Tag: public health

Future of Healthcare: Trends & Challenges

I see a future where healthcare will be in people’s mind as well as on their wrists, in their wedding rings and on their pens! It will be different, not only because it will be everywhere, but also because it will be in an individual’s own hands.

As we move away from the concept of ‘sick care’ to the concept of  ‘health care’,[1] the two basic needs have emerged.  First, the ability to connect an individual with a healthcare system [2]. Second, the ability of an individual to take care of his/her health [3].

This means that we have to think of healthcare as being away from centralized institutions like hospitals or health centers to people’s homes and their minds and form new patient-centered networks. We also need to redefine healthcare professionals as people who monitor and advice people on health in addition to curing disease. This de-institutionalization of healthcare and an increase in its ambit will mean the evolution of new ideas for monitoring, diagnosis, prevention, and treatment of disease [4].

Many of my colleagues in India think of this idea as prevention centric, however, new concepts and programs such as parkinson.net have demonstrated that taking healthcare out of the infirmaries into patient’s own home is as much about disease treatment as about prevention. In fact, the best thing about ubiquitous and networked healthcare is that it makes a whole continuum about health, prevention, disease and cure very much patient-centered while making the pitfalls verifiable [5].  This ensures improved care in the entire spectrum of health. Further, it also takes us closer to holistic health by considering and addressing various phases of health care.

However, there are various barriers and challenges to this type of healthcare. A lot has been said about the economic benefits of this type of healthcare. However, in my opinion, the economic benefits even though huge and long-lasting will not be immediate. In fact, by increasing the spectrum of care we might as well end up increasing the total cost of healthcare in the beginning. There will be some obvious sideways advantages like an improvement of growth in healthcare sector and jobs, but the real economic benefits due to reduced disease burden and per-capita expenditure on disease treatment will take some time to show. Another challenge will be about making this ubiquitous care really ubiquitous. Use of technology is dependent on financial status, literacy, and availability of resources, therefore, that there will be disparities based on these factors!  This means that it will make health care for all an even more far-fetched dream.  There are other challenges like ethical challenges and data confidentiality etc. which have to be addressed.

Therefore, even though we need to move forward towards this new phase of healthcare; our future researches should not only concentrate on making new ways to provide this new healthcare but, also on how this healthcare could be more beneficial, foolproof and universal.

References:

  1. Fani Marvasti F, Stafford RS. From sick care to health care–reengineering prevention into the U.S. system. N Engl J Med. 2012 Sep 6;367(10):889-91. doi:10.1056/NEJMp1206230. PubMed PMID: 22931257; PubMed Central PMCID: PMC4339086.
  2. Tomines A, Readhead H, Readhead A, Teutsch S. Applications of electronic health information in public health: uses, opportunities & barriers. EGEMS (Wash DC). 2013;1(2):1019. Published 2013 Oct 28. doi:10.13063/2327-9214.1019
  3. Pomey MP, Ghadiri DP, Karazivan P, Fernandez N, Clavel N. Patients as partners: a qualitative study of patients’ engagement in their health care. PLoS One. 2015;10(4):e0122499. Published 2015 Apr 9. doi:10.1371/journal.pone.0122499
  4. Technology and the future of healthcare. J Public Health Res. 2013;2(3):e28. Published 2013 Dec 1. doi:10.4081/jphr.2013.e28

5.      Thielst CB. Social media: ubiquitous community and patient engagement. Front Health Serv Manage. 2011 Winter;28(2):3-14. PubMed PMID: 22256506.

Manovember!

Dear Readers,

moustache

 

Many chronic and lifestyle-related diseases have a high predilection towards men [1]. Two of the most common modern epidemics – diabetes and cardiovascular disease have been consistently found to be more common in males than in females[2,3]. On the other hand, silent epidemic of depression in males has been mostly left unacknowledged and often under-diagnosed and untreated [4]. This has led to an increased incidence of suicides among men [5]. On the other hand, many cancers have a higher incidence in males as compared to females [6].

However, traditionally the domain of men’s health has either been left neglected [7] or has been limited to sexually-transmitted disease and malignancies of the prostate. Instead, due to taboos, discussion on men’s health has often been detoured into domains of physical fitness and diet [8]. Popular and commercially available literature fans these prejudices and makes venturing into men’s health issues like depression and suicide even tougher. It has been seen that men rarely if ever talk about their depression, stress and anxiety to even their closest ones. This leads to an increased impact of SAD trio and poorer outcomes. In 2017, the World Health Organization (WHO) gave the slogan – Depression, Let’s talk! in order to improve people’s attitude towards depression and make more people get themselves treated [9, 10].

As November closes in, various public health campaigns on men’s health like Movember and No-shave November have started gathering momentum. Our team at Vivact has picked this opportunity to make November a month on men’s health. Our boys have decided that they would write a blog on men’s health each week – particularly targeting the epidemic of depression among men. We will have a weekly article on this topic for the whole month as a part of our initiative named – Manovember! We invite you to discuss and think of men’s health this month to realize the goal of health for all.

Regards.

Team Vivact!

References:

  1. Sex and gender differences in health. Science & Society Series on Sex and Science. EMBO Rep. 2012;13(7):596-603. Published 2012 Jun 15. doi:10.1038/embor.2012.87
  2. Weidner, Gerdi. Why do men get more heart disease than women? An international perspective. Journal of American College Health6 (2000): 291-294.
  3. Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278-316.
  4. Ogrodniczuk JS, Oliffe JL. Men and depression. Can Fam Physician. 2011;57(2):153-5.
  5. Ogrodniczuk J, Oliffe J, Kuhl D, Gross PA. Men’s mental health: Spaces and places that work for men. Can Fam Physician. 2016;62(6):463-4.
  6. Dorak MT, Karpuzoglu E. Gender differences in cancer susceptibility: an inadequately addressed issue. Front Genet. 2012;3:268. Published 2012 Nov 28. doi:10.3389/fgene.2012.00268
  7. Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men’s health gap: men must be included in the global health equity agenda. Bull World Health Organ. 2014;92(8):618-20.
  8. Men’s Health: What Should We Know?. World J Mens Health. 2015;33(2):45-9.
  9. Chong, Siow Ann, Yee Ming Mok, and Mythily Subramaniam. Depression: Let’s Talk. 2017; 121-123.
  10. Behere PB, Kumar K, Behere AP. Depression: Why to talk?. Indian J Med Res. 2017;145(4):411-413.

Pain at midnight…

I opened the door in a partial slumber. It was a familiar face of the lady next door. She had been my favorite one as a kid…..

MES18_01_3a

I often played with her daughter, and would sometimes have dinner at her home as my mother kept calling for me. I liked what she cooked, and moreover, it was fun! That was long time back! However, tonight her face at the door couldn’t stop me from feeling irritated.

“I couldn’t get your number, and your uncle was in immense pain….” She seemed embarrassed. It was well past midnight, and she had apparently been ringing the doorbell since past 10 minutes or so before my mother answered it.

I quietly picked up my spectacles and slipped off the front gate into the cool night breeze that made me a little less sedated. When I reached him, the very look at his face made the pain obvious. It was just a small tooth in his mouth, and his entire life hung at its mercy at that moment!

He had already taken two doses of ‘Flexon’. It was useless. There was no other painkiller that they had. It was 1am. All the medicine shops or clinics would be closed, and this guy really needed relief! The doctor inside me didn’t know what to do. We were never taught this at the college, but, sometimes our education impacts our thinking so much that we stop thinking like humans. If only we could! As I thought about all the medical procedures that could stop the pain, the lady softly murmured, “I wish I could drive….”

It just struck me, that being a doctor isn’t all you need to cure suffering. Sometimes being human could benefit more. I just rushed back, grabbed my keys and drove to the 24 hours pharmacy at the nearest hospital. On my way back, I had two thoughts in my mind. The first one was that how easy was this! The second one was that what if this were a village and we had nothing around to get the medicine from?

As I handed over the medicine and stayed with him till he was fine again, my mind was preoccupied with the thought of a person in pain at midnight in a village. Though I was able to relieve that pain for him that day, my heart goes out for all those fellow countrymen who have to spend nights in pain because they have nowhere to go. As we relieve individual pain, we sometimes forget that real healthcare will be achieved only when we have pain relief for everyone a stone throw away, even at midnight!