Heroes Not Zombies

In today’s British Medical Journal, GP, Dr Iona Heath writes about how while the government talks about patient choice and patient centred care, in fact it is increasingly delivering a standardised, rule and protocol driven one-size-fits-all service. She links this dehumanisation of the NHS to the power of the pharmaceutical industry.

Only if doctors have the freedom to explore and explain options can patients be free to make their own decisions. Doctors who actively elicit the patient’s own values and priorities and support an informed decision based on awareness of both the possible harms and the potential benefits of a proposed treatment will reduce levels of pharmaceutical consumption. But, of course, this operates against the interests of the medical-industrial complex. If doctors are encouraged to offer standardised care, as they are under the quality and outcomes framework, pharmaceutical consumption rises and patient choices become constrained.

The growing gap — Heath 334 (7595): 670 — BMJ

This is a worrying trend. With the bureaucratic drive to “standardise” treatments, probably with the intention of attempting to control costs, patients are not encouraged to make individual informed choices about whether or not to start taking some form of medication. One of the consequences of this, Dr Heath argues, is that pharmaceutical consumption rises. Why is the NHS struggling financially despite record investment by the government? Partly because of rising drug costs.

This zombie-form of health care is not sustainable and the solution to the problem? A hero-form of health care. Heroes make free choices. That’s how they grow and that’s how they increase their health. Encouraging individual diversity is not only healthy for people, it’s healthy for the health services too. Probably the main losers are the pharmaceutical companies whose sales may be hit by patients choosing non-drug solutions to their problems.