The field of medicine is a significant pillar of society; it ensures the wellbeing of people so that they can have a good quality of life. With this being its main objective, modern medicine focuses on treating a health problem once the patient has presented themselves with possible symptoms or concerns, usually at a primary care institution such as a general practice. The global health system must come to realise that this system is flawed; the key reason for this is the lack of early symptom detection. Most diseases (most notoriously cancer but also others such as heart and kidney diseases) do not show any red flags until a stage when possible treatments are not effective. In addition to this, some diseases (usually chronic) do not currently have any known cure or treatment with a high efficacy so they may be fatal once symptoms are detected.
These are major hurdles that the medical profession needs to jump so that mortality rates can be suppressed and public health can be improved substantially. One of the strongest solutions is the focus on preventing people from getting the disease in the first place. In other words, disease prevention.
Roots in ancient medicine
The concept of disease prevention is not new; it has formed the foundational teachings of many ancient medical systems (e.g. Ayurveda medicine). They understood the significance of holistic treatment and how it can be incorporated into one’s lifestyle to prevent disease. Activities that centred around holistic treatment involved meditation, yoga and other non-invasive activities that aim to improve physical and mental wellbeing. It is time that we learn from the past and implement those lessons into our modern healthcare system.
Blueprints for Improvement
The task ahead is colossal as it requires a lot of change to a system that we are all used to. Therefore, it is essential that we have a basic skeleton of the benefits and how they can be embedded in the healthcare system.
Before we go through the health-related yields of this system, it is important to note the economic advantages. Prevention attempts to prevent infection and therefore the build-up of harmful symptoms. As a result, successful prevention can significantly reduce the financial burden on national healthcare systems (e.g. the NHS) due to the reduction in demand for resources (like ICU beds, expensive medication and treatment) needed to treat the symptoms. For instance, the NHS needs to acquire insulin for the treatment of people with type 1 diabetes. But they are paying roughly £400 per person on an annual basis; this is more than five times the average cost! By focusing on how diabetes can be prevented from developing in patients, (especially with people who have a family history that puts them at higher risk) it helps reduce these inflated costs that are controlled by corporate companies. This is just one of many ways that costs can be cut, making healthcare more economically sustainable.
People can suffer from physical and mental health problems. The latter is sometimes underestimated but can be a serious issue. For example, PTSD is a mental illness where the patient can face emotional distress and physical pain. Despite these severe symptoms, the NHS states that PTSD patients need to present symptoms for more four weeks before they are referred. This is shocking; by that time, they could have developed depression, isolated from family members, suffered from sleep deprivation etc. Has the healthcare system got a heart? Are they considering the patient? To tackle this, healthcare must give all people advice and guidance on how to stay physically and mentally healthy so that they do not develop a condition that causes them harm, specifically helping to avoid mental problems such as depression.
This is focus on holistic care is present in GPs but is only explored if the patient presents with problems. A change needs to be implemented in general practises because this is a place where 90% of patient contact occurs and is usually the first place people go to when they experience health problems. A plan for the future would be to increase social prescribing (e.g. ParkRun) and fitting that around the lifestyle of every person, regardless of whether they already have problems. Though this would put a strain on non-clinical social care, it is more financially viable to maintain good health than spend resource when serious health problems are developed.
Non-discriminant advice should also be given on diet, exercise and lifestyle choices. For instance, if a person has told their doctor that they have been smoking, assistance and guidance should be actively encouraged to help them stop smoking as soon as possible. This would prevent the patient developing problems (such as cancer, pregnancy problems, respiratory or cardiovascular diseases) which can be harmful or fatal for the patient and economically expensive for hospitals that need to provide the necessary treatment. To reiterate based on the example, prevention would be the best option rather than helping the patient after he has developed problems like cancer which could be very hard to successfully treat.
Normality of Life
Disease prevention is in the best interests of the patient. By not developing health conditions, they have less disruption in their daily lives. For example, if an alcoholic has suffered from liver failure and is need of kidney dialysis, their routine will be severely affected, meaning that they might not have time to complete work and socially interact with others. In addition to this, health insurance can be more expensive for people with conditions such as diabetes. Health problems can hinder an individual’s progress in society so prevention can reduce the chance of people being disadvantaged.
Looking towards the future
The NHS has already initiated a plan to prioritise disease prevention called the Five Year Forward View in 2012. This transformation will require GPs to work more closely with local non-clinical care centres, making these two sectors the core of primary care.
General check-up appointments can be utilised to not only diagnose and track progress on a condition but also to provide guidance towards holistic care and healthy lifestyle habits (e.g. yoga, meditation etc.). Patient literacy needs to be improved for this to work; informative posters and leaflets play a key role in this. These are the first baby-steps need to be taken in this long-term transformation. The change must run parallel with the treatment of patients with existing health conditions. The ultimate, idealistic goal is to achieve excellent public health which includes physical and mental wellbeing.
Let us raise awareness of this target so that our healthcare system can evolve for a better future.
Written By Surya Senthilkumar
The King’s Fund. 2017. How Does The NHS In England Work? An Alternative Guide.Available at: https://www.youtube.com/watch?v=DEARD4I3xtE&t=1s [Accessed 15 June 2020].
NHS, 2018. Treatment -Post-Traumatic Stress Disorder (PTSD). https://www.nhs.uk/. Available at: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/treatment/ [Accessed 15 June 2020].
Geissler, H., 2020. NHS Is Paying Five Times Over Cost Price For Insulin.Express.co.uk. Available at: https://www.express.co.uk/news/uk/1022879/NHS-is-paying-five-times-over-cost-price-for-insulin [Accessed 15 June 2020].
NHS, 2020. Symptoms -Post-Traumatic Stress Disorder (PTSD).https://www.nhs.uk/. Available at: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/symptoms/ [Accessed 15 June 2020].