What Were the Key Influences on the Reformulation of Health Care System - Essay Example

Biomedicine The WHO ambitiously defines health as 'A of complete physical, mental and social well being, not merely the absence of disease andinfirmity' (WHO, 1946). Biomedicine may be broadly defined as the branch of medical science that applies biological and physiological principles to clinical practice. (Source from website www. wordnet.princeton.edu/perl/webwn). Medicine is a branch of health science concerned with maintaining health and restoring it by treating disease. Medicine is both an area of knowledge (a science), and the application of that knowledge (by the medical profession and other health professionals such as nurses). Source en.wikipedia.org/wiki/Biomedicine The basic underlying principle of the health care system is to treat disease on the basis of diagnoses arrived at by using symptoms and investigations. However, the effectiveness of treatment based on this rationale has been questioned. This process, which often overlooks patients' specific environments, everyday experiences, social conditions and the external environment, has been reviewed with a different angle. During the last few decades, there has been much criticism associated with this rationale. A number of 'new' concepts have been introduced in the medical discussions, such as illness, health, life quality and function. This has heralded a need for change in the everyday practices of parts of the health care system. This healthcare system that consists of general practitioners, public health personnel, nurses and paramedics has been changing so subtly, that it has not kept pace with the momentum of change in the medical arena made more complex by the population explosion and healthcare issues. This is especially true of the initial diagnostic visits between the patient and the doctor where the primary encounters occur. This is also ripe for change in the preventive health care segment where a lot of earlier sidelined concepts have now started to emerge. Recently, concepts of health and illness have been changing from before. The comprehension of health and illness has been changing due to input fuelled by perspectives from many disciplines. Health has now become a more holistic concept and has benefited by the increasing acknowledgement of other sources like biology, environment, social position, and the role of the mind, culture, spirituality, race, and sex, that influence health and well being. These have served to widen the realm of focus on the issues of health and illness. The health care systems are now more of a social model of health and this could explain the reasons for the increasing use of alternative therapies such as homeopathy, natural healing methods, acupuncture etc. Last, but not the least, stress has been accepted to be a major causative factor, and prevention and stress management methods seem to be a great approach to managing health proactively. This creates more focus on prevention than cure and more reasons to treat the causative factors rather than the symptoms of the disease. The main influences that have initiated a need for the reformulation of biomedicine may be attributed to a number of causes, some of which have been discussed as follows. Rising costs of health care are not matched by corresponding gains in population health; in particular health inequalities seem to take an upward trend. (Hallam, 2003) Managed health care has become so commercialised that it has become a luxury rather than basic need to be able to access medical care when essential. Modern investigative medical tests and treatments are expensive, rendering it unaffordable to a lot of people in the society. Individuals are bereft when they are unable to afford the huge insurance premiums, especially, the lower socio economic groups. This results in postponement of a visit to the doctor until really chronic, thereby not only missing opportunities to diagnose serious illnesses earlier than later but adding to the burden of the healthcare system by the extensive treatment that would now be required. Since insurance companies and governments bear the burden, public health authorities around the world are moving to reduce total health expenditure by rationing or restricting medical resources. There are rigid conformities required with respect to the number of patients to be seen by the doctors and the physicians and this has compelled doctors to almost function on a automaton. A doctor-patient relationship is a thing of the past and a cursory impersonal visit often leaves the patient with a lack of confidence and the doctor missing out on crucial vitals. Sometimes, consultation each time occurs with a different physician, thus losing the knowledge gained by the doctor-patient relationship. Although healthcare policing and health care reforms are much in the news, they are more often linked to profits than to humaneness or public health considerations. Healthcare reforms that are profit driven and have politically vested interests will not contribute in increasing the overall competence of the system. Being plagued by total lack of transparency is another bane of the current scenario. Transparency of information is another critical factor defining a delivery system. Access to information on conditions, treatments, quality and pricing greatly affects the choice by consumers and also reflects upon the incentives of medical professionals. Medical research has definitely progressed and yielded results. However at the same time, it is largely performed in controlled settings and is often not closely related to the realistic environment. Often the drug trials are shorter when compared to the actual time taken for the side reactions and drug characteristics to be known through documented real life situations. Also the genetic characteristics of the animals experimented upon and the final drug consuming human beings are vastly different thereby affecting the course the disease might take. Clinical trials undertaken in current times require patient consent and this while protecting individual rights, often renders more bias in the trials due to awareness and psychological interactions. Another important reason would be the exaggerated outcomes about the efficacy of conventional treatment by the drug companies. These companies spend enormous amounts on research and vie with each other to be the first entrant and patent the drug. Spurred by the urgency to market their drugs and seize a piece of the market, they often f down play the effects and negative effects on patients' quality of life due to drugs. In extreme cases, when the fatal or chronic side effects are manifested, these drugs are pulled off the market, but the damage has already been done to hundreds of unsuspecting patients. This has led to public criticism of treatment standards and outcome measures. A very common iatrogenic effect is caused by drug interaction, when physicians fail to check for all medicaments a patient is taking, and the newly prescribed drug causes unfavourable interactions. The well known resistant strain of bacteria emerging due to evolution of antibiotic resistance is iatrogenic as well. Due to antibiotics being over prescribed, and people not completing the requisite dosage since they are symptomatically better, it has accelerated bacterial evolution towards resistance. A plain error of misreading handwritten prescriptions by the doctor, wrongful dispensing of medicine by a pharmacist and lack of clear instructions on ingesting the drugs may cause a setback to the patient's condition. Nothing is permanent except change and the healthcare and medical field is no exception to the rule. Health is a dynamic process incorporating the multidimensional states of wellness and illness. It is influenced by social, cultural, political, economic and environmental conditions of society in which we live. Individual, group, and community health are intertwined. When a healthy environment is fostered through ambient conditions, it goes along way in improving the wellness of an individual. Wellness occurs when the human being is in harmony with both internal and external environments. A sense of well being experienced by people often translates into better health for the individuals. The connection between mind and body is a proven one and being at peace with oneself is considered a genuine solution for health and wellness. Thus medical progress that is commercialised, enhances risks by its medicines, is unaffordable to the public and poses hidden threats is questionable as true progress at all. When we consider how illnesses are exaggerated to the point of being accepted as the norm rather than an exception and popping pills is no longer given a second thought, the question whether current medical progress is truly a step forward arises. Mental illnesses that were considered a manifestation of simple day-to-day stresses are now hyped up and are often labelled stigmatising the individual in the eyes of the society. Many insurance policies even shy away from offering coverage for mental illnesses making counselling sessions more unattainable. Healing is a dynamic interplay between the mind, body, and spirit. It encompasses the capacity to examine the challenges and opportunities that illness presents, with an aim to restore optimal wellness. Changing concepts have brought to focus that lifestyle changes like not smoking and reducing consumption of alcohol etc can contribute significantly to reducing illness. While the prevalent healthcare performs well in surgical cures for emergency medical situations, its greatest challenge lies in being accessible to the common man, rather than being an elusive entity that is beyond reach at critical times. Only when health care is shaped predominantly by those who genuinely need it, the only accountable parameter are the health outcomes, can we pragmatically expect to see consistent and progressive improvements in the standard, quality and outcome of modern health care. The reformulation also needs to readdress medicine to treat the mind, body and spirit of the individual, and understand where he is coming from and incorporate it into his cures. Addressing the cause rather than his symptoms and steps promoting wellness tailored to his individual needs will be a welcome and refreshing change. Allowing nature to help heal and reducing dependency on instant cure, while not hesitating to factor in alternative therapies with an open mind, will result in overall quality of health. Sources "Challenges of Biomedicine" [Online] http://www.univie.ac.at/virusss/cob/lang=en 1 Feb 2006 Williamson Graham "Global Health Trends" [Online] 17 June 2005 http://www.holistichealthtopics.com/HMG/medicine.html 1 Feb 2006 Furedi, Frank "Our Unhealthy Obsession with Sickness" [Online] 23 Mar 2005 http://www.spiked-online.com/Articles/0000000CA958.htm 1 Feb 2006 Gold, Lawrence " Care, Cure and Sufficiency" [Online] http://www.somatics.com/carecure.htm 1 Feb 2006 "Iatrogenesis" [Online] http://en.wikipedia.org/wiki/Iatrogenesis 1 Feb 2006 Hallam, Adrienne Louise, Globalisation, Public Policy and Health, Chapter 4 in Globalisation, Human Genomic Research and the Shaping of Health: An Australian Perspective, Australian Digital Theses Program, Griffith University, 2003 Holmes, Leonard PhD" The Problem(s) with managed care" [Online] http://mentalhealth.about.com/library/weekly/aa112497.htm 1 Feb 2006 Journal, Engel, G.L "The need for a new medical model: a challenge for biomedicine" Science vol 196, p129-136 (1977) Doyle, Rodger Pirnie "How Medical Facts Are Developed: Why Some Are More Potent Than Others" [Online] 6 Oct 2004 http://www.quackwatch.org/06ResearchProjects/doyle.html 1 Feb 2006 "Medicine"[Online] http://en.wikipedia.org/wiki/Medicine 1 Feb 2006 Read More