The content of this website is intended for healthcare professionals only

Previous Posts

1 2 3  > 

Disrupting traditional general practice

Hard-wired GP

Luke Koupparis

Wednesday, 03 October 2018

AdobeStock_140206744_lb.jpgI have recently learnt a new term.

“Disruptive technology” or “disruptive innovation”.

In business, a disruptive innovation is an innovation that creates a new market and value network and eventually disrupts an existing market and value network, displacing established market-leading firms, products, and alliances.

Medicine has generally been a profession where there is value based on face to face communication. In primary care, GPs have been part of the local community, known by name to the patients and who know many of their patients and families having grown older with them. We have not been subjected to competition from clever IT systems, promising to deliver faster and cheaper healthcare. Sure, we have been faced with Dr Google for a number of years but in most cases the patient will come to discuss their findings in person with their family doctor.

However, things are now changing, and GPs are faced with competition from new app-based video consulting which promises patients the ability to talk to a doctor within minutes 24/7. People who use the service are told they will get advice from “top-quality doctors” who are “handpicked” to “deliver” medical-advice, answer questions and give you peace of mind”. In addition, artificial intelligence systems are having massive sums of money invested in them to analyse medical symptoms to provide information on the diagnosis and treatment. No doctor required. All sounds pretty different to many people’s vision of the traditional GP, sitting in surgery plodding through a three-hour surgery at 10-minute intervals (with the odd DNA thrown in to allow catch-up).

In an interview with the Babylon CEO, Dr Ali Parsa, he said the following:

“If you can take and identify what people need in healthcare, such as a diagnosis or a treatment and then teach machines to do that, we can solve big problems. Once we did that, making it accessible was pretty straightforward.”

I am sure you can easily see why this technology is disruptive to general practice. In London, where these services have started to roll out huge numbers of patients have moved from the traditional general practice model to re-register with these new services. Patients who tend to move are younger and fitter but value convenience over continuity or a doctor who they know and trust. Practices then lose income from the loss of these patients and are left with complex multi-morbidity patients and less income.

The trouble is that these technologies are not only being sold to patients as fast, convenient access but that they are relieving the pressure on hard-pressed practices. Patients feel they are doing practices a favour by moving away from the traditional model to virtual services. This may well be the case but many patients will be unaware of the unintended consequences of leaving their practices for the virtual pastures.

Our new health secretary has only recently said that every patient should be able to skype their GP on a smartphone, assess symptoms using a chatbot or see a GP at one of five central hubs. He sees this disruptive technology as the solution to end a “postcode lottery” in accessing care.

So there we have it. This technology is now gaining traction in all areas of UK healthcare and most categorically in the primary care market. Although many GPs have been sceptical of the move towards this, it looks like we now have no choice but to start to embrace this within our practices. You could say that we are being forced to take this on or find our practice populations reduced, with the associated financial instability.

Practices will need to innovate, regardless of what they think about this technology. They will need to offer eGP consulting in a number of forms for their patients. Practices who have already started to meld their traditional offering with a virtual service have seen a large jump in registration numbers so it can be done. The risks of ignoring this technology to deliver new ways of delivering consultations to our patients are too high. We cannot adopt the watchful waiting method to see how this pans out given time, as by then it will be too late to preserve the traditional model of general practice that we all know needs to survive.

Further reading

Author's Image

Luke Koupparis

Luke is a general practitioner in the Bristol area with interests in men's health, child health, minor surgery, online education and medical information technology. He is the IT lead for Bristol clinical commissioning group, LMC representative and chair of the locality provider group. He also works as the medical editor to OnMedica helping to deliver high quality, peer reviewed information to the wider medical community. In his spare time he is a keen road cyclist and likes to ski with his children.
Registered in England and Wales. Reg No. 2530185. c/o Wilmington plc, 5th Floor, 10 Whitechapel High Street, London E1 8QS. Reg No. 30158470