Ochre Health must be doing something right to keep rural practices staffed and open.
Ochre Health has made it where many have failed. In 2002, literally in the back of Bourke, two entrepreneurial GPs, Hamish Meldrum and Ross Lamplugh started a locum service for the Australian outback. They were able to find staff for rural practices where the health department could not.
Fast forward and the doctors started buying up failing, rural general practices. Co-founder Dr Meldrum told HSD that leveraging economies of scale and a corporate approach to recruitment and retention helped them find ways to serve rural patients sustainably.
Now, Ochre Health operations span city and country and engage over 450 doctors.
What’s been keeping you busy lately?
Two things – banks and Christmas parties.
We considered an IPO about 18 months ago but didn’t proceed so now it’s about accessing capital to help us get the right mix in our acquisition strategy. So we are engaging our bank facility. We’re also focused on improving our productivity gains in our current business and trying to make sure we’ve got that balance right.
I’ve also been going to lots of Christmas parties. Life has gone from running from conference to conference to running from Christmas party to Christmas party.
I just got back from our Canberra party. We had 182 people there and gave out lots of awards like best nurse, best doctor, most improved outcomes. There was lots of cheering. This weekend I’m off to Lightning Ridge which will be a combination of Walgett, Lightning Ridge and Collarenebri practices and we’ll have, maybe, 20 people there, some may bring their families.
Where do you think Australian healthcare is going?
Twenty years ago, I thought that general practice was probably going to move to more outcome-based funding. I didn’t think Medicare would ever be canned but I thought that general practice would probably be less dependent on Medicare fee-for-service funding methods. I thought the funding mix would change to reward practices that could demonstrate better outcomes or measures other than just activity.
Thinking about the role of general practice and population health and how we measure health outcomes is important.
Doctors are voting with their feet and a bigger percentage of them now work in hospitals, compared to general practices 20 years ago. The problem with that is you then read in the newspaper that too many patients are going to the hospital.
Well, if you build it they will come. If you employ more and more doctors within the hospital system, more and more patients will follow where the doctors are going. If you provide more services, the patients will follow the services.
What opportunities do you see for Ochre Health?
We’re excited about the digital opportunity. We are launching a company-based, telehealth platform early in the new year that we think will be unique.
Currently, if a patient needs a telehealth consultation out-of-hours they will use a deputising service (an external telehealth provider). That doctor will send us a letter with consultation notes.
Our new solution will allow a patient to virtually see one of our doctors, not necessarily their personal doctor, but that doctor will be able to access the patient’s full medical record and process a Medicare claim.
There’s few telehealth services that work across multiple practices, where the doctor can access the patient’s actual medical level, record the consult directly into the patient management system and the patient can get a rebate for that service. Our new platform, using Best Practice, will be able to.
What keeps you awake at night?
We’ve got a lot of regulatory risk, like payroll tax and we spend lot of mental energy and time managing that regulatory risk. However, we’d actually rather be out providing services.
Our real challenge is being an organisation that is attractive to doctors without cannibalising the margins. Anybody can just hire people by paying them more, by giving them a higher percentage fee-split, but what challenges me is how we can make the user experience for doctors better.
It’s about culture and career. One of most important things about a medical centre is that it feels good when you walk in – that it seems like a place that you’d like to work. The other critical thing is to be viable and generate revenue. Ultimately though, no matter how much money you generate, nobody’s going to be happy in a place without a good vibe.
It’s been a bit of a tough time lately though. Professor Dennis Pashen was a big leader in rural health and he died about two weeks ago. He worked for us for the best part of 10 years. He wasn’t unwell so it was unexpected and quite tragic. We’re looking to establish a Dennis Pashen Award in Oche Health, probably for someone who has shown outstanding service, as Dennis did.
That’s a great loss.
Yes. There have been a few curveballs thrown at us at the moment.
How do you manage that when you have a lot of staff?
As a leader, sometimes when everybody’s exuberant, you need to calm the team down a little bit and say, “our next challenge can be just around the corner.” Other times if people are very low or disappointed you need to try to get people to be, not more optimistic, but to stand in the middle of fluctuating emotions.
The bigger picture is important too. General practice still a great space. It’s still worth it. It still provides great value to the Australian public. It’s still a great career and rural generalism is a also still a great career.
Wildcard question: What’s a nice thing that happened in your world in the past month?
I was watching the cricket World Cup final in a pub in my neighbourhood very early one morning. Out of the blue, my regular barista from down the road turns up in the pub. He walks straight in with a cup of coffee, my regular order, and hands it to me – in the pub at six o’clock in the morning!
It was such an unexpected and very nice thing to do and made me feel very good and very looked after. A random act of kindness that was very much appreciated during a lot of curve balls.
Dr Hamish Meldrum will be speaking at Burning GP summit – a new event brought to you by The Medical Republic and Health Services Daily.
Burning GP will be held at Mantra on Salt Beach, Kingscliff on 14 and 15 June, 2024.
Over one and a half days, we will bring together key leaders and influencers from general practice, government, and the technology sector to examine key trends affecting the profession of general practice and map out an alternative and more positive trajectory for the sector.
Burning GP – GPs taking back control of their destiny.