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Screening success generates backlog

Hutt News 15/3/2003

There’s a lot of talk about preventative health measures; the ‘fence at the top of the cliff, not the ambulance at the bottom’; heading off health ailments before there’s a need for hospital care, etc., etc. A Te Atiawa early intervention/ screening programme walks the talk.

Fifteen months ago Te Awakairangi Regional Broad launched the Tamaiti Whangai Screening Service Pilot project. It’s run by Dr Angela Suarez.

 It involves comprehensive medical check-ups, referrals to specialist if necessary and a medical/ lifestyle  ‘plan of action ‘ that the patient and his/her GP work on for the future.

 Dr Suarez says the initial consultation involves a full physical examination and check of past medical history. Screening tests are done for cholesterol, diabetes, hepatitis B’ and any other investigations that may be required’.

 The process seldom takes less than an hour and a half, often it’s longer. One of the keys to its success, Dr Suarez believes, its that there’s no rush. She’s not a family GP with a line-up of patients on the other side of the door and no time to really talk to the client about his/her health.

On the second visit the results of the first consultation are reviewed and she and the patient talk about any issues that have been thrown up. Its much easier to point out the need for lifestyle changes – lose weight, dump the cigarettes, cut back on the alcohol, go and see that specialist – when there is hard data on the effect it’s having on the body. A written plan of action is agreed and the patient is discharged back into the care of his usual family GP.

 Dr Suarez says it used to be that she’d leave it to the patient to take she’d leave it to the patient to take the action plan to his GP but she was finding that some continue to ignore the reality of health problems, and don’t get around to following up. So now a copy of the report automatically goes to the GP too.

 Even with that, nothing is really going to change “Unless the patient contributes themselves and is proactive”, she says.

Almost always with the comprehensive checks there is some “Surprise” for the patient. It may be a symptom or ailment that has so long running they thought it was normal, untreatable or nothing to worry about. After putting 154 patients through the screening process, there have been several cases of breast and cervical cancer detected, a small number who had no idea they carried hepatitis B.

A review of the first  50 patients showed smoking (passive and active) and obesity were the main ‘lifestyle’ issues, but the percentage with sleeping problems, incontinence issues and menstrual abnormalities and the like was also high. Acute/ chronic problems such as hypertension and diabetes also cropped up.

The first 50 patients were 82% female. As word of the service has spread, the gender balance is now more even at 67% female 33% male but it’s probably still a case of men being blasé` about their health until a problem gets acute and can no longer be ignored.

Te Runanga’s health overseer Ken Szeto says health  says the screening service has proved so popular there is now a backlog of six months of bookings are still building.

“Were getting acceptance from  other PHOs whose doctors are having trouble finding the time (for such a comprehensive approach). The patient goes back to their own GP but our biggest asset is our time and  ability to prepare that baseline profile”.

Dr Suarez is now generating recommendations to Te Runanga on how the screening service might be progressed from now. Already the possibility of taking on another GP is being looked at and there have been enquiries from businesses interested in using  the health checks, or ongoing care of valued staff.

There is also discussions of how often it would be useful for a person to have these comprehensive checks. Obviously that could depend on age and general health, but Dr Suarez’s felling is that people could benefit from this assistance every two to three years.

Runanga CEO Kara Puketapu says patients interview/ consultation with Dr Suarez is “so deep, so open” that they often leave feeling elated that they’ve had someone Knowledgeable they could open up to about anything to do with their health. Other whanau have noticed the difference and there is evidence that after one family member undergoes the screening, there’s pressure from within the family for others to go and get a check done.