80% of the health problems in the United States are chronic diseases. We spend more money per person on healthcare than any country on the planet. Why might we be in the dismal embarrassing Health System Ranking of 70th by the World Health Organization? We are doing more poorly than countries like Columbia and Costa Rica. What is wrong with this picture? (1)
Halstead Holman, MD. Dean Emeritus of Stanford School of Medicine has written and published articles in medical journals such as the one below published in the Journal of the American Medical Association. (2)
“It is axiomatic that medical education should prepare students well for the clinical problems they will face in their future practice. However, that is not happening for the most prevalent problem in health care today: chronic disease.”
“The inadequacy of clinical education is a consequence of the failure of health care and medical education to adapt to 2 related transformations in the past 50 years that are central to good health care today. In the first, chronic disease replaced acute disease as the dominant health problem. Chronic disease is now the principal cause of disability and use of health services and consumes 78% of health expenditures. In the second, chronic disease dramatically transformed the role of the patient.”
“The differences between acute and chronic disease are substantial. Acute disease is episodic. The patient is usually inexperienced and passive while the physician administers treatment.” (see the full text of the article at reference (2) )
Dr. Halstead writes that we need a new medical training approach for physicians to help those with chronic (long-standing) health problems. The acute care (emergency-room) model of health care in ineffective and far too costly for most of our chronic disease problems.
In the book, “Living a Healthy Life With Chronic Conditions”, co-written by Dr. Halstead, the approach is to teach people to manage their chronic disease whether it be heart disease, diabetes, arthritis or asthma.
The book includes a nice chart contrasting the different care approaches. The chart has been modified and expanded below.
As you can see, the medical system works well for the acute care approach. Our medical model is failing miserably for helping the chronic disease care. So our medical doctors are left with the option of managing the symptoms of chronic diseases. Their primary treatment of choice for chronic diseases management is medications.
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