Cum Scientia Caritas; with knowledge, compassion

Hauora is a Māori philosophy of health that is unique to New Zealand. It takes a broad view of wellbeing where physical, mental/emotional, social, and spiritual wellbeing are all considerations for ‘good health.’ With Hauora, a patient doesn’t visit the doctor and leave with a prescription; they meet their doctor, understand each other, come to a shared understanding of treatment (which can often involve their whānau or community) and doctor and patient work together towards wellbeing, whatever that looks like for that individual.

It’s a philosophy of health that Dr Kēri Rātima, GP and Pou Whirinaki of The Royal New Zealand College of General Practitioners says, “aligns with a Māori worldview, and with my own beliefs and values.”

And it’s a philosophy she shared with nine General Practice Education Programme (GPEP) year 1 registrars at Te Ahunga (the orientation) in Hastings in February 2021. Dr Rātima spoke about the hui process, a framework for consultations that has four specific components to it and that takes a slightly different path than a traditional GP consult.  

The four components are:

1. Mihimihi – a doctor introduces themselves and greets the patient in the initial engagement.
2. Whakawhanaungatanga – the process of creating connections and finding common ground.
3. Kaupapa – the clinical process of setting out what is going to happen, although this may involve different expectations for doctor and patient. As Dr Rātima said to the registrars, “my patient might want to talk to me about a sore toe, but my agenda might be to also chase up a mammogram or smear that hasn’t happened for a while so there needs to be clarity about what is going to happen at an appointment.”
4. Poroaki – the conclusion where doctor and patient have a plan and agree on what’s achievable together. Registrar Dr Rowena Woodhams mentioned in response that, “It’s no good having a plan with a patient if they don’t want to do what’s being suggested,” highlighting the importance of working together to achieve incremental health outcomes. 

“By working in this framework GPs can help reduce the barriers to healthcare for Māori people but to achieve this we need the support of like-minded GPs,” said Dr Rātima.