WONCA 2020: Q&A with Professor Trish Greenhalgh

3 December 2019

In April 2020, the College will be hosting the WONCA Asia Pacific Regional Conference, in conjunction with their partners, the Rural General Practice Network and Te Ohu Rata o Aotearoa - Māori Medical Practitioners Association. 

Ahead of this major conference, we had a chat with one of the six keynote speakers – Professor Trish Greenhalgh. Prof Greenhalgh hails from the UK and is an internationally recognised academic in primary health care. She is currently working at the University of Oxford.

What are you most looking forward to about speaking at the WONCA Asia Pacific Conference in New Zealand next year?

The focus of the conference, hosted by WONCA new Zealand, is ‘equity, quality and compassion’. From the other side of the world, these are values for which New Zealand is known and admired around the world. So it seems very appropriate for the Asia Pacific countries to be gathering in Auckland to consider, in relation to contemporary general practice, how we can improve equity, raise quality and keep compassion at the centre of the care relationship. 

Could you please tell us what you'll be speaking about at WONCA?

I want to consider, at both a practical and a philosophical level, the changing nature of clinical knowledge. On the one hand, we have more research evidence at our fingertips than ever (i.e. we seem to be getting closer to the ‘truth’). Technologies have produced novel and more accurate imaging options. They allow detailed monitoring of biomarkers (the genome, the proteome and more) and point-of-care diagnostic testing. ‘Empowered’ patients often do their own self-monitoring and titrating of treatments. On the other hand, the place of old-fashioned history-taking, hands-on clinical examination and relationship-based care in today’s evidence-driven and technology-saturated clinical world is unclear – and medical ‘truth’ often remains elusive. What does it mean, in 2020, to know one’s patient – and (to put it another way) what kind of knowledge do we need in order to care for our patient? 

What are you hoping delegates will take away from your presentation?

I’m hoping they’ll go away more confident in the traditional skills and qualities they possess as family doctors, while also acknowledging the huge potential of technologies (of different kinds) to help them make evidence-based diagnoses and decisions, relieve suffering, improve outcomes and generate new knowledge. 

A lot of your work has focused on quality improvements in primary care.  Can you outline one action that our GPs and practices should be taking to ensure that are delivering a quality service? 

I’d prefer to answer that at a meta-level, rather than picking a particular innovation to recommend. General practice is one of the most complex elements in the complex system of healthcare.  What do we know about innovation in a complex system?  We know, for example, that there is no formulaic or universal blueprint. Rather, the approach needs to be look around you (“horizon-scan”) for good ideas; visit places where those ideas are up and running; initiate change on a small scale and measure carefully to see if it’s working; and involve everyone (staff and patients) in evaluating and refining the new service model.  

What else are you planning to do while you’re in NZ? 

We’ll be spending some time on a remote Fijian island with our elder son who is a marine biologist and conservationist. I’ll be doing a workshop for the New Zealand Health Quality and Safety Commission in Auckland. Then we’ll hire a car and see how much of the north Island we can see in the time we have left!  


Professor Trish Greenhalgh
University of Oxford