How I Accidentally Became a Gonzo Healthcare Journalist in a Melbourne Café
Sometimes, I wonder if I’m an industry plant. Or maybe it’s everyone else in the room, and I’m here to observe, connect the dots, and report back. I wasn’t even supposed to be working in this café today—I was just early for a catch-up with a friend and figured I’d make use of the time, so out came the laptop for some emails. But, without my usual noise-cancelling headphones, I found myself fully immersed in the animated conversation of a lively group of friends, perhaps in their mid to late 60s, at a nearby table.
Then another man walked in, greeted with warmth and laughter, and the conversation began in earnest. And that’s when my ears pricked up. Here I was, wondering if I’d become the accidental gonzo journalist of the healthcare ecosystem, out here on the front line.
As I listened, the man shared a story about attending physiotherapy to help improve his mobility. Their conversation centred on his post-orthopaedic surgery rehab through a private physiotherapy provider. This also happens to be an area I know deeply, having had the privilege of managing community rehab teams and sitting on the executive of a connected hospital service in my previous tenure. It also happens to be one of my favourite spaces to ideate over, and here it was, a live case study unfolding right in front of me. So, keyboard at the ready, this unplanned moment became a fascinating collision of anecdote, expertise, and ongoing advocacy—right here on a mundane Thursday in a quintessential Melbourne café.
It turns out this man had been attending physiotherapy as part of his rehab plan post-surgery. He attended his first session and paid out of pocket, assuming it wasn’t covered by his insurance, only to receive a call from the physio provider later to find out it actually was, and so too would a series of sessions. This moment of discovery highlighted a gap that’s all too common in healthcare—people often don’t know what their coverage includes until they stumble upon it by chance, if they’re lucky enough or literate enough to understand. Doctors often recommend community-based treatment or even specific private providers but don’t know or suggest asking if it can be funded as part of the associated hospital episode or through their private health insurance extras, etc.
The $100,000 Question
As the discussion continued, one of the other friends shared another story—this time about a recent surgery that cost ‘their’ insurer $100,000, according to the statement they received. The table was aghast at the cost, and the conversation quickly turned to the value of preventive care. “That’s why insurers should be investing in and paying for programs like physio and exercise physiology,” one remarked. “It’s simple maths.” And yet, this straightforward equation—prevention costs less than cure—often gets lost in the system fragmentation.
As someone with deep healthcare expertise who by this point is actively eavesdropping with no shame, I continued listening… and it’s at this point, I was actually wondering if I was in The Truman Show—could this conversation really be happening? I couldn’t have scripted a better user insights session if I’d tried!
The Invisible Bridge
The conversation then took another thematic turn when one of the friends mentioned that they were now seeing a new cardiologist, a “well-known specialist” especially known for his prevention-first approach. To which one of the people at the table quipped, "Isn’t that how all doctors should practise?" Touché, I thought to myself. But as someone who has worked in health for a long time, I also understand that preventive medicine isn’t the lens that all practitioners come from. I don’t say that because we don’t know it’s a great framework or because health economists haven’t for years shown the data as to why governments should fund our system this way but because it’s more nuanced than this. Generationally, as a clinician, you may not have been trained from this stance. Further, Western medicine’s philosophical approach was not historically rooted in preventive methodologies, and it continues to not support how our public and often private funding models are set up. Most of us who have had to try and describe symptoms or experiences in a ten-minute window in a doctor’s appointment, or recount in a twenty-minute appointment how the previous three doctors you visited tried to get to the bottom of a complaint, understand this nuance (with no disrespect to doctors, who are often also overworked and booked back-to-back under these MBS billing structures).
Then the table started discussing why they felt doctors and funders should focus on preventive approaches and programs. At this point, I was convinced I was either in The Truman Show or inside a glitch in the matrix. Or perhaps it was simply a very powerful reminder that what I’ve been working toward and advocating for throughout my career, as well as what I try to imbue in my design processes, actually does reflect what the people I’ve been working on behalf of have always told me and importantly I’ve always listened to the lived experience of - we (that is the healthcare system and it’s custodians) are actually not doing well enough in meeting their needs in the ways they want them met or expect.
We’re witnessing a unique opportunity in healthcare. On one side, we have an ageing population both ‘burdening’ our health system, some of whom are also actively interested in maintaining their health and independence. On the other, we have funders and providers with preventative programs and products already in place, and clinicians who choose prevention-focused practices. Between them all though lies an invisible bridge of missed connections and lost opportunities.
So, this raises an even more fundamental question: How do people find these aligned services, products, funders, and practitioners? how do they even know to look for them? How do funders ensure that their customers understand the true value of their policies, or, in the context of public health, what preventive programs can be scaled for good at a low cost?
The Three-Part Problem
The challenge before us breaks down into three interconnected issues:
Health Literacy Gap: People often don’t know what they don’t know. Many, like the man I overheard, are unaware of the preventative services available through their existing insurance coverage or public health services, whether community, not-for-profit, or online.
Provider Visibility: Clinicians, whether doctors or allied health, practising prevention-focused medicine within legacy models such as hospitals or private practice often lack effective communication channels with reach that integrate through to consumers who would most benefit from their approach.
System Fragmentation: Funders, whether private or public, despite having clear financial (and social) incentives to promote preventative care, struggle to meaningfully communicate the pathway to these services or offer them at scale to their end users at the right time in the right way.
The Bigger Question: Why Are These Dots So Hard to Connect?
Reflecting on this conversation, I couldn’t help but wonder: why do we have all these essential services and the willingness to engage with them, yet consistently fail to connect them at the points where they’re most needed? In so many other industries—take tech, for instance—intuitive design has transformed how we engage with products. Companies like Apple have shown that when design and communication are seamless, users can access even the most complex functionality almost instinctively, without needing an instruction manual. Yet we in healthcare continue to struggle to transpose this in this legacy industry (not all some entrepreneurs are disrupting as they should, and we should be paying attention to them).
In the broad healthcare ecosystem, this kind of seamless communication and design remains elusive. Is it a failure of providers and funders to clearly communicate the benefits? Or does it reflect a broader systemic issue—one where healthcare struggles to align its services and convey their value at the most critical junctures?
Bridging the Divide
The solution I continue to advocate for is about connecting existing dots, amplifying user-generated stories, and clarifying fragmented pathways. We need to stop expecting and asking non-experts to do the heavy lifting in a system that even those of us on the business side understand is too complex to fully ‘crack.’
Imagine a healthcare ecosystem where:
Human-centred design is embedded across the entire ecosystem—not just in marketing and ‘products’ but also in contracting, technology, operations at every touch point internally and externally with your business.
Insurance providers develop clear, accessible platforms and touchpoints allowing their members to realise the value of their preventative care options.
User-generated content becomes part of your core business, not leaving it sitting in its decentralised format, but rather inviting it inside to add value to your offerings and strengthening your strategic intent.
Providers have a channel or mechanism to signal their focus on prevention, alongside traditional curative medicine.
Patients can navigate their healthcare options as easily as browsing restaurant reviews or swiping on their next Tinder match.
This overheard conversation reaffirmed my core tenets for a vision of a health ecosystem where providers and funders—whether private insurers or government—meet people where they are, informing and empowering them to make proactive choices about their chosen pathways and care options. Imagine a system where users don’t have to hunt for what’s covered, or guess what might help them, but instead are guided seamlessly, engaging with healthcare as intuitively as any other well-designed service or product.
This café chat may have been casual, but it underscored a vital point: our healthcare system has many of the necessary pieces. Now, the challenge—and opportunity—is to bring them together in ways that allow people to take control of their health journey before a crisis hits. After all, if we can’t make preventive, community-delivered care intuitive and accessible, we’re leaving far too much on the table—for individuals and for the sustainability of our healthcare system.
If you're looking to bridge the gaps in healthcare, from strategy to design and communication, let's connect. At Dialectical Consulting, we specialise in creating healthcare solutions that meet people where they are—helping providers and insurers deliver impactful, user-centred care. Reach out to explore how we can transform your approach to healthcare via info@dialecticalconsulting.com.au or contact me via LinkedIn.
