Dr Lynn McBain: data a powerful tool in delivering better health outcomes

Member news
12 March 2018

Head of the University of Otago Wellington’s Department of Primary Health Care and General Practice, Associate Professor Lynn McBain, says data can be an incredibly powerful tool for primary care management and quality.

Dr McBain is also Medical Director of Wellington region primary health organisation Compass Health, which has introduced a new quality initiative of wellness checks for patients prescribed antipsychotics.

Wellness checks

“We know that people experiencing mental health and/or addiction issues are at unacceptably greater risk for a range of chronic health conditions, have worse physical health outcomes and are at risk of dying earlier than their general population peers,” says Dr McBain.

“These antipsychotics cause side effects and it’s really important for GPs to be aware of that, no matter what they’re prescribing them for – and it’s even more important to be aware of the physical effects of these medications in patients with major mental illness.”

A real-time report generated by the practice management system identifies those patients taking antipsychotics in the past year who have not had a cardiovascular risk assessment, their BMI, HbAlc, lipids and blood pressure checked, or, for smokers, brief advice to quit.

She says the reporting and follow up has already hugely increased Compass Health GPs’ awareness of the need to pay closer attention to the physical health care of their patients who are prescribed antipsychotics.

“It is helping to identify underlying issues earlier, enables proactive intervention and will reduce the impact of long-term conditions.”

The quality initiative is part of Compass Health’s commitment to Equally Well, which aims to improve the physical health of people experiencing mental health and/or addiction issues.

Lynn's medical career

Primary care quality improvement, service evaluation and the factors that enable practices to deliver better patient outcomes are of particular interest to Dr McBain, whose distinguished medical career began somewhat by chance when she was at school in Nova Scotia, Canada.

“There weren’t many career options in those days, so the school counsellor suggested medicine because I was good at science and mathematics. No one in my family worked in medicine and I was the first to go to university.”

She developed an early interest in medical politics, becoming president of her medical school’s students’ association.

After qualifying, she relocated to British Columbia for her internship. “Just moving to the other side of the country was quite an adventure in those days.” It sparked a desire to travel further, so when she saw a job advertised in New Zealand, she applied.

She didn’t get that job, but a while later, in 1984, received her first ever telegram offering her a house surgeon position at Hawera Hospital.

“In those days, there weren’t enough New Zealand graduates to work in rural hospitals, so there were a lot of us from different countries. I really enjoyed it.”

In time, after also working in Gore, she moved to Wellington where she met her husband Peter and joined the Brooklyn Medical Centre she now co-owns.

In the late 1980s she became involved in the GP-led establishment of Wellington’s first after-hours clinic.

“This was a big thing for Wellington GPs because before that, each practice had to do their own after-hours on call. We shared ours with another Brooklyn practice and one in Island Bay.

“I was keen to see the after-hours clinic established because I wanted to have a family and I knew being on call for an entire weekend wasn’t very compatible with family life.”

In fact, the Wellington clinic opened the week Dr McBain’s first child was born. “It worked so well for my career, raising our family.” Something of their mother’s influence obviously rubbed off on the couple’s children - one is a nurse and the other two are in medical school.

She was also involved in establishing the Wellington Independent Practitioners Association (IPA) – a group that collaborated on general practice service innovation and development.

“We were one of the original six practices involved in the Wellington IPA in the 1990s and I was also on the board.” The IPA developed into Capital PHO and then Compass Health.

Dr McBain has a strong interest in clinical governance and quality improvement in primary care. She chairs the regional Laboratory Alliance Leadership Team, the Impairment Committees for the New Zealand Education Council and is a member of the Professional Conduct Committees for the New Zealand Medical Council. She is also a member of the Pharmaceutical Society of New Zealand’s national executive.

In 2011 she was awarded the Distinguished Fellowship of the Royal New Zealand College of General Practitioners.

Two upcoming New Zealand Medical Journal articles about appropriate prescribing and monitoring of the anticoagulant Dabigatran and of the antipsychotic Quetiapine point to another of Dr McBain’s particular interests – medication safety.

She has been involved with Otago School of Medicine Wellington since 1995, initially as a contract teacher, gradually combining her clinical practice hours with a half-time academic role.

She has also served on Compass Health’s board. “Our rotation policy means we can only serve a maximum of three terms, so when I was coming to the end of my third term last year, I was looking for a different challenge and became Compass Health’s Medical Director.

“I also took on the role of Head of the Department of Primary Health Care and General Practice at Otago School of Medicine Wellington, where I’ve increased my academic hours while continuing to work three half days a week in clinical general practice.”

Dr McBain says her move into both medical management and academia was a natural progression. “I’ve had a fantastic combination career and feel I can present a much more balanced point of view when I’m teaching or advising practices because I own a practice and understand the pressures.”

Dr Lynn McBain