The systemic inefficiencies you point out fail everyone in the American healthcare and it's sad. From what you've mentioned here, patients aren't positive they'll get the best care they need, and the physicians who care about their patients aren't able to provide the best support that they can.
That is sad and unfortunately mostly accurate. The main critique I've always had regarding modern medical practice in general, the model we are taught and incentivized to use is a symptom-centric model, where we wait for disease to manifest and then use the medical tools (mostly drugs) to address it.
What I believe is the best model to serve the healthcare needs of people is a system-centric model where we recognize that all organ systems in the human body are intimately interconnected and problems with one tend to affect many other systems in predictable ways. With such approach we can use medications to treat a symptom while simultaneously engage in identifying and correcting the underlying cause of the disease state. Medications, while useful and oftentimes necessary to prevent serious complications or mortality, most of the time are not a cure but rather a limited intervention in the dysfunctional process.
Many of what we call chronic conditions have an initial insult that triggers a compensatory or defensive mechanism that remains in place as long as the insult remains. Overtime these natural compensatory mechanisms worsen the original condition and are responsible for most of the symptoms we treat and for the disabling effects of the disease itself—is your body’s defensive mechanism turning against your own body.
A systems-centric approach would be more alert at identifying and appropriately addressing the trigger of the symptom and the system-wide mechanics leading to early intervention and perhaps even a cure in some cases (one of the most well documented examples is pre-diabetes reversal through early intervention). It will also allow for something we rarely do in modern medicine: prevention.
My objective with this series is document the many different points of failure of the healthcare system. Is a very complex problem that will not be solved by finger pointing at a single actor (is what politicians want everyone to do), but by fully understanding all the issues and addressing them honestly and dispassionately… that’s what the last piece in this series attempts to do.
As a chronic disease researcher in the Caribbean, I see we share some of the same problems. Our local public health systems are overwhelmed. Doctors are still using the same symptom-centric guidelines for care. Staff are demoralized because they can’t adequately treat with their patients for many of the same reasons you’ve mentioned.
But I can see a little hope for the future as programmes for prevention of NCDs at the school level are making a difference. Here’s to hoping both our systems improve!
The systemic inefficiencies you point out fail everyone in the American healthcare and it's sad. From what you've mentioned here, patients aren't positive they'll get the best care they need, and the physicians who care about their patients aren't able to provide the best support that they can.
That is sad and unfortunately mostly accurate. The main critique I've always had regarding modern medical practice in general, the model we are taught and incentivized to use is a symptom-centric model, where we wait for disease to manifest and then use the medical tools (mostly drugs) to address it.
What I believe is the best model to serve the healthcare needs of people is a system-centric model where we recognize that all organ systems in the human body are intimately interconnected and problems with one tend to affect many other systems in predictable ways. With such approach we can use medications to treat a symptom while simultaneously engage in identifying and correcting the underlying cause of the disease state. Medications, while useful and oftentimes necessary to prevent serious complications or mortality, most of the time are not a cure but rather a limited intervention in the dysfunctional process.
Many of what we call chronic conditions have an initial insult that triggers a compensatory or defensive mechanism that remains in place as long as the insult remains. Overtime these natural compensatory mechanisms worsen the original condition and are responsible for most of the symptoms we treat and for the disabling effects of the disease itself—is your body’s defensive mechanism turning against your own body.
A systems-centric approach would be more alert at identifying and appropriately addressing the trigger of the symptom and the system-wide mechanics leading to early intervention and perhaps even a cure in some cases (one of the most well documented examples is pre-diabetes reversal through early intervention). It will also allow for something we rarely do in modern medicine: prevention.
My objective with this series is document the many different points of failure of the healthcare system. Is a very complex problem that will not be solved by finger pointing at a single actor (is what politicians want everyone to do), but by fully understanding all the issues and addressing them honestly and dispassionately… that’s what the last piece in this series attempts to do.
Thanks for reading.
I agree, it’s a very complex issue.
As a chronic disease researcher in the Caribbean, I see we share some of the same problems. Our local public health systems are overwhelmed. Doctors are still using the same symptom-centric guidelines for care. Staff are demoralized because they can’t adequately treat with their patients for many of the same reasons you’ve mentioned.
But I can see a little hope for the future as programmes for prevention of NCDs at the school level are making a difference. Here’s to hoping both our systems improve!