Why is it so difficult to provide integrated rheumatology care?

By Dr Irwin Lim, Rheumatologist

Yesterday, I was invited to present at an international symposium in Germany on rheumatoid arthritis. My brief was to discuss how BJC Health, our clinic, provides integrated patient care for rheumatic disease. As it turns out, I had to turn down the invite due to conflicting commitments.

But I was flattered. Our Connected Care approach is being noticed.

Over the course of the last 24 hours, I've been thinking about what I would actually say about BJC Health and our integrated approach to rheumatology if I was to give such a presentation.

Sure, we've had some wins and we do have a dynamic, interesting workplace.

But, there have also been challenges. It's simply not easy to provide integrated rheumatology care. Not if the goal is to always strive to improve the standard of care and to improve the patient's experience on their individual journey to better health.

I started to ask myself why this is so?

Why is it so difficult to provide integrated rheumatology care? By this, I mean, coordinated, comprehensive care for our patients suffering from rheumatic disease (most patients do require input from a variety of different health professionals). Care which is convenient, co-located, and cohesive.

It's not cost or affordability. This is of course important but where there's a will, there's usually a way around these.

It's not procedures or processes. Great clinical prowess and good business practice needs by necessity to be present for a well-functioning, viable medical clinic.

The answer I think is the Staff.

Staff are people and people are complex.

Rheumatologists, physiotherapists, exercise physiologists, dietitians, administration staff, etc. We all have our own bias. We were all trained differently, in different systems and different hospitals/clinics. Unfortunately, none of our training systems were geared towards integrated care.

Getting a bunch of very busy individuals to work together in a coordinated manner, where each understands the other's role and has confidence in one another, as well as a commitment to take that extra step to further the patient's cause, is a big challenge.

Building a team.

Creating a great work culture.

Connecting care.

All these take loads of time and loads of commitment.

As I said, I was flattered. But I also realise that our clinic still has a long way to go. We do a great job in treating rheumatic disease but we would like to do an even better job.

Patients suffering from arthritis and rheumatic disease deserve an integrated approach to their care.