Our general perception of healthcare has three basic steps: get ill; do
something; get better. However, the pressures on the NHS mean that this is not
sustainable. Does the answer lie in use of technology or eHealth? A future
where doctors prescribe Apps as well as medicine? This was the subject of my
talk at Cornwall’s first TEDx event last month, TEDxTruro.
The ‘do something’ step has a number of familiar options in it, including taking a rest, light exercise, seeing your GP, having tests, taking medication or some other form of more significant medical treatment.
There is a general belief that if we are ill, we will ‘get better’, eventually, and that this process is sped up by assertive healthcare and medical support.
However, about 30 per cent of us don’t get better and are left with one or more long-term conditions, such as chronic pain, diabetes, heart problems, neurological problems, injuries and often disabilities.
The starting point for my TEDxTruro talk was to ask the audience to imagine what it is like to live with a long term medical condition that has no cure. For some it would not be difficult to imagine – they may already be living with that reality, or caring for a loved one with a chronic illness. I wanted them to really understand the frustration and despondency that can set in when people don’t get better.
When people don’t get better they often revert to their doctor for more tests, more interventions, more reassurance and more monitoring. In our society, we don’t have a common narrative for how we ‘live with’ a significant health problem in a way that is meaningful and without suffering.
The cost of these 30 per cent of patients with long term conditions accounts for 70 per cent of all healthcare costs in the UK. These numbers are on the increase. Medicine gets better at keeping us alive – but with that comes increased longevity and associated complex conditions.
The demands on healthcare will ultimately mean that the three step model (get ill; do something; get better) will be outdated and in fact cause our health systems to collapse. A new model is needed.
A fourth step – ‘adapting and coping’ with health problems will require a society wide shift in how we see health.
The first solution will likely be an understanding of how someone lives with a long-term condition. How they accept their condition, learn to be compassionate to themselves, adopt new health strategies that are not about cure but about living (these include pacing, relaxation, mindfulness, positive thinking) and design new lifestyles to fit new limitations.