Lean and Healthy

Health Networks Australia

The public is likely most aware of the organisation’s sports medicine service, as the company operates nearly forty LifeCare branded centres around the country and has developed plans for expansion into further medical sectors. LifeCare General Manager Michael Kenihan tells us about that growth.

Whether the discipline of sports medicine is a misnomer (since its principles apply just as much to the chap who injures his ankle jumping off a bus as to the scrum-half scrunched in a tackle) is, says Michael, “an interesting argument that has been going on for many years. ‘Sports’ medicine implies active diagnosis and treatment to get [a patient] back to activity, be it on the sports field, walking down the street or on the sports field. Sports medicine is even used as a metaphor in the realm of workplace injury. It’s all about getting the patient active again as soon as possible.”

He believes this wider sense of the term is now largely accepted by the general public. “It’s really about time and education and exposure of the issue.” It’s not coincidental, he adds, that the company’s strapline is, “Everybody needs Lifecare” – meaning you don’t have to be on the Titans’ or Cats’ squad to qualify for treatment.

LifeCare is starting to ride the wave of success created by Pilates, the exercise regime developed by Joseph Pilates who said, in 1965 at the age of 86, “I must be right. Never an aspirin. Never injured a day in my life. The whole country, the whole world, should be doing my exercises. They’d be happier.” Indeed, Pilates is enjoying worldwide popularity. Part of its attraction, says Michael, is that it is class-based, with up to four people in a session, so you don’t toil alone. The company set up two such clinics in the last year and plans to expand that model. “Class-based exercise is a growing phenomenon. You see it in gyms or personal trainers and in the last couple of years it has moved more into the rehabilitation field, particularly for women, who generally don’t like the gym environment.”

At this stage, the LifeCare plan has been to acquire existing physiotherapy clinics in Western Australia. The company is also acquiring practices in Canberra but, at this point, this is more opportunistic. LifeCare is happy to develop new clinics where there is measurable demand, although it takes care to keep the pace of expansion manageable. According to Michael, expansion is “based on demand, plus we like to be rather on the ‘cutting edge’ of what is happening.”

Michael says that LifeCare has nearly reached its aim to render all its practices ‘paperless’ or fully digital. “Uptake has been a little slow in some of the larger clinics but we think, within the next twelve months, every practice will be paperless.” LifeCare is helping one of the Medicare Local sites to work on the roll-out of the PCEHR (a Personally Controlled Electronic Health Record launched in July 2012).

There is, of course, some connection with the government-led campaign to encourage everyone to apply for a PCEHR. But Michael points out that full digitisation is a good thing for business efficiency and is improving customer handling and patient relationships as well. “Interesting statistic: in a paper-based practice, around one third of a receptionist’s time is spent managing paper. Once you free up that person, he or she can enhance the customer experience and provide better service to the practitioners,” he explains. The investment cost is modest in the context – some more PCs and software from Zedmed (a pioneer in the PCEHR project – see Healthcare in Focus, February 2012) – and facilitates’ wider use of online training, education and knowledge top-ups for therapists and students both within LifeCare and beyond.

On the occupational health side of the business, the company has opened further sites dealing with network pain management. This programme brings together occupational physicians, psychologists and physiotherapists to jointly manage patients with chronic pain. There are three sites in Victoria so far (Michael says it is generally the case that new ideas are implemented first in the company’s ‘home’ state), run in conjunction with the publicly funded authority Worksafe.

In terms of demand, of course one of the fastest growing medical sectors lies in aged care. Australia-wide company Vivir provides rehabilitation services primarily to residents of aged care facilities, community programs and hospitals as well as patients at home, and LifeCare has begun working with Vivir to provide physiotherapists on contract to facilities such as nursing homes. This helps Vivir with supply of labour and provides the medical staff with some extra variety in caseloads, but Michael also says that there is a considerable and ongoing shortage of appropriately trained physiotherapists, which acts as a slight brake on the expansion programme. “I think it may continue as a bit of a problem; there are not enough graduates to work in private practice.”

The LifeCare model has three tiers of practice ownership. Beneath the holding company are a series of stake-based trusts formed of equity holders and in each state there are unit trusts for each practice “so an individual can take equity in the trust for the practice they work in. It’s quite a unique structure and it works well. It’s a good model because the practitioner can be an owner of the practice he or she works in partnership with a stake-based ownership shared between certain individuals and the holding company.”

Currently around eighty per cent of the practices have an equity holder at practice level and Michael says the aim is to extend this model to every facility. “In new start-ups, there will be an equity holder in the practice right from the word ‘go’. We find it helps to drive the practice forward in terms of marketing and means the management of the practice is focussed, not only on practising, but on the business as well.” There is a highly supportive six-month mentoring programme for those entering practice ownership, to bring them up to speed with the commercial aspects of running the practice.

All of which – new directions and making sure the existing businesses continue to thrive – leave one hoping Michael and his colleagues keep fit. Still, they can always fall back on their own services if they falter!

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July 20, 2018, 12:39 PM AEST

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