Shifting from Managed Care to Self Managed Care
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Self care is a basic and timeless health practice dating back centuries. Self care refers to nursing a cold, assisting a family member through recovery or hospicing a dying person at the end of life. We have to look at health care through a different lens. While the intent here is to underscore self care and positive health practices, there are many books available on these subjects. The focus of this chapter is to retool your thinking from merely managing symptoms to uncovering causes.
Today healthcare providers spend huge sums of money diagnosing and treating diseases. Once the disease is diagnosed, then treatment of that disease begins—treatment that focuses organs and illnesses all in isolation of one another. Over the past 50 years we’ve all been conditioned to turn our healthcare decisions and self care management ability over to others and replaced it all with the drugs, procedures and the instant fixes of western medicine.
The missing piece in this approach is determining the cause(s) of the illness or the disease. If healthcare providers spent half the time seeking causes rather than just treating symptoms, we would drop the costs of healthcare overnight. How? I’ll give you a personal example.
I had been diagnosed with a low thyroid problem and a blood test was drawn. This test didn’t even measure the right amounts of thyroid hormone. Despite this reality I was prescribed thyroid medication and ongoing follow up blood tests. So my health insurance paid for the doctor visits, the lab tests and the subsequent medication—all designed to keep me (the patient) coming back for more lab tests and ongoing medication (prescription) renewals.
But the actual lab tests that would best uncover my problem were not covered by insurance; and the brand name medication I needed wasn’t prescribed because insurance didn’t pay for it. Yet, the question that was never asked by my physician was this one: Why does a healthy 40 year old have a thyroid problem?
What was my reason? The cause was mercury toxicity. Once I treated the cause (mercury toxicity) that was not covered by insurance, the symptoms for which I was treated (low thyroid) disappeared. My personal situation is not unique as no one physician manages the healthcare of the whole person. Too many of us have a “whole list of doctors” rather than a “holistic doctor,” And this subtle difference makes a huge difference in the practice of self managed care.
Self Managed Care
What is self-managed care? Self managed care means taking responsibility for managing your own care. It is that simple. There are three components to self managed care:
- Retaining good health;
- Recovering and improving health;
- Managing a chronic health condition.
Retaining Good Health
Retaining your good health happens at two distinct levels: individually and within your communities.
At the individual level your daily health practices such as eating well and exercising are the best methods for you to retain health. All the recommendations you hear about and your physicians advise. Again there are many books available on these subjects.
At the community level good health practices include ongoing sanitation, lowering pollution levels and accessing basic healthcare services. While immunizations and screenings played a key role in prevention, it has been social reform and public health campaigns that offered the greatest improvements in health. Better nutrition, monitoring food supplies and improved sanitation efforts helped to erase communicable diseases. Access to basic healthcare services prevent serious health conditions and keep people out of expensive places, such as emergency rooms. Unfortunately we have a long way to go here with millions of people still uninsured.
Recovering and Improving Health
No matter how hard you focus on wellness and prevention, illness and injury are a part of life. In fact, treating injury is where our western model of healthcare excels. We have mastered the science and the art of dealing with massive trauma which has given millions of people hope and recovery.
However, after the initial rescue our healthcare system falls apart. In fact, the United States ranks at the bottom of the world population in many health indicators such as life expectancy and infant mortality rates. We spend more than $8000 per person on healthcare yet have lower scores than some third world countries.
Managing a Chronic Health Condition
Chronic illness has surpassed acute illness both in prevalence and cost. A chronic health condition is defined as a condition that lasts for more than three months such as diabetes or asthma. Chronic illness does not have a single cause, a specific treatment or an individual cure. Managing chronic illness is where the western healthcare system fails. Why?
Healthcare providers treat chronic health problems with acute care medical approaches which cause tremendous harm. Why? We know the best methods in managing chronic health problems are through lifestyle changes and more importantly in finding causes and not just treating symptoms.
For example, Patty has diabetes and pays close attention to her blood sugar monitoring results, adhering to a diet and exercising to keep her weight down. Her goal is to avoid the consequences that out-of-control diabetes can cause (such as blindness, circulation problems or kidney failure). She knows that diabetes is not a death sentence and she can live long and well with the disease once she learns how to manage it. She prevents the chronic illnesses of neuropathy and kidney failure through effective management of her diabetes.
Effective management of chronic illness, such as diabetes, isn’t managed with just a pill or with surgery. Education, support and a commitment to self managed care is the best medicine. If we all managed are own health in the same way Patty manages her health, and if we all took that same responsibility we could drop healthcare costs overnight.