Chronic illness is one of the most demanding career challenges of our time. Though improved drug treatments have shortened the duration of these longer-term illnesses — the MRSA epidemic brought us the antibiotic-resistant superbug methicillin-resistant Staphylococcus aureus (MRSA) — experts expect longer-term illness to pose formidable challenges.
This past summer, two of the world’s best-known noted health writers published studies of how existing health literature could be updated for the era of influenza and pandemics. In “In Good Faith — Understanding Pandemics,” Thomas Watson presents the case that should have been taught at medical school 10 or 20 years ago.
Moreover, in “In Good Faith: Literature to Take Care of Yourself and your Family” Fredrick Wilhelms coolly lays out a way to help us better understand the reality of pandemics.
These have often been underestimated and under-disseminated. This usually occurs because we long ago stopped thinking of patients as “human beings.”
At the turn of the 20th century, the definition of “patient” consisted of a human being. Anyone diagnosed with a disease was considered “a patient.”
The term was officially dropped in the 1940s. I’ve argued for this change for decades. In school you teach that patients may be unable to study, they may never master English, they may have poor social skills, and they may lack good doctors and nurses. That’s all true. But it’s not how patients think, what’s normal.
Our lives are unique. We have only “one body” and we each have unique needs. Patients may need to eat alone. They may need to dress alone.
Patients often resist doctor’s orders (of course they do. Many think they’re not sick enough.)
We think of patients as healthier than they actually are. We used to equate health with the number of pills they take. Patients were labeled “senior citizens” and their prescriptions were described as “medications for the elderly.” But seniors often included patients who were so fragile that their medications reduced their ability to take them.
Many patients prefer to take their meds in their own home rather than in a doctor’s office. But the holidays can become a time when they can’t, even to see friends. Loved ones go to watch them take their pills.
Government regulation reduced costs and delays associated with hospitalization. More patients live home. But the many barriers that patients lack might require their medical care to be provided at home, in nursing homes or at long-term care facilities (LTCF).
But for busy parents, the time off gives them more time to be at home. Many avoid developing dementia.
Prison or nursing home has long been considered an obvious option. But there are also better options, such as LTCF or hospice. When CVS Caremark completed its merger with Aetna, CEO Larry Merlo said, “We will be one of the key healthcare companies that will evolve in the coming decades.”
The stakes of reducing risk and over-the-top fees associated with forced hospitalizations seem clear.
When Michael J. Watkins says patients and care providers should talk with each other, we think of therapists and counselors. But doctors are important partners too.
We can’t assume doctors will understand our needs, or care about patients as patients. Still, some doctors’ intuition has not left us and we should be ready to listen to it.
Even as our relationships with the doctors improve, we have to balance our refusal to always trust them with our recognition that the health of our patients is our business.