August 22, 2008

The Healthcare Debate: Greater Access to a Failing System? -or- Why Are We Always Stuck on Stupid?

Earlier today, I came across a heated online discussion about healthcare. The conversation revolved around the usual hot topics in the health care debate: (1) access to care and (2) the costs/benefits of "socialized" v. private medicine. While the public and the media are arguing and obsessing over these important questions, a third and critical issue is ignored entirely. So, I had to jump into the fray:
Consumers of healthcare in the US need to understand that our healthcare problems are far more serious than costs and access alone. While access to the existing system is important, all the money and insurance coverage in the world won't fix a system that has unacceptable outcomes.

Traditional clinical medicine in the US is unable to help many people with chronic illness and, in fact, often makes things far worse. Medical mistakes and just plain bad medicine kill and sicken thousands needlessly every year. The system needs a major overhaul from a near-medieval reductionist approach to an approach that recognizes and respects the human body as a system. It must stop focusing on treatment of disease and begin to care for whole human beings--body, mind, and soul.

The Human Genome Project, for example, had to consult engineers and computer scientists to make real progress because biology and medicine utterly failed to consider genes in the context of the body as a whole. Computer scientists had to educate HGP scientists on the idea that the human body is a s-y-s-t-e-m.
If computer science approached computer problems the way medical science has approached medical problems, Bill Gates would be "Bill who??", and we'd all be communicating with paper and pencil. It's insane! But from this experience emerged the long-overdue field of systems biology. For more information, google "systems biology" and "reductionism in medicine."

Until clinical medicine approaches the human body as a system, until it shifts from attacking disease to healing human beings, and until doctors stop relying on drug companies for information and treatment protocols, all the access in the world won't result in the good health care we sorely need.
Check out these excellent articles at PLoS Med:
The Clinical Application of a Systems Approach
The Limits of Reductionism in Medicine

Clinical medicine must change!

1 comment:

Healthnews said...

Excellent comment.

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