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Is it really just a Game of Thrones?

Dr Hayley Scott shares her Game of Thrones analogy for general practice in New Zealand. Where is our Jon Snow?

While I admit to being a little behind the rest of the world, I finally got to sit down and watch Game of Thrones in its totality. I do like a bit of fantasy, and although I had to close my eyes a few times (after all I am rather naïve and didn't want to be lead astray), I managed to watch enough to follow the story.

After about the third or fourth series I couldn't help but see some parallels between the trials and tribulations of the Lords such as the Stark's and the Lannister's, and our little peace of paradise here in New Zealand.

So, imagine the Stark's, Lannister's, Tyrell's etc as PHOs, and their bannermen as GP practices. The registered patients of GPs could be considered to be the normal, everyday men and women who make up the bannermen's households. I would love to say that general practices in New Zealand all get along, but unfortunately that is not always the case when separate businesses are owned by different people with different values - just as the Stark's, Lannister's and Tyrell's have different values.

Some think that winter is coming, some prefer to hear me roar and yet others think they are growing strong.

The great houses bicker over who has more power, more land and more followers.

While in the North the real fight awaits - the White Walkers are amassing.

So, in this analogy who are the white walkers? For me, this changes on a day to day basis. Sometimes it's the Health Ministry as I wait for, what I consider to be, quality health leadership in New Zealand. Sometimes it's the DHBs as I see another patient that I could help more, had I the correct resources. Sometimes its society itself, who continue to get equity and equality so confused.

Whomever it is though, the point is that while we bicker, while the Roose Bolton's of the GP world change allegiances according to what is the best deal for Roose, while PHOs fight to hold their place in this system, the White Walkers develop more power, and the people that rely on us are the ones that pay the price.

"What to do? Where is our Daenerys with her dragons to come along and fight the White Walkers? Where is our John Snow, the bastard son of Ned Stark, who will unite the people and then give up everything to let someone else rule?"

And this is where it becomes a bit sappy, so feel free to stop reading if you can't handle it.

I believe the dragons are the old values of love, compassion and empathy for our fellow humans. I am not suggesting we as lords and bannermen should lay down our weapons and surrender, but I do wish we could agree that other GPs and PHOs are not the enemy. At the end of the day we all want successful, reliable general practice for our children and grandchildren to use. This means sustainable businesses that can support our communities and the men and women who run our households.

It is time to use the principles of love, compassion and empathy to drive our health care system forward. Patients getting what they need, not what they can pay for, or what their particular area provides. Providers who are passionate about serving their communities, and this truly comes ahead of personal monetary gain. Primary care organisations such as PHOs and the College sharing information and ideas, agreeing that the outcome is more important than whomever mooted the idea. Looking towards and learning from those who are already doing something great.

But this does need some leadership. And this is where we need John Snow. 

"So, all you bastards out there - is there anyone prepared to put up their hand and lead us into battle against the White Walkers?" 

So far I have not seen an appropriate candidate, but I continue to search for someone to support who is truly in this for the right reasons.

As for me, now I'm looking on Neon for the next series which can provide me with more insight into healthcare. Perhaps "Grey's Anatomy"? Nah, no insight there. Perhaps "Shameless" would be better? Hmm perhaps I need to stop thinking while I watch TV...

Dr Hayley Scott is a director at Health Te Aroha, an early adopter of the Health Care Home. She regularly presents at Health Care Home open days and supports practices to make the transition to a new way of working.

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