... people are strained trying to access all that they can for patients, but they get frustrated when waitlists are expanding or colleagues are leaving the system because of burnout," Dr Aust said.
"Systems that actually support clinicians to spend time with their patients is so important because this is why we're here."
