Reactive vs. Proactive Medicine

Doctor Apple“Our healthcare system is broken” is what a friend has written over and over in her blog that chronicled her experience in the final months of her husband’s life.  Her husband may not have died as a direct result of the gaps in our healthcare system, but his remaining months could have been less stressful had there been a better continuity of care.

Sadly, their story is just one of millions.  Everyone has a failed-by-the-healthcare-system story with varying levels of severity.

That said, I am a very lucky human being.  I won the birth lottery and was born in a first world nation with government-subsidized healthcare.  I have never had to pay for a doctor’s visit.  My husband has a gastrointestinal disease that has required lengthy hospital stays, weekly blood testing and more specialist appointments than a day planner could hold.  The only bill we’ve ever received (aside from medications) was for an ambulance ride he needed one night when he could not stand without passing out because he had lost too much blood.

My father in law died after his second battle with cancer.  In addition to many week-long inpatient chemotherapy treatments, he had 6 weeks where he received 2 radiation treatments per day, 5 days a week as an outpatient.  He had surgery to remove a football-sized tumour.  He and his widow never received a bill for anything.

It is for these reasons that I’m hesitant to complain too loudly about our healthcare system, because I cannot imagine how uninsured Americans are ever able to pay their hospital bills.   My 35-year-old cousin has had 2 open-heart surgeries to replace valves in the past 10 years.  How would an American ever pay for that?  It’s too much for me to comprehend.

Now that I’ve got the PC bullshit out of the way, the major flaw I see in our system is that it’s reactive instead of proactive. What if we put more value on preventing the disease than treating it?

Let’s look at nutrition.  Proper nutritional education is key in preventing or delaying life-threatening diseases like diabetes, obesity, heart disease, and more.  Our family doctors don’t have the time to educate patients on proper nutrition – they barely have time to see the patients they have!  It’s not uncommon around here to be dropped by your doctor if you don’t see them at least once a year.  On the flip side, doctors have been known to drop patients who require too much of their time.  Our family doctors are overworked as it is because there aren’t enough of them per capita.

Now let’s turn to mental illness.  My government will pay for psychiatric appointments, but not therapy appointments.  Because a registered, well-educated therapist cannot write a prescription, their work is not subsidized.  In the past 5 years I have seen 3 different psychiatrists.  None of them helped me even a fraction of what my therapist has.  I’ve been working with her for 4 months and I’m amazed at the progress I’ve made.

Again, I am a very lucky human being.  I was born into a first world nation to a middle-class family and both my husband and I hold steady, decent-paying jobs.  I am able to afford the $90/session cost to see a therapist.  It is saddening and frustrating to think of the countless number of people who are not lucky enough to be able to see a therapist.  I imagine that the positive ripple effect that would come from government-subsidized therapy would be far-reaching.

Imagine if someone who needed the help was able to see a registered therapist twice a month.  It could have the potential to help someone continue to be a productive member of society.

I am likely over-reaching and I loudly admit that I have zero concept of economics and the potential costs a preventative healthcare system could incur.  But on a human level, as someone who’s experienced a little bit of the system first-hand and as a caregiver, I would like to see patients having options that could help improve their future quality of life.

And with that, I will go to my family doctor tomorrow as a follow-up to a psych appointment I had 2 weeks ago and will discuss my new course of medication.  We’ll also discuss the results of an ultrasound I recently after an annual physical.  And none of this (other than medication) will cost me a dime.  I am a very lucky human being.

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2 thoughts on “Reactive vs. Proactive Medicine

  1. Gabor Maté “When the Body Says No”… http://drgabormate.com/writings/books/when-the-body-says-no/ I have been harping on about Gabor a lot recently – I am in New Zealand, we have a public health service that has saved my ass and is free. But then again, level of service is probably less than Americans paid for system. The relationship between attachment, mental health and disease or chronic illness is absolutely astounding. Pro – active would pretty much mean everyone goes to “health counselling”. The people doing YOGA and Balancing on One Leg whilst Watching the SUnRise whilst Going OOOHHMMMMMMMMMM *are* actually going to reduce their chances of dying from chronic illness.

    There are many risk management strategies. Drinking, smoking, working hard, being angry all the time, watching tv, eating McDonalds and generally being insecure and unhappy are not risk management. They are playing into the hands of the drug companies and the undertakers.

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  2. Uninsured Americans can’t pay their medical bills. 😦
    Interesting I found this blog tonight because when I was walking out of the pharmacy with 3 prescriptions that are taken on a regular basis , the thought came to me. I am so lucky to have insurance; and it made me sad for those who don’t. Last week I picked up 3 rx’s for a back spasm.
    I do have insurance and I do pay for my prescriptions and trust me I am not complaining.

    The lack of insurance in the US has a huge ripple effect. I don’t know how to fix it the insurance problem here, I wish someone knew how to!

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