It was excellent to meet many world-class thinkers, doers, and past, present, and future leaders in healthcare at the revolutionary Wild Health Leaders Summit

I was humbled to be invited to sit and present my topic: What would a set of peer-reviewed sustainable clinical and ethical standards in medicine and healthcare professions do for reform and the healthcare industry globally and locally (glocally)? 

This remarkable event has given open-minded grass-roots community and health leaders a unique and friendly opportunity to cross each other’s paths from a different perspective. 

The event was free of agendas, groupthink, or conflicts of interest. Many heartfelt and amusing candid discussions provided much richer and deeper insight, fueling a refreshingly new healthcare debate. 

Thank you to Jeremy Knibbs, Jay Rebbeck, and the team for facilitating this amazing initiative.

It was a real honour to be among some of the most influential and like-minded thought leaders. With everyone’s help, our future is safe in their hands. 

My journey as a patient and provider advocate began in 1989 after my “horrific” car crash and nine operations later with various medical and healthcare systems.

As a medical practice adviser and tax accountant, my healthcare standards topic first caught my  interest in the mid-1990’s after my female doctor client was prosecuted by Medicare for “doing too many pap smears!” 

At the time, female patients demanded a female doctor. We gave them what they wanted and needed. However, the government had brought this to an abrupt end.

This continues to come at a greater cost to the public health system and the taxpayer. The system under rewards prevention and unnecessarily rewards a painful but avoidable cure.

At the time, I had called the Canberra Medicare cops. Accountants, not lawyers or doctors, ordered my client to pay back the money, or else they would escalate her prosecution!

 

 

I was left dumbfounded. This was all due to a bizarre statistical anomaly. She  performed more pap smears in a dedicated tears and smears clinic compared to her male counterparts. 

There was no clinical subspecialty profiling, no interviewing of patients, or reference to clinical peer-reviewed healthcare and ethical standards. 

To this day, no centralized, open and transparent, commonly agreed-upon, peer-reviewed healthcare or ethical standards exist for the medical or healthcare profession. Nor do they exist to protect doctors and healthcare workers from undue scrutiny. 

This continued approach leaves much uncertainty. It deeply affects workforce morale, recruitment, retention, and appropriate funding for healthcare services.

Daily, this does more harm than good to both patients and providers. 

More about this later.

Gleaning from the event, I will discuss the three primary takeaways I see facing our healthcare system and propose a three-step solution to address these issues.

Three key problems and a three-step solution to solving our healthcare problems

The objective is to glocally create a sustainable and socially responsible patient- and community-centered healthcare system. 

If you do get to the end of this article, you can view a proposed model that can address many, if not all, of the concerns raised at the event. Please contact me for more details.

Respectfully, to any detractors: I am happy to stand corrected on any points that I may have misunderstood. I look forward to a constructive discussion on the most optimal way we can all move forward.

“The ultimate goal: positive patient outcomes”

These are the three key problems from the summit participants:

  • Patients and providers do not know what they want or need 
  • A lack of a unified healthcare vision for patients and providers is why there is a perennial funding problem
  • For the government, the definition of insanity is spending more money on solving the wrong problem 

 

The solution (in order of priority)?

  • Set a common vision for the future of patients, the community, and the healthcare industry
  • Set glocally patient and peer-reviewed clinical and sustainable governance framework, standards, and ethics Wikipedia
  • Data interoperability lacking context, is not useful or meaningful without peer-reviewed, commonly agreed healthcare and ethical standards.

For me, consumer advocate Clare Mullen  set the no-BS tone for the event. Provider-driven health literacy is key.

Patient and provider trust is the new oil.

Many are mistaken; it is simply not about having access to health data. Health data needs to be meaningful, useful, and reliable for patients, providers, and users of healthcare information. These standards do not yet exist because the relevant medical and health professional bodies must approve of these peer-reviewed standards and health information data sets.

Privacy breaches aside, patients have keyboard access to an overwhelming amount of unvetted healthcare information. In the absence of a trusted clinician, much of this information lacks any useful and meaningful context for both patients, providers, regulators, and users of healthcare information. 

Left unchecked, Dr. Google can only do more harm than good as it makes its way towards a serious collision course with reality. AI is being mooted as the new competition is set to compete for a patient’s mind and healthcare dollars. 

There is an increasing lack of affordable access to healthcare workers. Understandably, patients are self-diagnosing their healthcare needs. They are looking for convenient access to high-quality and reliable healthcare information.

Until computers can feel, do not worry healthcare workers; you will not lose your day job. It’s like being concerned that a calculator or spreadsheet will take your job as an accountant. It is a great tool but has many limitations; alternatively, you may need to do some serious upskilling.

Centralised open, and transparent patient-centered, peer-reviewed healthcare and ethical standards enforced by the relevant clinical medical and healthcare bodies are the only real game changers. 

The problem is that no such peer-reviewed, commonly agreed-upon healthcare and ethical standards exist. The following 2017 BMJ study on healthcare guidelines reveals:

 

 

Alarmingly, despite WHO’s call for standardisation, there is little appreciation, or appetite yet to urgently address and set a useful and practical solution.

 

 

Costing billions each year, the World Health Orginisation (WHO) confirms that every 5 minutes, a patient dies due to a lack of patient safety. Many more are either permanently affected or have had their lives significantly disrupted. Doing the simpler things can make a huge difference, but despite all the evidence, there seems to be a cultural aversion to self-accountability.

Understandably, patients and their caregivers and providers are losing faith and trust in the healthcare system. They are finding it dangerously difficult and harder to constructively engage with multiple providers in an increasingly difficult-to-navigate healthcare system.

Often the simplest of solutions are overlooked, which could solve many unnecessarily complex problems. Ironically, this overloads our healthcare system and our hardworking front-line workforce.

Notably, this adroit group concluded that many of the problems are mindset barriers that are perceived and not real. A higher appreciation of simple changes such as effective governance standards and collaboration should provide much-needed relief.

This is what is stressing everyone out. Nobody really knows who is in control of the care process or what that process should look like.

An overwhelming majority of attendees agree there is an urgent need for open and transparent, commonly agreed-upon patient and peer-reviewed healthcare standards.

A commonly agreed-upon governance framework is critical to ensuring affordable, appropriate, and timely delivery of patient care. Effective patient and provider feedback loops must capture and leverage any patient or provider expectation gaps. 

 

A patient-centric standards feedback loop example

 

By taking a deeper look, many of us have assumed the system is working, which may be far from reality. Currently, patient feedback appears to be less than optimal.

Ultimately, everyone’s endgame should be to serve patients and communities so they can live a more useful and meaningful life. Any argument must go beyond how much the government is willing to pay for a well-intentioned service. The real question is: is it really meeting the needs of the patient?

At the event, after 30 years in the industry, I routinely heard the same merry-go-round of preventable patient and provider war stories. 

There can be a tendency to over engineer every step of a healthcare system.

As Sarah Barter Aged Care presenter at the Summit said, simple and effective solutions can still make a significant difference, like reviewing a patient survey or publishing a website article on how to navigate common medical problems. This could save a patient’s life. Improving how doctors, providers, and the system communicate with patients and providers could save millions or billions of dollars each year. 

Working smarter and not harder can be difficult to achieve, especially when patients are caught up in an internal provider’s fight for clinical autonomy, such as scope of practice. There are many unforeseen factors that affect high-quality and timely care. Standards can play a large role in ameliorating any concerns. 

Technological solutions that address clinical technical (clinical standards) inefficiencies may be seen as a barrier to change unless a member’s professional body of peers endorses such an implementation. 

As one presenter said, “No turkey is going to vote for Thanksgiving!” especially when they are being pushed from the outside into the oven.

Anecdotal solutions remain excellent signposts; however, the event was a clarion call to say it is time to look top-down and not just bottom-up; we urgently need systemic change. 

By carefully solving the right problem, people will ultimately find that there are no losers, only winners.

Starting from the top, the summit proved we need cost-effective, scaleable, and sustainable solutions that provide optimal patient care.

While we are not all on the same page and have different levels of competing interests, we cannot solve this solvable problem in a hurry without peer review, leadership, and support from the top.

Surprisingly, this has been the hardest challenge to date. A friendly nudge from the government may begin to fast-track this solution.

 

  • Patients and providers do not know what they want or need.

Source: determinantsofhealth.org

Consumer advocate Clare Mullen  said people do not know what they want, and surprisingly, “many are not that interested in healthcare if they are outside of it.” The need for proactive patient education and advocacy remains paramount and is the responsibility of the provider. 

On the flip side, providers report being clear about what they want and need. Finding and having more access to a future workforce that is supported and recognised is a recurring claim. However, Mullen feels some still have a long way to go when it comes to meeting patients’ expectations.

I said in my presentation, we have eminently qualified and experienced bricklayers, electricians, and plumbers, but we appear to be building igloos that are not fit for purpose. 

In the Federal Parliament’s Medicare Senate Inquiry in 2011 and in a subsequent meeting with Professor Stephen Duckett in 2014, I stated that open and transparent healthcare standards were required. 

Unfortunately, despite many attempts, not much has changed since. There is no real appetite or urgency for change unless the government drives or legislates for reform. Defunding is one way of forcing efficiencies and driving economic reform. However, this is a short term solution that will do more harm than good.

A deeper dive reveals that this matter needs to go beyond the funding argument. Addressing the politically less alluring structural (governance relationship with providers and funding) reform should result in significant social dividends.  

Any significant quality improvements and sustainable structural operational savings cannot be achieved if the transactional reform agenda with grants and Medicare item number rationing continues. 

The summit attendees made it clear that the industry needs to share a collective vision and plan for patients and the community. Without one, a suboptimal piecemeal approach based on who screams the loudest. Utilising and leveraging a well thought out governance framework may provide a more effective feedback loop.

Unfortunately, too much is left to assume or for the government to attend to. This can be disempowering. Stakeholders must be encouraged to take ownership of mutually agreed-upon outcomes and seek a fair return for their commitment. 

 

  • A lack of a unified healthcare vision for patients and providers is why there is a funding problem

 

 

With so many mouths to feed and houses to build, the government is understandably reluctant to commit large sums of taxpayer money. Many decades of good intentions have passed without seeing the building drawings and the floor plans first. In good times, this hit-and-miss approach may have worked. 

However, in our leaner and meaner times, this may no longer appear to be the case.

Many have argued that it is the responsibility of the government to take charge of the healthcare agenda. But as the IT FHIR Summit presenter Grahame Grieve said, “nobody asked for the iPhone or iPad,” there is a big role providers can play in creating a better experience for patients.

In the end, the government has to justify why it is spending the money to the voters. They need to be seen as getting value for money for the taxpayer. 

It is all about optics; the government needs something tangible they can easily point to as proof that they are funding world-class healthcare services that meet open and transparent standards. Failing that, any additional funding must keep the Treasury happy.

The fact is…

“there are no commonly peer-reviewed patient- and community-centered open and transparent centralised healthcare and ethical standards.” 

This provides glaring evidence that the system is left open to abuse, mismanagement, or maladministration. Healthcare resources are scarce; this should be raising alarm bells everywhere. The fact that there is a deafening silence and a lack of urgency around this problem is remarkable.  

The fact that your local doctor, patient, or provider cannot point to one peer-reviewed, commonly agreed upon patient and community-centric, centralised healthcare, and ethical standard is a case in point. 

When I ask them why, I am usually met with stunned silence. You should give this a try and ask your local doctor or healthcare practitioner.

Centralising healthcare and ethical standards represents a holy grail of opportunities for improving patient safety, research, teaching, workforce burnout, recruitment and retention, reduced patient complaints, wastage, duplication, and increased funding opportunities. 

It’s interesting how many well-intentioned doctors dismissively dismiss this idea as an impossibility, despite the fact that their own peers have said it is possible.

 

 

In the absence of enforceable, open, and transparent standards, it becomes unfairly harder for providers to provide higher-quality and more affordable care. This can only do more harm than good. 

The court of public opinion is based on optics. Only when they can see tangible, non-contradictory evidence, such as a commonly agreed-upon published peer-reviewed

healthcare standard endorsed and enforced by a professional body, can they trust and better engage with the system.

Similarly, the courts, medico-legal insurance companies, and payers for healthcare services tend to follow a similar line that lawyers, accountants, and other professionals have been encouraged to follow in exchange for lower insurance premiums and capped limited liability. Federal laws have been in favour of these initiatives.

 

Source: Professional Standards Council

 

This is why your local accountant prepares your financial statements in accordance with global standards. If you do not believe me, check your latest financial statements.

The bottom line is that it is human nature to spend more money on things we can see. A hospital opening scores more public political points than a hard-working healthcare worker that nobody sees. 

We urgently need a building drawing and then a floor plan for the healthcare industry that everyone can follow and believe in. Only then can providers attract the right people for the right funding that is needed.

To the contrary, many patients and providers in the communities will continue to be left out in the cold. 

  • For the government, the definition of insanity is spending more money on solving the wrong problem.

Context is king. The government could consider holding back on spending more money on health unless there was a clear governance mandate.   

A mandate to set peer-reviewed, commonly agreed medical and health governance frameworks in every professional body or healthcare organisation with a view to publishing patient- and peer-reviewed healthcare and ethical standards.

The key is to make the intangible nature of high-quality care tangible. A peer-reviewed Wikipedia glocal healthcare and ethical standards would go a long way to building trust and value between all stakeholders. 

This information could then be programmed in real time into medical and healthcare software systems that automatically prompt patients and providers. This is how the accounting industry works, with accounting software programs like Xero and MYOB that directly connect to the Australian Tax Office.

When professional bodies voluntarily remove this uncertainty for consumers or payers of healthcare, this would make it easier for them to compare and pay for higher-quality care with providers that meet or exceed any peer-reviewed standards.

Accounting professionals enjoy global mutual recognition for their qualifications and skills.  The mobility of their credentials enables them to work anywhere in the world. Imagine how this could relieve local workforce challenges. 

From the summit: The next steps (in order) would look like this:

  1. Set a common vision for the future of patients, the community, and the healthcare industry.
 

A low socio-economic healthcare service and funding model example

Summit leaders made it clear that there is a need for a commonly agreed-upon vision for the healthcare industry. 

There is a clear lack of global community, local and individual context when it comes to allocating finite healthcare resources. A lot of duplication and wastage exists. If not handled carefully, any reform is likely to be met with resistance. Some people will feel like turkeys being asked to vote for thanksgiving.

There is an urgent need to simplify the problem back to first principles; how else can the government or an individual fund their health journey unless you know where you are and where they want to be? 

Of equal importance surely it is far more efficient and effective if the medical and healthcare professions could self-regulated themselves within a set but adaptable patient-community centered global governance framework? 

Why “global” for a starter local Courts and laws do recognise peer reviewed open and transparent professional standards. Furthermore this simply demonstrates there is no bias involved when providers are being questioned on the standard of care they provide by patients, payers or regulators.  

In other words, the kudos and authority for adapting world’s best practice gives providers instant global credibility.

Should a provider go astray is it not more powerful to respectfully “ask a thief to catch a thief”? Surely if a doctor or healthcare provider was discretely tapped on the shoulder by their professional body this would have a greater impact? To prevent criticism that  one may be met with a “boys club” response, professional bodies that do not offer due process risk all their members and themselves from special statutory privileges such as capped indemnity and less regulatory oversight from the Government. 

A professional body who was charged responsible for enforcing a global governance framework, and enforcing healthcare and ethical standards would save the tax payer, providers and patients a lot of money and time with AHPRA and Court disputes and costs? 

In Australia, for decades, accounting professional bodies like CPA, Chartered Accountants Australia an New Zealand and IPA in the accounting  profession have jointly been used in this way. They contextually and cost effectively triage and deal with public and peer complaints where many are easily resolved and are based on a simply misunderstanding. 

The more expensive and last resort local regulatory avenues remain should a dispute remain unresolved.

This has certainly been achieved in the global accounting profession. Since the 1980’s global corporate collapses, this has rebuilt public trust and confidence amongst all key stakeholders. This has laid the very foundations of the global financial system or we would not have one, albeit no system is perfect. 

Any system is open to corruption if they are not at all times open and transparent.

To prevent a future pandemic and to improve global healthcare outcomes, surely we need a similar global healthcare system that discretely talks to each other? Currently there is no global healthcare system. It exists in silos, it is fragmented and each part symptomatically treats a problem.

The World Health Organisation had admitted in March 2022 it has no mandate to enforce compliance towards any healthcare reform as each country has their own laws that cannot be simply overturned.

An independent not for profit international healthcare standards and ethics board becomes an elegant solution to a complex problem.

 

To open the debate to a new narrative, I will make the following suggestions.

We need a collective written agreement amongst industry leaders and their members that the primary purpose of the healthcare industry, together with the community, is to enable patients to lead a useful and meaningful life and to do no harm to others.

A secondary objective is to ensure every person experiences a safe, sustainable, innovative, and high-quality healthcare system that breeds a patient-centered, healthy, and resilient community. 

Before we can move on to the next step, key medical and healthcare bodies need to agree in principle that these are appropriate objectives to adopt and promulgate to the community at large. 

At the summit, I had outlined how, with very little money during the 1980’s corporate collapses, a crisis of public confidence loomed over the accounting profession. How remarkably the accounting profession responded is noteworthy. 

In 2006, in Sydney, Australia, they created the Accounting Professional Ethics and Standard Board (APESB). This was achieved by competing professional bodies coming together, realising government regulation and red tape would do more harm than good.

Since this time, they have enjoyed global and regulatory recognition and success in over 110 countries.

Where is the independent voice for collective health reform?

The medical and healthcare professions and industries cannot leave everything up to the government. This is not fair on the government; many functions we expect it to perform are significantly outside of its scope and capability. The healthcare industry needs to define its own vision and not be part of someone else’s.

The government should be viewed as an enabler or facilitator of a commonly agreed-upon solution, not the implementer of the ultimate solution. This did not work for the aviation or accounting industries in the mid-1940’s. Only when governments were reviewed did airline safety experience a significant reduction in airline crashes.

 

Collectively, via self-regulation with tacit government oversight, the healthcare industry needs to represent to consumers its collective vision and solution for healthcare.

At some point, the industry has to set and drive the agenda with the government’s blessing. 

The real question is, “Who should and who is going to lead this solution?” Should it be the medical profession or someone else? I would like to see patients and their GP’s lead this discussion via their relevant consumer and professional bodies at a national level.

GP’s are a natural and trusted independent patient advocate and gatekeeper to the healthcare system. They should be protected at all times. A regular GP will normally have a longitudinal helicopter view of your health, which is far more useful than just a bottom-up granular view. 

With strong collective leadership, the AMA, RACGP, and ACRRM could lead and empower the entire healthcare industry.

Due to a constitutional legal impediment, if you carefully read the Health Insurance Act, the AMA must be consulted, and a safe place for multilateral discussions is required. 

Like the accounting profession, a way forward is to establish a not-for-profit independent international healthcare standards and ethics board co-owned by competing medical and healthcare professional bodies. Standards, scope of practice, and multidisciplinary care, research, and teaching could be developed and promulgated throughout the Australian and global healthcare systems. 

This is timely as the WHO is seeking a global response to future pandemics. This model may provide a more legislatively friendly framework for all countries to abide by.

Without this solution, health reform will continue to move at a glacial pace.

2. Set glocally patient and peer-reviewed clinical and sustainable governance framework, standards, and ethics Wikipedia

 

Source: a universal organisational model

 

Summit participants demanded commonly agreed-upon healthcare frameworks and standards. A key workforce bugbear is the lack of a “documented scope of practice.” 

Above is a suggested multi-disciplinary organisational flow diagram example that could easily apply to all stakeholders and encourage the collaboration and co-designing of a documented scope of practice that could be developed under this organisational model.

Australia could lead in producing patient-co-designed, peer-reviewed multidisciplinary healthcare and ethical standards that are open and transparent. These are principle-based standards.

This organisational framework would form the basis for producing globally centralised, contextualized, customizable standards that can respond on a timely basis to global and local concerns. This would attract the best ideas around the world that could be cost-effectively implemented locally without reinventing the wheel.

All stakeholders would then have, like a GPS in a car, a policy and funding tool to optimally target all areas of need.

  1. Data interoperability is not useful or meaningful without peer-reviewed, commonly agreed healthcare and ethical standards.
 

Healthcare technology is not the problem. Data interoperability is clearly a brick-and-mortar technical efficiency solution. Its business case for now may be limited to administrative purposes only, such as allowing names and addresses to be more conveniently imported and exported into and out of computer programs.

Without commonly agreed-upon peer-reviewed clinical standards, this may be, on the face of it, more harmful than useful if clinical data is being imported without any peer-reviewed clinical context.

There is a reason why stakeholders such as patients and providers are slow to argue for this change. Many are not aware of what data interoperability means or who is gaining access to it without their knowledge. 

Integrating and collecting data that is not useful or meaningful does not create a sense of urgency amongst users, i.e., doctors and patients. 

To engender any support, it must be both trusted and relevant to the patient, providers, and other interested parties such as regulators and funders. This is also the reason why My Health Record or any medical or healthcare software program will never meet its true potential other than as a sophisticated quasi-word processor. You cannot legislate behaviour if people do not want it for themselves.

The accounting software provider Xero is a New Zealand-based, 2006-startup, $20 billion global software company. This is a good case study on how to solve this data interoperability problem.

Xero has enjoyed much global success in this area. It could demonstrate to the end user(s) that the accountant’s client had full access to their own records. Furthermore, the client and trusted accountant controlled drilling access rights to some or all of their records. Not only did the program integrate with statutory regulators such as the tax office, but it also provided instant convenience to both the accountant and their client.

Most importantly, it has helped the accountant prepare financial statements to peer-reviewed global accounting and ethical standards. This satisfied their daily legal and compliance-risk obligations to regulators and their clients. This was my main reason for moving from the on-premises MYOB accounting software program that I had used for over 24 years straight to Xero in the cloud, which was cheaper, safer, and more useful.

What is missing are consumer, clinical, and stakeholder peer-reviewed health care standards when defining what data needs to be collected and reported. This is an inherent weakness in any IT health data initiative. If professional medical and healthcare

bodies do not endorse ICHOM or SNOW Med data standards, then we remain a long way off from collecting useful and meaningful clinical data. 

If we do not address this problem first, we will continue to see low technology adoption rates among both patients and providers and other users of healthcare data.

We have begun a process that international medical and healthcare leaders, academics, and politicians believe is achievable and sustainable.

 

The accountants’ model in over 196 countries has simplified a complex array of trillions of transactions and information into useful and meaningful information that has for decades been used by governments as the backbone for the global financial system.

So useful is this conceptual framework that the United Nations, in 2023 has made in their 196 country Paris agreement the International Federation of Accountants (IFAC the accountant’s penultimate global body all accounting bodies report to) responsible for monitoring climate change. 

Providing useful and meaningful healthcare statements to patients expressed in financial terms might be a better way to convey complex healthcare data that may nudge patients into action. 

After all, you do not have to be a chartered accountant to work out you have a low bank balance. 

After all, you do not have to be a chartered accountant to work out you have a low bank balance. 

This means you may have to cut down your expenses or increase the number of hours you work in order to maintain your lifestyle.

Where do we go from here?

There is strong evidence for the healthcare industry, which desperately needs money from the Treasury, to explore this proven model. Alternatively, is there a better solution?

If healthcare data speaks the same business case language that any responsible treasurer can easily understand and approve of, there is a greater chance of securing aany type of healthcare funding.

A self-funded self-regulatory solution neds further exploration by our leading medical and healthcare professional bodies and organisations. The government like they did with the accounting profession needs to give them an urgent nudge.

The key benefits are summarised below:

The medical and healthcare professions need to start with commonly agreed-upon open and transparent healthcare and ethical standards. 

With the key objectives of reducing unnecessary medical and healthcare errors, wastage, duplication, burnout, bullying, and stress. This will make the professions more attractive for recruitment and retention and globally mobile.

The threat of future pandemics, will force the global healthcare industry towards this logical platform. We live in a highly transient world. People pass on diseases wherever they go, we now know you cannot quarantine a biosecurity threat you can only prevent. 

The pandemic has created mistrust in our local and global healthcare systems. This may have been avoided had the two doctors who had stumbled across the disease had a safe place to speak up away from the geo-political spotlight. 

We need a global healthcare system where trusted agencies can be forewarned and forearmed with immediate access to globally centralised resources. Over ten million unnecessary deaths and a significant disruption to human life may have been avoided with a smarter and more responsive healthcare system such as IHSEB.

On the flipside who may find the above all too eosteric, money is what pays for health. Everyone will always want to know what they are paying for and why. So maybe keeping an accountant in the room may do more good than harm. We all need to take a multi-disciplinary team approach.

Using smart technology, patient education with your trusted provider will be key.

Until the government pushes for a self-regulated industry, healthcare will not change much for the better.

Thank you to the Wild Health Summit team, which has shed new light on this topic.

If you want to make a genuine difference in healthcare, get involved with the Wild Health team or us. For more information, visit the not-for-profit International Healthcare Standards and Ethics Board at www.ihseb.org

Once again, thank you, Michelle O’Brien, Jeremy Knibbs, and the team, for your leadership and vision and organising this forum!

People who change the world are like minded people who collaborate with the hungry, humble, and curious.

For more insights visit our blog.

About me: David Dahm BA (Acc.), CA., FCPA, CTA, FFin, CPM, FAAPM, FAIM, FGLF.

Chartered Accountant, Chartered Tax Adviser, Registered Tax Agent, Former AGPAL Surveyor 10 years of service

David Dahm is CEO and founder of the national medical and healthcare chartered accounting firm Health and Life and global Founder and CEO of the not for profit project the International Healthcare Standards and Ethics Board (www.ihseb.org)

After a serious work related car accident in 1989, and nine operations later I continue to be a patient and provider advocate. I enter my third decade as a national Chartered Accountant for Medical and Healthcare practices in Australia. I am a former 10-year Australian General Practice Accreditation surveyor. I come from a medico family. I have served on the AAPM national Board and was the inaugural national Chair of the Certified Practice Manager CPM post nominal. I continue to provide accounting tax and practice management advice to many practices all over Australia.

You know who you are and I thank you for this real honour and privilege to serve you and your community through you. Note, I am not a lawyer please seek appropriate legal and accounting advice. This information is for general information and discussion only.

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