I am a physical therapist who has been working in healthcare for nearly 20 years. Over that time I have worked in all types of settings: skilled nursing facilities, outpatient clinics, schools, hospitals and home health. I see two unfortunate common themes across all of these settings; the emphasis on increased productivity and siloed healthcare. Both of these do a disservice to both patients and the treating clinicians. Relating to productivity, the clinician goes home at the end of the day tired and stressed. The patient walks out of the medical office thinking, “why did I even bother with that appointment?” I know this because I have been “that” provider and I hear the complaints from the patients I work with. Additionally, specialization in areas can have a deleterious effect if you are only using this one frame to view the patient. As the psychologist Abraham Maslow said, “if all you have is a hammer, everything looks like a nail.” In fact, this morning, I was with a patient who told me she has had chronic back pain for 15 years and nobody knows what is going on. “It doesn’t seem like they really care. They make me feel like it is all in my head, but I know it’s not.” Is it always the patient’s fault that improvements aren’t made in their health or are we looking through too narrow of a lens or perhaps the wrong lens entirely? And what could we uncover if we had the ability to spend more face to face time with our patients? All of us need to look at the current model of healthcare and question if we are doing this right.
I suggest a paradigm shift. 1) Healthcare workers need more flexibility in their schedules to be able to provide their undivided attention and listen for understanding to each patients' individual concerns. 2) Practitioners should take a step back to see how all of our body systems are interconnected. This may include more collaboration between “team members” which also requires more time. 3) Medicine needs to stop looking at the averages and assigning these values as “normal” for everyone. 4) We should identify and educate sooner on how lifestyle changes are critical in managing chronic disease even when the numbers “aren’t that bad” versus waiting until the problem exist in force. 5) Providers and patients need to dig deeper and identify the upstream problems instead of band-aid remedies to symptoms, passing the buck onto a different provider or worst of all dismissing the patient’s concerns altogether.
We must make this shift now to an integrative health model. And we must stand up to the corporations who are demanding more from our time and losing sight of the most valuable person on the “team”, the patient.
Let me know one way you can help facilitate the necessary shifts to providing the highest quality healthcare.
