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?
Heroes Not Zombies 
Well, personally I agree with this Dr here…http://news.bbc.co.uk/1/hi/health/3931157.stm
I mean he has a fine name appropriate to his calling. I think we really should be mass medicating people , all of them ….whilst we are at it put some ‘soma’ into loch Katrine and Glasgow will move along nicely in some kind of slumber of contentment http://www.huxley.net/soma/somaquote.html
People need to wake up to the fact that we are in a ‘new’ era of chronic disease management and new systems and approaches should evolve. The health professions should move to acknowledge this I feel , starting with the educational institutions .
Perhaps by understanding the interrelated nature of chronic disease physiologically and concepts such as allostasis could allow people to think about the wider influences on health. Practically, some of the rehabilitation and nursing professions could integrate and create a more integrated approach that would be less pharmaceutically driven ?
The status quo of repeated quick appointments to top up the statins/antidepressants/diabetes/cardiovascular medications and then sending people off to numerous specialist appointments surely is not the best way of going about things? Its ironic to me that only the most complex and long-standing issues are thought of as being appropriate for things like self management programmes and referral to your place?!
yours Ivan Ilich
Perhaps I’m in a particularly downbeat frame of mind this morning but the way I see it is that the healthcare industry is being driven by corporate needs. Human beings are treated as ‘resources’ designed to fulfil their employer’s need. They are reduced as people and are further reduced to working components. When something goes wrong with that human being then it must be fixed quickly to allow that person to resume productivity….or else obsolescence.Thus the drive for a pill for all ill. How then can the advocates of ‘slow medicine’ find a voice among the clamour for quick fixes?
Reblogged this on Science-based Homeopathy and commented:
con-med is undoubtedly a fantasy medicine
Have a read of “Pharmageddon” by Prof David Healy. It may open some of your eyes.