Volume 191 - Issue 2
Basic health education is for schools, not doctors, to provide
Author: Tony A Marshal
Med J Aust 2009; 191 (2): 127. || doi: 10.5694/j.1326-5377.2009.tb02713.x
Published online: 20 July 2009
Published online: 20 July 2009
To the Editor: One of the most talked about solutions to some of the problems of our health care system is “preventive health”. The rationale appears to be that “an ounce of prevention is better (and presumably cheaper) than a pound of cure”. Perhaps this is the reasoning behind the ever-increasing Medicare Benefits Schedule item numbers, inducing general practitioners to do more and more preventive health checks. This is expected of GPs, conditional on the services being “cost neutral” to the government.1
Reasonable as it sounds on the face of it, this may be neither efficient nor cost-effective, given that:
most preventive health issues (such as asthma, diabetes, obesity, hypertension and stroke) can not be covered reasonably well in less than several hours or several long consultations, depending on the educational level of the target audience;
Medicare Australia appears reluctant to pay a fair fee for these long consultations without imposing a lot of red tape; and
the average patient seeking such preventive health advice is usually middle-aged or older, and the opportunities for true prevention (rather than risk factor management) may have long passed.
A better solution to this predicament may lie in changes to school curricula. Any time spent on general common-sense health and hygiene topics in high schools would be cheaper to provide (costing only tens of dollars per hour if provided by teachers versus hundreds of dollars if provided by GPs). Health education in schools may also help students establish a healthy lifestyle from a young age, benefits of which could be reaped for decades. In other words, health education may have to become a compulsory part of the curriculum for prospective teachers.
Local GPs could give lectures on health education to aspiring teachers. Topics could include the importance of adequate sleep, adequate exercise and an adequate intake of fresh fruit and vegetables on a daily basis; the hazards of smoking and drinking; and mundane but important areas such as simple hygiene practices, skin care and even dental care.
If more patients had some basic knowledge of these and many other common topics, such as the differences in symptoms and natural history between viral and bacterial respiratory infections, the number and length of GP consultations could potentially be reduced. This, in turn, would have a direct flow-on effect on the overall efficiency of the primary health care system and, undoubtedly, the tertiary health care system as well.
References
- Australian Medical Association. AMA submission on red tape to the Productivity Commission. 13 March 2009. http://www.ama.com.au/node/4518 (accessed May 2009).