Heroes Not Zombies

Karol Sikora, a well-known “cancer doctor”, just said this –

It doesn’t make much difference whether you are one of the people who get cured or not

He was talking about cancer care in “the NHS” (as a Scot, it bugs me every time when people refer to “the NHS”, as if there only was one). I suspect he was saying things in a controversial way to promote his new book, but this particular sentence really caught my attention.

He’s referring to how organisations and systems can be managed to work “efficiently”, and I think this probably applies to most health care systems around the world. We’ve developed a way of delivering health care as if individual patients don’t matter. Protocols are created based on the statistics from research into the experiences of groups of patients. I’ve even heard a young doctor say they were told that if a patient takes an evidence based drug and it doesn’t work, then either they haven’t taken the drug or they are lying. These are the kinds of things which happen when doctors take their eye off the ball.

When we base health care on management systems designed for industries which produce physical objects to sell, then, it seems, statistics become king.

It doesn’t make much difference whether you are one of the people who get cured or not

Really?

In what way does it not make much difference? To the individual it makes all the difference in the world. To the doctor? Shouldn’t it matter if this individual gets cured or not? Isn’t that an irreducible fundamental of all medical codes of behaviour? It’s always this patient, this very patient I am dealing with right now who has the right to the best possible care I can provide.

I struggled a bit to find a photo to go with this post then stumbled across this one of a sculpture I saw recently in a garden. It seems to capture that sense of caring for the individual. And it seems the character’s hair is standing on end. Maybe the little bird just told him what Karol Sikora had said!

We can’t accept this way of delivering health care, can we?

This story also made me think of those pretty pointless statistics you can see every day on billboards at railway stations, telling you what percentage of trains arrived on time this week. Should we deliver health care by aiming at percentages of patients properly cared for? Or should we deliver health care by always, I mean always, giving the very best care and attention to every single patient in every single interaction?