Taking care of my grandchildren reminds me of all those parenting years, from birth to striking out on their own. Once my kids left the nest I sort of forgot just how dependent they were on my wife and me for most of their needs. As they got older their dependency shifted to learning to make wise choices on their own.
Depending on others to occasionally help us is not unwise. But why does depending on others to manage our health seem to be the norm?
To some extent the well meaning medical profession might have had some hand in this. For example, the first American Medical Association code of ethics in 1847 counsels physicians:
“The obedience of a patient to the prescriptions of his physician should be prompt and implicit. He should never permit his own crude opinions as to their fitness, to influence his attention to them.” [emphasis added]
A pretty strong statement, but perhaps fitting for the times.
Even though the statement of ethics changed over time, it’s only been in the last few years that we’ve seen a shift towards patients being more involved in decisions about their health.
In his paper “Building Patient-Centeredness in the Real World: The Engaged Patient and the Accountable Care Organization”, Michael L. Millenson makes the point:
“Patients’ experience of care and patient-reported functional outcomes began to be measured in validated clinical formats only in the 1980s. As time went on, research has shown that patients’ and physicians’ perceptions of outcomes differed and taking into account patients’ self-perceptions of health status could lead to more effective interventions. Meanwhile, other studies that showed treatment decisions were frequently shaped more by doctor preferences than by the evidence gave rise to an emphasis on patient preferences and values being part of a shared decision-making structure.”
Research supports the concept that when patients are involved in their own health care decisions the outcomes are better.
Interestingly, even though the change was slow, the medical profession and lawmakers are now demanding that the patient take an active role in their well-being and health management. The 2013 Oregon legislature passed a bill which, among other things, required a newly created task force to:
“…develop recommendations for legislation that will establish mechanisms to meaningfully engage [patients] in their own health, disease prevention and wellness activities,…”
Is a law necessary to make people assume responsibility for their health? These two stories suggest otherwise.
A diagnosis of MS confronted Heather Garden in 1991. The disease progressed until she was unable to walk on her own or use her arms and hands. After being told by her physicians that she needed to plan for a lifetime of MS, she decided to take responsibility for her health, and to make her own decisions. She began a strict regimen of complimentary and alternative therapies. Today, Heather has no symptoms of the disease and leads a normal active live.
One might argue that Heather’s case was an anomaly, or a miracle. But another case of MS might give us a different perspective. Jane Starrett was also diagnosed with symptoms of MS. Unlike Heather, however, she didn’t pursue a conventional medical approach to the disease, nor did she engage with CAM treatments. Rather, she pursued a regimen of prayer which resulted in a reversal of the diagnosis.
Taking responsibility for one’s well-being is not a new idea. We find King Solomon’s wisdom in the following statement in the Bible written around 950 B.C..
“For as man thinketh in his heart, so is he:” (Prov 23:7)
To me this suggests that even 3,000 years ago it was understood that one’s thoughts directly affect his or her experience. And certainly we are responsible for our own thoughts.
These are two dramatic examples of how people have taken personal responsibility for their health with positive results. And of course, there are many other examples that include patient-doctor relationships.
Fortunately, there is a growing movement of recognition of how important it is for people to be active in maintaining their health. And there is a growing body of evidence that lifestyle choices we make are important for our health.
Whether one chooses to participate with his or her doctor on health care decisions, to maintain an active lifestyle, to have a robust social network, or is compassionate and caring for others, taking responsibility for one’s own health is key.
And perhaps, like Jane’s decision, spirituality can be an important choice.