Maybe its not just in mental health – maybe our whole approach to healthcare is making us sick – or at best not helping us get well and stay well….
Can a system designed and optimised to apply 19th and 20th century industrial models of organisation of resources to tackle infectious diseases work for the kind of chronic illnesses we now face?
How does a “factory” model designed to make it easy to deliver industrial healthcare interventions requiring capital intensive machinery, OR theatres, and highly trained physicians help with the kind of chronic illnesses that many folks live with today. Maybe that model doesn’t suit so well and nto that one model of ‘healthcare delivery” we need to develop a different, more social approach like the one in Grmany mentioned in the article.
Our current institutions are based on glamour, attracting large research grants spent on technology and a race to find the cure and donations to build magnificent edifices which serve many good purposes but also lead to “patients” feel they have less and less power over their own bodies and lifes.
It’s difficult to make a connection between all that and healing.
How can our existing model of large institutions marshalling huge technological resources, and in which we “the patient” play a largely passive role, work for the kind of illnesses we now know are on the increase?
Especially with chronic illnesses, the choices we make daily play as a important a role as any other – be it our genes, our environment, our experiences of life and the medications and other tools available to us. Even with current vogue for talk about “patient centred care” in our healthcare system it is still the healthcare professions who decide what that looks like.
system for the delivery of medicine
Too often it seems we don’t have a healthcare system but a system for the delivery of “medicine” .
In this the experience of the patient plays but a small role: the first person experience is regarded so often as merely ancillary.
So much more money and energy is spent on guarding against or controlling the risks that patients represent – patients create work, ask awkward questions, make personal demands- or horror: patents might sue! … than is ever spent on listening to patients or asking patients what they think they want or need.
Yet more radical, how about working with patients so they can contribute to designing an improved experience?
To often it seems people worling inside the system have become worn down by it – snared in a thinking trap and – minded to belive that the system would likely work a lot better if only they didn’t have to deal with patients..
Yet the vast majority of people in healthcare joined to do th e oposite and often feel as ill-treated, trapped or powerless as patients might. “People behave according to the systems they are in”.
It’s tough to make connections between a system that so clearly makes so many of it’s own workers tired, stressed, burned out, and ill can “deliver healthcare”.
In an insightful article from EYE Weekly, Aug 2011 by Brian Keenan- in which he asks questions like this and talks with Sholoum Glouberman, Philosopher in Residence at Baycrest Healthcare, and founder of Patients Association of Canada.
There are different approaches available to us..The article briefly mentions an example of “social medicine” pratised in Germany: a system created within neighburhoods in which neighbours help each other learn how to look after themselves and expensive equipment assets are based in the community. Not only does it help people learn to take a bigger role in looking after themselves but it also strengthens community bonds that reinforce people’s connection with each there so individual and community health improves.
Keenan contrasts this with it’s equivalent in UK – big hospital, highly trained staff and high tech approach which costs more, “delivers poorer outcomes” as the terminology goes, and is proving difficult to sustain.
Patients’ Association of Canada
for more on the Patients Association of Canada and its work trying to reform Canadian Healthcare through in a different kind of advocacy- not by yelling, raising angry shaking fists or suiing but by working with healthcare organisations .