Two papers published in the Lancet recently present contrasting views of the future of health care. Researchers in Scotland highlighted the fact that many people with chronic conditions suffer from more than one disease at a time.
The study looked for 40 chronic conditions among the participants’ data. Researchers found that 42% of patients had one or more conditions and 23% had two or more. It also found that only 9% of those with coronary heart disease, had that one disease alone. Similarly, only 23% of those with cancer, had only cancer and no other long-term disease
Why is this such an important point? Well, as the authors of the paper say
“Any country with an ageing population is heading in this direction. All these countries are waking up to the problem. “The status quo isn’t an option because it leads in the wrong direction.” Prof Watt said that rather than more specialists, patients with multiple conditions “need someone who can oversee all the problems of a patient”. “These patients need continuity, and we need ways of measuring how well care is joined-up.”
They highlight the need for more generalist approaches where the patient is seen in the context of their whole life, and that in particular people need continuity of care, co-ordination of care, and individualised care.
we’ve actually learned is that, whatever your level of cholesterol, reducing it further is beneficial.
“If we are going to prevent that half of cardiac or stroke deaths, then we’ve got to consider treating healthy people. “It can’t be done any other way.”
Well, that’s a phrase that raises my “aye, that’ll be right!” antennae – anyone who claims “there is no alternative” is pushing their personal view of the correctness of their own opinions too far! We see that with economists, politicians, and scientists. But we live in a complex world and we cannot reduce human life to such simplistic analyses and expect the predictions to work out. The claim of these latter researchers that putting all 50 year olds onto statins for the rest of their lives would “save 2000 lives a year” is pure fantasy.
Which vision appeals to you more? Individualised, holistic care, or mass medicating based on age alone?