Published March 2022: https://www.dumbofeather.com/partners/beyond-the-b-osana/
Dr Kevin Cheng is a GP on a mission to improve our health system and communities. He is the founder of Osana, a new model of General Practice and primary care in Australia. Kevin shares the story and impact of Osana here.
When I was growing up in a small country town in Western Australia, the doctors were seen as heroes. They cared for families over generations; they were involved in the community; they spent time with patients rather than just bouncing them around the medical system. In urban settings today we’re more likely to experience what we call “frequent medicine” — short and sharp visits to the doctor where patients are left scratching their heads and feeling rushed.
At Osana, we practice slow medicine. This means that we spend twice as long with our patients as the national average, which is around 13 minutes. We refer to our patients as “members”, and we currently have between 6000 and 7000 members. The idea is to build solid relationships with our community and shift the mindset so that people come to see us when they’re well, as opposed to only visiting when something goes wrong. In other words, we want people to subscribe to their health.
The business is three years old, and we became certified as a B Corp early on. Being a B Corp means being an organisation with a social focus and a mission to positively impact the world. It was a natural progression for Osana because we’ve always been a social enterprise and we’ve always been more focused on proving out our model than any commercial mandate. We’re here to change the health system and shift it towards a much more proactive, preventative approach. B Corp accreditation became a way to document this new approach.
So far, we’ve kept people out of hospital at a rate about 50 per cent higher than other GPs. We’ve helped people lose weight, reduce drinking and improve their mental health. We manage chronic disease very well, and we can safely say we’re about double the Australian benchmarks on chronic disease management. Reducing chronic disease means that people live longer and experience fewer health complications later in life, and that they have less need for hospital visits, specialists, medications and procedures.
We function as a kind of village — a diverse range of doctors, nurses, other clinicians and non-clinicians who look after the whole person so that care becomes not one-to-one, but one-to-many. We frequently gather for team “huddles” so we can devise solutions and really wrap around our members, and we have dashboards for each member so that they stay on our radar, even when they’re not around. During bushfire season, for example, we made a list of all of our members with asthma or other lung issues and we called them to ensure they knew what to do if there was a crisis.
Because of our focus on slow medicine and this village structure, you could say that elements of our model hark back to ancient times — and you would be right. But we’re equally devoted to harnessing the power of modern technology and innovation. We were the first GP clinic in Australia to use Coviu, the main telehealth platform in Australia, to provide phone and video consultations for free to patients. This was pre-Covid – because that helped our members at home. We’ve also built an app to gamify healthcare. Members see their health plan on the app and earn points for doing things like attending their program or improving their blood pressure. Our vision is a culture where people map out their health goals the same way they consider their financial or career goals.
Ultimately, it’s about activating and empowering people to have knowledge and agency when it comes to their wellbeing. This runs counter to how so many medical businesses operate — they essentially rely on ill health to survive. I don’t see our GPs as better GPs than ones practicing anywhere else, but I feel that our model of care is better than the dominant model. We see our role as less paternalistic and more in the space of partner or coach: we want to be cheerleaders for our members and to help them shift their habits and behaviours in the long-term. One in two Australians is living with a chronic health condition, and they spend a whole lot more time managing their health at home than they do in the company of a doctor. Therefore, improving people’s capacity for self-management is a total gamechanger. One of the best descriptors of what we do at Osana is “lifestyle medicine”, because lifestyle is the biggest determinant of health and longevity — not your genes or how good your doctor is or where you live.
Osana means “health and wellbeing” in Spanish. It’s a simple goal, really — to see a shift in the health and wellbeing of Australians — and yet it’s also ambitious. Australia has a good healthcare system, but it’s at a tipping point thanks to the mounting prevalence of chronic health conditions. For things to change we need the government, the medical fraternity and the community on-board. We have to want better health together. If there was more funding for preventative health — say, 20 or 30 per cent of the health budget as opposed to one per cent — we’d be living in a radically different society.