The future of healthcare - its all about connecting people

When I was a student I spent a year or so working for Scotland’s telephone contact centre, NHS 24. We would take calls from all over the country. The system was operated on a triangular principle of call centres, in Glasgow, Edinburgh and Aberdeen. Due to the geographical nature of Scotland, the highlands and islands specifically, getting medical help and advice could be difficult. 

Sometimes when taking calls where we would have to lead the caller through a set of processes, the outcome being determined by the answers they would give. We would rely heavily on the their descriptions of themselves or the person they were calling about. They would say things like ‘its a bit swollen’ or ‘the rash is red and raised’ and a million other variations of those types of things. Often I would sit there on the phone thinking, what if we could see this. Wouldn’t that be so much easier

I was an undergraduate podiatry student then. Fast forward six years, I am the director of a company, an employer and yet still a podiatrist above all. I enjoy being a podiatrist. And my standard answer to those who say ‘how can you do this job’ has become something along the lines of ‘ I enjoy helping people. I take away pain and advise people on improving their health’. Wanting to help people comes from somewhere deep within care givers, whatever form that might take, the doctor, the nurse or indeed the podiatrist. 

I can hear the phone at reception from my office. Sometimes we are unable to offer patients appointments. Victims of our own success some might say. Its true to say that my team of podiatrists are proud of providing very good care to patients. That can mean from time to time we struggle to help everyone who asks for it, when they need it most. I thought on the solution for around a year. I knew if I could connect with patients remotely, just like I thought of when I was at NHS 24, I could help more people, faster. 

It wasn’t until a dinner with friend and colleague Damien Gough, who was well versed in the application of technology in healthcare that the notion started to become a reality. Damien and I had shared our motivations and passion for helping people on a larger scale than we were already able to do. Across our meatballs and pasta we returned suggestions like, Skype, Facebook messenger, and various others. All these would be discounted for a number of reasons including data security, encryption and what we thought was a trusted, serious platform for patients to engage with. After a few months of exchanges we finally developed a system that would work. It was secure, private, reputable. It was easy to use and reliable. Finally, we had done it. So after a year in the planning, in the end, it took only a matter of weeks to finalise once we had something tangible to work with. 

The system is simple. From the outset I wanted to have the fewest number of clicks required to connect, ensuring it was uncomplicated for the user. Now we have a care portal which 

 user through 3 clicks of a mouse can be face to face with an expert. No waiting times, no busy waiting rooms, transport or parking issues to worry about. The future of healthcare provision has arrived. I predict that virtual consultations will become routine. Change takes time and Im sure it wont be without resistance from those who fear it but it still feels good to be at the front end of it.

You can watch our short video explaining how our tele-medicine portal works here

Or if you would like to use the service right now click here

The awkward conversation

We need to talk.....about fees.....

 My first blog entry for a year, or over a year and its an awkward one. It's one that we need to discuss and one which I know frustrates a lot of my peers in the profession. 

Every couple of weeks or thereabouts I deliver a short talk to various community groups about podiatry, how it has changed and how it might differ from a pre-existing perception. Its fair to say that the feedback from the talks, which are generally to church guilds and woman institute groups, is good. They find it interesting and educational and perhaps even a little tiny bit entertaining. I demonstrate to them how things have changed and that podiatry has moved on. I show them some of the modalities at our disposal and the investment that a modern, forward thinking podiatrist will make. Shockwave therapy and ultrasound for example represent significant financial investment in order to bring services to the client or patient group. To frame that more clearly, a reasonable diagnostic ultrasound machine will set you back in the region of about £25, 000 and a decent patient chair to sit on.... anywhere between 2 - 5 thousand pounds. 

It wasn't until I read a facebook post a few days ago where someone talked about going to see a podiatrist for her heel pain which was so bad she could 'barely walk'. She went on to say.....'but its £36 for a 30 minute appointment and insoles on top of that at £45......that's pretty expensive". 

Of course 'expense' is a subjective thing. But therein lies the real problem. Its not the price, or the expense of an item or service. Whats is wrong with this statement is that the lady completely misunderstands the difference between 'price' and 'value'. What is the cost of pain relief in any case? What is the limit that a person is prepared to pay? And scratching further beneath the surface, what price do we place on the skill of the clinician. And now, were getting down to brass tax. 

Think for a moment, if you will, about your washing machine at home, just as an example. It breaks down, but you need it! How will you wash your laundry. It's a household essential. You go online and start looking for the engineer in your area. They agree to come out to see it but you have to pay a call out fee. Typically anywhere between £50 - 90. Once he gets there you'll be billed for the parts he needs and the time spent to fix it. So where are we, £120 - 150? 

Fees for podiatry treatment remain among some 

of the most modist private healthcare fees with 

a national average of around £40. 

Now just hold that thought, and add to it the statement ' I can barely walk. I am in so much pain - but the podiatrist is ...well pretty expensive'. 

Podiatry forms one of our greatest yet most unsung allied health professions. I admit we have a massive identity crisis facing us. One which we are desperately trying to move away with the perceptions of old. Having to justify the clinical skills and re-enforce daily, hourly perhaps in some cases our entitlement to charge fees for our skills and the services we deliver. We are often asked or expected to do work for free, albeit mundane, simple foot care tasks. But how insulting is that. Would any other professional person, whose invested time and money in a university education be expected to work for free?  

There are many examples and parallels that can be drawn, much like the washing machine engineer, the hairdresser being another favorite that springs to mind. But I will resist, because this was never supposed to be some kind of rant. It is, however,  important to talk about the difference between 'price' and 'value' and the overall attitude that we have towards our health and well being. When the skills of the tradesmen (no disrespect to them of course they too, are skilled), are valued greater than those of the health care professional who, within their armory can remove pain, prevent falls, educate and ultimately improve the quality of your life, I suppose in much the same way clean clothes do.