The purchase and installation of new technology in any environment generates excitement—whether it’s in the office, school, hospital or home. Owning the latest technology is exciting.
There is a certain seduction in owning the ‘latest and greatest’ technology. And for decades, the sales departments of manufacturers have played the ‘status’ card in their persuasive sales pitches. In the education field, school storerooms around the globe are filled with equipment that no one on site was trained to use properly, and no one was trained to maintain or repair.
Over the last 50 years a revolution has occurred in healthcare with pacemakers, artificial joints, organ transplants, and now, a whole new horizon is opening with stem cell research. However, just as in education, many developing countries find themselves flooded with sophisticated medical equipment they can neither fully utilise nor maintain.
The technology salesmen have sold medical equipment even to the nations in which the local health issues do not warrant such expenditure, As a result, technology sales usurp the resources that are available for basic healthcare. This misallocation of resources happens not only in the US but also in every other nation.
The development of national Health Information Technology (HIT) programmes, on the other hand, could help to reduce healthcare costs and improve safety in delivery to patients. Others nations’ experiences in developing national HIT provide immediate and salient lessons for organisations and nations just beginning the process.
Still, the implementation of any technology carries the risk of diminished attention to the patient’s well-being. The evolution of medical care in the US over the past 60 to 70 years is a demonstration of myopia brought on by focussing on the wonders of technology.
Until the mid-1930s the American Medical Association coexisted fairly well with naturopaths and other health practitioners. Many MDs incorporated forms of natural healing into their practices, such as herbs, baths, breathing and exercise programmes. As the chemist labs cranked up in the 1930s, MDs began prescribing pharmaceutical drugs instead of homeopathic or herbal remedies. Between the two world wars, great strides were made in surgical techniques.
Advances in surgery and the development of pharmaceutical drugs combined to sweep mainstream medicine towards a more technological approach to healthcare. By the end of the 20th century the consequences have grown dire.
Deadly reliance on pharmaceuticals
Americans, who are only 4 per cent of the world’s population, consume about 50 per cent of the world’s pharmaceutical drugs. A study of US hospital emergency room visits published in 2006 showed that 700,000 ER visits annually are due to interactions or contraindications of pharmaceuticals. Since most ER admissions are undiagnosed or misdiagnosed, the authors of the article in JAMA (18 October, 2006) suspect this number is an underestimation.
Add to the 700,000 visits to ERs, 100,000 deaths annually from pharmaceuticals. So, every year nearly one million Americans are killed or seriously injured due to use of pharmaceuticals, but you won’t read this in the mainstream American media. The public’s health has become secondary to business interests: pharmaceutical advertising is a major revenue source for broadcasters and print media since 1998, and American media are almost entirely owned by conglomerates.
The loss of other medical models
With American medical education heavily supported by the pharmaceutical companies and medical students learning no other forms of treatment but ‘pills and scalpels’ common sense, non-tech treatments and traditional treatments for health are being forgotten.
At a health conference in September 2008, an executive of the Robert Wood Johnson Foundation told the 700 in attendance a story of his patient whose stool tests indicated possible cancerous cells. He was advised to have a colonoscopy, but he had limited funds, and Medicare wouldn’t cover the full cost. Unable to obtain an estimate of his personal costs for the test from area hospitals, he chose instead to buy a much-needed furnace for his home instead of getting the test.
Apparently the MDs couldn’t recommend any other courses of action, other than a colonoscopy and chemotherapy, so the patient died of colon cancer within two years.
Health practitioners trained in natural, non-tech treatments (as well as educated consumers / patients) would have advised the above patient to do a colon cleanse. Herbal colon cleansing has been known to flush out cancerous cells. In any case, the outcome couldn’t have been worse than that from the AMA route, which was death.
The price of technological health solutions
The cost of medical testing points to another major reason to keep one’s perspective on use of technology—escalating costs. In 2003, US spending per capita was US$ 5,635, two-and-a-half times the median for other industrialised nations (the OECD members). As a per centage of the gross domestic product, the US spends nearly twice the expenditures of other nations (15 per cent vs. 8 per cent).
With all these expenditures, up to 60 million Americans do not have enough or no health coverage at all or during the year. These were the figures before the financial crisis which is putting millions more out of work, and health insurance in the US is tied to employment. Over 80 per cent of Americans told the Commonwealth Fund in 2008 that the US healthcare system needs a major overhaul, and two-thirds of the population has problems in paying medical bills or they don’t seek medical services due to costs.
American model – Unhealthy outcomes
For all this technology and money spent, the outcomes of American healthcare are so poor that the US is not even ranked among other industrialised nations. The WHO ranked the US 37th in the last survey, two notches above Cuba.
Like many US universities, American medical schools are setting up campuses overseas. And the American medical institutions are leading their foreign clients right down the same path that has put US healthcare where it is now—no longer ranking among industrialised nations.
The World Organization of Family Doctors met in Dubai in February 2008. Dr Richard Roberts, a Wisconsin physician and president-elect of the organisation, told the Gulf News that the UAE risks making the same mistakes as the US by putting more emphasis on development of medical specialities than on primary healthcare.
This Gulf nation is restructuring its healthcare system—with legions of advisors from Harvard Medical School, Cleveland Clinic, and Johns Hopkins University. Dr Roberts told the Gulf News, “The UAE is making the same mistakes as the US, listening to (the likes of) Harvard and Cleveland Clinic. It’s like a nuclear arms race. Everybody will be trying to top everybody with their special this and special that.”
The warning regarding medical specialisation is part of the technology domain. Primary care or family medicine physicians are trained to consider the whole person. I have compared the medical specialists to blind men trying to describe an elephant—they can only ‘see’ that area that is their speciality and have no comprehension on how the whole system works.
Integrate techno-model with traditional medicine
The great majority of Americans know only of the techno-model of medicine for three generations now. Most are ignorant of any other means of taking care of themselves except chemical medicines, but the expenses and painful outcomes are causing a slow-stirring revolt.
Asia is fortunate to have several traditions in health treatments that have been successful for thousands of years. Healthcare in Asia will be most successful if the traditions of Ayurveda, Chinese medicine, and other tried-and-tested indigenous medical treatments remain at the forefront in medical care. Technology is best regarded as a supplement, an aid in diagnosing and treatment but not the centre of healthcare. A holistic view of the patient should remain at the centre.
Keeping the patients responsible for their own health will improve health outcomes. Contributing to the diagnosis and jointly making decisions with their doctors aids patients in their recovery. An actively involved patient is a faster-healing patient. Asia has the tradition of taking charge of one’s own health. That must not be lost in a technology-centred health system.
Beverly A Jensen is the founder of www.WomensMedicineBowl.com. She has worked as a communications strategist and program manager in development projects in Africa, the Middle East and Eastern Europe since 1993. Currently she teaches strategic communication and health promotion in the UAE.