Health Care vs Disease Care: two very different things.
Although the difference is subtle, it is significant. Let’s use a simple analogy to demonstrate health care vs disease care.
Most cases of hypertension result from the body‘s reaction to restricted blood flow caused by coronary disease, inflammation, etc. Because blood is no longer flowing easily, the heart has to increase pressure. This is increased pressure is hypertension.
One solution is medicine. Hypertension medication decreases blood pressure to protect the heart, eyes, kidneys, etc. However, this decreased pressure comes at the expense of other tissues that need strong blood flow.
Disease care is intervention from an outside source to create a change in physiology, anatomy, or function to combat a process that is unwanted. For example, hypertension medication decreases unwanted high blood pressure. This intervention is beneficial because it protects the heart, eyes, kidneys, etc. However, this decreased pressure comes at the expense of other tissues that need strong blood flow. For example, erectile dysfunction is secondary to hypertension medication because of decreased blood flow.
Health care also addresses hypertension, but from a different direction. This approach focuses on changing the body physiology so that there is no longer restricted blood flow. In other words, find a way to improve the insufficient arteries.
Healthcare is also intervention to make a change within the body, but with a goal of changing the body to create improvement in physiology.
While disease care and healthcare have the same goal – Protect the body from hypertension – the difference is the approach.
Disease care mostly focuses on changing the effect, whereas healthcare focuses on addressing the cause.
Disease care attempts to address the environment around the body whereas healthcare attempts to address the body in the environment.
Disease care works exceptionally well for emergency medicine, crisis intervention, and other acute presentations that include pain and injury.
Healthcare is better used for chronic conditions that includes cancer, heart disease, diabetes, gastrointestinal dysfunction, etc.
We have run into a big problem as a society because we tend to use disease care when healthcare should be used. And sometimes we use healthcare when disease care should be used.
Unfortunately most of our current “healthcare system” is only able to deliver disease care. We see it too often in hospitals, urgent care centers, telemedicine, and doctor’s offices. This does not work. And this is the primary fundamental underlying cause of the “healthcare” failure in the United States.
Why? Because, ‘Health is a state of optimal physical, mental, physiological, and emotional well-being, and not merely the absence of disease or infirmity’. There are many people who have a disease, and they will emphatically state that they are healthy because they feel good. These conditions may include diabetes, asymptomatic heart disease or cancer, etc. Intuitively you know that that’s not the case. Just being symptom-free doesn’t mean that you are healthy.
So why do we have a healthcare crisis in the United States? One factor is how we study medical information.
Most medical interventions are based on study types 1 through 3:
1: Epidemiological studies
Epidemiological studies are studies of causes and risk factors for disease in certain populations.
2: Clinical studies
These studies are conducted through randomized clinical trials to test various hypotheses from other studies (pillars).
3: Basic research
Basic research is conducted to develop theories, hypotheses, and predictions.
But there are 2 other pillars of research that are clinically valuable but are too often neglected:
4: Aging studies
These are studies conducted on seniors and older people. In other words, what has the longest lived healthiest people in a society and what have they done to get to that age.
5: Complex system studies
These studies complement the other four pillars by providing reference points and useful analogies. Think of human beings as a plane or a car. If you drive your car hard all the time, it’s going to break down. The body has self-repair mechanisms, but if it’s overused, it’s going to break down. These studies are useful when it comes to understanding variables that may affect health-span.
Disease care exists within pillars 1 -3. Healthcare exists within pillars 1-5
Understanding the niche in which human beings developed is as important as understanding how to set a broken bone or stop a bleeding artery.
Just as every electronic you purchase comes with a user manual, the human body also has a user manual. It has been developed over millennia and can be seen if we look at the niche in which humans have lived for thousands of years.
The duck billed platypus is uniquely suited for the niche in which it developed. Similarly, the human being functions best as an organism when exposed to the environment in which it developed.
We know that human beings traditionally ate a significant amount of fiber, had no processed food in their diet, exercised in excess of one hour a day, and had ample amounts of socializing and mental downtime. Genetically and physiologically we are identical to those people who thrived in that environment. Therefore, it must follow that the human body needs a similar lifestyle to thrive and not just survive.
And what makes us so special today, that we think we shouldn’t continue to live like that. (The spartan King Leonids was 60 years old when he fought at Thermopylae)