A 12-Step Program for Healthcare?

Addictions often stem from things that are meant to serve a valuable purpose (e.g., food, pain medication, etc.). But, with over-use or obsessive need…. despite negative consequences, addictions develop. Often, there is a desire to change circumstances, change actions to get better results and/or change to lead a more satisfying life. This change happens through the 12-steps of recovery.

So, you’re probably wondering what any of this has to do with healthcare. Right?

Does Healthcare Suffer from Addictions?

Don’t get me wrong.  There are many good things that happen in healthcare. I’ve been involved in it for over 36 years, and have seen amazing healing, life-saving interventions and smiling patients.  Yet, I hear from family, friends and professionals in the field that there is a systemic void in care as it is experienced, failures along a number of fronts and a dire need for real change.

This awareness leads me to the following questions.   Might valuable tools or practices be overly used to the point of blinding reasoning and practicality?  Is the experience of care diminished by industry obsessions?  It strikes me that healthcare may be stuck in a set of addictive cycles, unintentionally resulting in negative consequences.

6 Areas of Fixation or Habit Where Dependence Exists

I see six areas where an addiction may likely exist.  Remember, all of these represent good, valuable aspects of healthcare…but with over-reliance, over-usage, habit and infatuation…negative consequences can arise.

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To illustrate, let’s look at real-life comments on the consequences of each.

The Negative Consequences & Dissatisfaction

Words from the people who use the healthcare system today:

  • On Technology: “With all the technology, healthcare is far less  personal.”  ”The computer screen gets more attention than me!” “I waited over 2 weeks for the  ’systems’ to exchange my MRI and CT images, readings and reports, from one facility to another. I was beside myself. So I finally drove over to the hospital, demanded to pick up my information and delivered it myself to my doctor, so that we could get my cancer treatment started.  I can’t believe everyone else was content to just keep waiting and waiting, with nothing moving, while I’m panicking!”
  • On Cure it/Fix it: “I go in for a problem and that’s all they want to look at.  It’s in and out.  Fix the problem.”  ”I can’t believe my doctor doesn’t listen to my chest or examine me when I go in.  It’s like he’s only there to fix my problem and not really care for me.”  ”I have multiple medical issues.  But when I see the doctor we just focus on the problem I’m having that day.  Isn’t it weird that we don’t talk about my other conditions?”
  • On Data/Big Data:  “Data this, data that….are we treating data or a human?”  ”All this talk about ‘big data’.  Seems like we are getting lost in all that data and not  treating individuals anymore.”   “The nurses don’t talk to or touch patients much anymore.  It seems all they do is pass out pills and document on their computer.  I asked why that’s the case, and she told me that the hospital collects all this data and their performance is evaluated based on this data”.
  • On Evidence-based: “If science can’t prove it then they don’t even consider it”.  ”I really want to know what my doctor’s clinical experience is instead of hearing about some studies.”  ”Has medicine lost touch with practical solutions?  What about what I want?”
  • On Rx/Prescribe it: “Why is the fix always a pill?”  ”You gotta wonder, when you have to pay a lot more  out of pocket for a medication….is the doctor being financially motivated by the pharmaceutical company to prescribe that drug, versus one that will do the job and won’t cost me an arm and a leg?!”  ”I was beyond shocked when I went to see my doctor about my high cholesterol.  I admitted right off that I had gained some weight.  She didn’t even talk with me about my diet or what  I was eating.  She didn’t even give me a hard time about exercise…that was a surprise.  She just said I needed medication to get my cholesterol level down.”
  • On Profit Maximization:  “There’s little time for me.  When I finally get a chance to ask questions the doctor’s gone.  How many patients does he need to cram in to make a decent dollar?”  ”I don’t trust decisions anymore about my care when they mention ‘too costly’ or ‘cheaper alternative’.”  ”So, the hospital just spent all this money on a fancy new building….tell me why they can’t afford to get more nurses and staff to take care of people who need care?”

Change & The 12-Steps

The mantra for change sounds familiar to that which I was hearing in the late 70’s, when I was a freshly minted RN.  Understandably, for something as complex and huge as healthcare, change doesn’t come fast or easy.

So, what if we looked at a program that’s successfully brought about change and transformation to the lives of billions worldwide?  What if we centered our focus on the people for whom healthcare is intended?  What if we listened to their experience of healthcare, as a means to making change?  Here’s one way a 12-step program might look, borrowing from the formal programs for those with addictions:

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A New Reality

I know that to some this analogy might seem trite and, for others, change in this manner seen as unfeasible.   The danger we face is to continue believing we’re doing all the right things absent the wisdom of voices from those who have experienced care in a system with which they are unhappy.  A 12-step program for healthcare…now wouldn’t that be revolutionary?!?!

 

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