Your Health - Life or Death Situation. So Pick your Management Consultants with Care......
The World Health Organisation (WHO) has just released a report showing that one patient in ten entering a British and most other European hospital ends up suffering “measurable harm”. The 10% risk to patients being caused by blunders, superbugs, faulty equipment and drug side effects. The risk is three times greater than in the US, but much lower than in Australia, where the risk factor is 16.6%. That’s interesting. I’d never have known that last bit about Oz.
If you are American I wouldn’t be too complacent about this if I were you. A 4% risk of harm is still far too high. And consider this. The American Medical Association (AMA) recently released a survey showing that well over 100,000 people were killed in US hospitals every year by correctly administered medicines. How many people do you suppose are killed by incorrectly prescribed medicine? And this is only in hospitals. How many people would you guess are killed by both correctly and incorrectly prescribed drugs by doctors outside hospitals?
The number must be truly horrendous. Far exceeding the homicide rate, and probably on a par with road deaths, cancer and heart attack. You’d have thought that there would be one hell of a public stink about such a figure, wouldn’t you? But there isn’t. Now why do you think that is?
Well, I can think of several reasons.
We’d all prefer not to think too much about serious illness and death. Medicine is a complicated subject we can never fully understand and we’d much prefer to leave it to the doctors whom, we’d like to believe, like demigods can heal us of practically anything. If we think about it we know it’s not like that. Doctoring is a much more human and imprecise art than that.
Taking Responsibility
The main thing is to resist the temptation to abdicate responsibility for our own health to someone else, no matter how well qualified. It’s your body, ultimately you are the one to decide. If you are the CEO of a successful company and you have a problem, you might consult experts but you wouldn’t let them run the company would you?
Picking a partner to work with in the lifelong enterprise of your health is probably one of the most important decisions you can make. And yet, millions of people, who could make a choice, don’t. They leave it up to chance or geography. Of course, there are many millions more who are not in any position to make a choice and are lucky to receive any medical attention at all. So if you do have choice, you are one of the lucky ones and should exercise the privilege.
Doctors come in all shapes and sizes. For the most part they are dedicated men and women who do a great job. They have undergone years of training and will know more than anybody about the human body and what can go wrong with it than anyone. Only a fool would ignore such a reservoir of knowledge. I mean, if you’ve been in a car accident you don’t go to a naturopath to put yourself back together do you? But that does not mean you should not select your doctor or doctors with the utmost care and be sure that they’re what you need.
The Man in the White Coat
The traditional medical training was developed in the 19thC in the great teaching hospitals of the time. It was very structured and authoritarian. The first thing a medical student was taught was to depersonalise the doctor/patient relationship so that emotion did not enter it. The patient was simply a body or a symptom to be treated. Through his initiation in an esoteric art the doctor assumed a mantle of authority and aura of omnipotence. As an intern a young doctor is put under enormous stress so he or she can perform adequately, if not well, under the greatest of pressures. No wonder then that medical students are famous for their ghoulish sense of humour. The de-mystification of the human body is a necessary initiation into the healing arts that requires the slaying of the anima. At worst it may degenerate into a process of desensitivisation, even brutalisation.
A friend of mine told me how this moment was for him. It was an early pathology class at medical school. The cadaver of a beautiful and entirely whole 12-year old girl was wheeled in. He knew exactly what was going to happen and that there was no way he could take up a knife and dismember that perfect little body. In that moment he knew he could never realise his vocation and be a doctor. And yet, when the time came he could. His mind went to a different place where all that mattered was to find out why that young girl had died. This is a defining moment and necessary part in the making of any physician.
It was, he said, years later that he understood how important it was to re-incorporate the anima into his persona, both as a healer and a human being. Unfortunately that is not a required part of ongoing medical education and nobody teaches you that. It either comes with life, or it does not. And for many it never comes. My advise to you when selecting any doctor or specialist is to find the ones who do treat you as an entire human being and not just a walking symptom. That is so much more than a comforting bedside manner.
Watch out for Dr. MLM!
Money is a big factor to look out for. Doctors have as much right as anyone else to make a good living. Some do very well indeed and deservedly so. Others work hard with great dedication for long hours and get paid very little. What you should avoid are those doctors who have become businessmen rather than physicians. You’ll know them when you see them. Pushing MLM products via their practice is one indicator. Having you in an out of his or her surgery in under 10 minutes is another. If that happens you are simply not being heard and that is not good doctoring. Avoid too those doctors who are too busy to answer your questions or become irritated when you ask them. It either means they don’t know the answers, or they find it an impertinence that you should question them in the first place. Often it’s both. Doctors are busy people and you should respect that. Do not waste their time, inform yourself as much as possible beforehand so that your questions are relevant. A good physician is not afraid of telling you that he doesn’t know when he doesn’t. Nor are they above looking into an avenue of treatment you may suggest if they’re not already familiar with it.
Intervention v. Prevention
Despite the undoubted marvels of Western diagnostic, surgical and pharmacological medicine, it only goes so far. Essentially, it will keep a few rich folks alive a while longer. If they found a cure for all cancers tomorrow it would only add 2 years to the average life span. The basics of hygiene, good diet and healthy lifestyle would add decades for the rich and the poor across the planet. The key question facing us is intervention v. prevention. Both are necessary, but hi-tech medicine is where the action and the money is. If a fraction of all the money spent on intervention was directed toward educating people how lifestyle modification could improve, and prolong their lives, and on low-tech mechanisms to improve water and sanitation etc., untold billions of lives would be saved. Prevention is by far the most effective and cost-efficient allocation of medical resources. Yet it is the poor relation.
In the question of socialised v. privatised medicine, both are needed but neither system works well. In fact they are breaking down. The Institute of Medicine for the US National Academy of Sciences announced this week that, “the American health care system is incapable of meeting the present let alone the future needs of the American public”. The cost of private health insurance increases at 12% p.a. and yet delivers fewer benefits. The number of uninsured increases every year and right now 41.2 million Americans or 14.5% of the population have no medical cover.
Private medicine is overspecialized. Like an upturned pyramid there are far too few general practitioners struggling to cope, serving a host of specialists, who may work wonders treating the symptoms of their speciality (your disease) but may have little to contribute to your overall well being or even keeping you alive. The whole system, funded as it is by medical insurance, is now at breaking point. Yet the huge and increasing number of uneccesary surgical procedures is a cause of deep concern.
In Europe and other developed countries things are no better. Most systems of subsidised medicine are also in danger of breaking down. Costs have risen dramatically, despite the downward pressure of centralised governmental decision making on procedures and drug purchase. Doctors and nurses are poorly paid and who can blame them for decamping to the private sector. People wait years for badly needed operations. The standards of medical treatment vary enormously. It becomes a lottery.
Pushing Old Drugs Kills
I came across a striking example of this recently. New Zealand used to have one of the most admired state systems around. Not any more it seems. A person I know there has early osteoporosis and was prescribed a drug called Didronel. Now I have good reason to know that almost 10 years ago this drug was actually found to cause more hip fractures and early deaths. Although it appeared to put on bone mass, the bone was old and brittle and as a result the drug is no longer commonly prescribed.Woops! they said, Sorry! But now we’ve got a new drug....... and since then they’ve come up with Fosamax, Evista and Actonel. Ten years on, what on earth is the New Zealand government and their medical system doing subsidising and prescribing a drug which they know causes more bone fractures than if you didn’t take it all? This person is now on Fosamax, which is non-state subsidised and costs US$8.00 a pill. That is 8 times more expensive than what you’d have to pay for it in the US, which is more expensive than most places. So much for socialised medicine! One can only wonder what other out of date and dangerous drugs are being foisted on an all too trusting population? And I don’t think NZ will by any means be unusual in this.
Who Can Afford Cover?
It should be clear to all but an ostrich that things cannot go on as they are. Medical insurance premiums for the best levels of cover are reaching absurd amounts of money. Soon only the very rich will be able to afford them. Premiums become even more prohibitive as you age. And worse, some insurers will even toss you out of their schemes entirely aged 65 (watch that!). Subsidised state medical systems are becoming so overloaded they simply cannot cope. The populations of most countries are aging and growing fast. They depend on a shrinking base of young and employed taxpayers to look after them. You don’t have to be a demographic genius to know that spells trouble not so far down down the pike.
There are no easy answers, but some things are clear. The very rich will always be able to afford the best of treatment. Corporate senior management and their families will be fine. The rest of us will have a problem. It is absolutely right that money should be spend on research and pushing the boundaries of medical knowledge as far as they can go, for that eventually benefits us all. It is also clear that the dream of first class treatment for everyone is a vision beyond our competence, at least for the foreseeable future. There will just have to be different levels of treatment which people will have to pay for according to their means, either privately though medical insurance or via the state through taxes.
The only ray of hope that I can see is if there is a radical shift in the allocation of resources, talent and money toward disease prevention. This isn’t an easy option. It will shift the demographics of dying. The rich will be OK, as always, but the middle classes will be squeezed having to pay more or receive less subsidised treatment and they will resist that. The poor everywhere will be the greatest beneficiaries by the improvement in basic health amenities. But overall it is in everybody’s best interests. The essential principle is an obvious one. The more we prevent people getting sick, the more resources we have to treat those who do get sick.
“ Lifestyle” Diseases
Most importantly, our perceptions have to change. It is a brutal fact that most of the chronic diseases that actually kill us are optional. They are life style diseases. If enough of us took greater responsibility for ourselves so as not to get sick it would free up untold resources. That means taking an honest look at your lifestyle and bothering to find out to what extent it is likely to prevent or contribute to your having a heart attack, getting cancer, a stroke, diabetes or any other of the top killers of our day and age. And then do what’s necessary. It’s not hard, the information is all out there. The essentials are simple enough: eat right, don’t eat too much, exercise, don’t smoke or drink excessively and try to be happy. Knowing that is of course the easy bit, then you’ve actually got to do something about it......
You can’t expect young people to think like this of course, and perhaps they shouldn’t, but somewhere between 30 to 40 you need to take stock. If you think you can live hard and when your time comes you’ll go out like a light, Good Luck! It’s possible, but I wouldn’t bank on it if I were you. The odds are against you. You need to get rich or take care of yourself. Better still, do both! Finding yourself an doctor of integrative medicine with whom you can work is key. And just remember, in the venture of your good health you are not only the CEO but you own all the shares.
Insert Quote :
What on Earth is the NZ national health system doing still dishing out a drug for osteoporosis nobody prescribes anymore, because 10 years ago it was shown to actually cause hip fractures......?
ParacelsusAsia
Comments or queries
ParacelsusAsia@yahoo.com
