Representing the future of practice management

Dwayne Stewart had no experience working in health when he applied for the position of business manager at Health Te Aroha.

Mr Stewart had been Rentokil’s national fumigation manager for New Zealand and Fiji, travelling often across the Pacific.

But when the opportunity came up at Health Te Aroha, he was sold the minute he visited the practice.

“When I walked in the door, the vibe and the ethos was just amazing – it’s a real credit to the practice owners.”

He has developed the role in the nearly four years since he joined the practice and, for this, was awarded Practice or Business Manager of the Year at the New Zealand Primary Healthcare Awards | He Tohu Mauri Ora held earlier this year.

Michelle Meenagh, of Raglan Medical, was fellow finalist.

Judges said Mr Stewart, a relatively “new kid” on the block, appeared to have achieved plenty and his innovations had met with wide approval.

Mr Stewart didn’t know he had been nominated until a month before the big awards night in Auckland on 15 May.

“I didn’t really look much into it, either,” he says, “so I was surprised when we got there – it was so much bigger than I’d realised.”

He says it was nice to receive the recognition for his work.

At Pinnacle Midlands Health Network, which nominated him, chief executive Helen Parker says he has, in a short space of time, developed his role into one that represents the future of practice management.

Among his strengths is the way he uses data to inform decision-making, including mapping acute demand over the past three years, and staffing the practice accordingly.

He has embraced the health care home model, led a patient participation group that led to service redesign in the reception, and led the acquisition and merger of another practice, Hauraki Plains Health Centre in Ngatea, in April.

Mr Stewart says working at Health Te Aroha is “massively different” from his previous role but, at its heart, it is still a business.

“The journey has been fantastic, the practice is great, the owners are amazing, and they’ve given me lots of support,” he says.

He enjoys the clinical ownership and says adding his own non-clinical viewpoint means there are different ways of looking at how the business is going.

It was a steep learning curve getting to grips with how general practice runs, he recalls.

“The funding was a real eye-opener – from the outside, I had no idea health is funded the way it is, [or of] capitation and the different ways you can get funding.

“So I was learning how to maximise opportunities, but also keeping on top of the funding streams, which change reasonably often...

“Managing and filing claims, like ACC or the different pathways for patients to other services and doing it right – that’s the tricky thing.”

Mr Stewart says Health Te Aroha is a forward-thinking practice.

“They’re used to change, so when the COVID-19 pandemic hit, it wasn’t a big deal, we were doing phone consults and telehealth, but we are also used to adapting to achieve better outcomes for both patients and staff.”

GP recruitment is his biggest challenge. The GP shortage affects all general practices but rural practices in particular, especially as COVID-19 has sent their workload through the roof, he says.

“We’re actively looking for GPs, but also upskilling our team, training nurses to be nurse prescribers and nurse practitioners.

“We’re thinking about what we can offer and do differently, so everyone can work at the top of their scope.”

He would like to see a broader range of health services available for people in Te Aroha.

Patients can get x-rays in nearby Morrinsville but, other than that, it’s a 100km round trip to Hamilton for most secondary services, including mental health.