When I think of the strengths of our conventional Western healthcare, several things come to mind. Among them are amazing robotic surgical advancements, trauma care, and the availability of sophisticated diagnostic radiology. However, the areas where it seems we fall short of our potential are prevention and chronic disease management. If we use the acute care model to name a diagnosis and right away look for a medication to treat it, we will have missed the patient’s whole life story. That story often never gets a chance of being heard, while it almost always points to the root cause of the presenting illness in a holistic manner.
The “Name it, Blame it, Tame it” medical care model is one of the reasons why our healthcare spending is projected to grow at an average annual rate of 5.4%, reaching 6.2 trillion dollars by 2028. Indeed, we have the highest health expenditure per capita of any civilized nation in the world. And in this present healthcare paradigm, 55% of Americans take at least four prescription medications a day, and the rates of obesity, hypertension, and diabetes are rising in our country at unprecedented rates.
How the System FAILS Caregivers
Since the days of my emigration from Ukraine in 1986, I have observed a rapid deterioration of the heart of our medical establishment. Doctors’ time spent with the patients became infinitely devalued by insurances, and this became a no-go for doctors taking their time to really listen to the patients.
One American women physicians even revealed that:
- 75% said managed care negatively impacted their ability to practice medicine
- 77% reported fatigue and burnout
- Top causes included bureaucratic tasks, lack of autonomy, low compensation, and little respect from administration.
A doctor who is inundated by all of these woes is unlikely to be able to practice compassion and serve the patient’s complex needs instead of trying to quickly fix them. For doctor-patient relationships to work, time spent with each other matters.
The Holistic Power of the Patient’s Story
There are many chronic diseases where listening to the whole story is of paramount importance: high blood pressure, depression, acid reflux, migraines, irritable bowel syndrome, elevated cholesterol, autoimmune disease, and chronic fatigue, to name a few. Instead, patients often feel rushed, unheard, and are extremely sensitive to how they perceive their doctor’s attitude towards their illness.
And this perception affects healthcare outcomes. In fact, an older study found that the less empathetic and less thorough the doctor was during the encounter, the longer the duration and severity of the illness lasted. Interestingly, in that same study, not seeing the doctor at all was better than seeing a doctor who was perceived to be overly quick and non-empathetic by the patient!
Reclaiming the Heart of Medicine
Before the heart of medicine is lost, we should focus on compassionate health care in which we listen intently to the patient’s story and design the healing protocol in the context of the patient’s daily living situation. Naturally, physicians who partner with their patients in addressing social and emotional aspects of chronic illness have better outcomes in patient anxiety, function, symptom improvement, blood pressure control, sugar control, and pain management.
This doctor-patient partnership and collaboration IS the holistic heart of medicine, which we all should strive to preserve.
