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This is a transcript of a "Consumer's Guide To Health" episode on BlogTalkRadio (2/3/2009).
Competent Self Care is a term I have used for many years. It really is the future of health and health care in this country. Though we would like to believe that our current system is client-centered, it is not. We would like to believe that our medical system is the best in the world - but it's not. We spend 50 percent more on health care than any other country in the world, but we rank only 15th in preventable death, 24th in life expectancy, and 28th in infant mortality. Our current system emphasizes "prevention", and yet we still have an increasing rate of chronic medical conditions that will ultimately tap out our system. For example, the statistics would indicate that 57% of adults are overweight, with 1 in 4 having a body mass index of 30 - a level that is considered obese. As they say - if you do what you've done, you'll get what you've gotten - and look where were are right now.
Why is competent self care important? How about a few issues to ponder. The first would be cost. Chronic disease is going to bankrupt the medical system. When you have a generation of children that are the first to have a life expectancy shorter than their parents, you have to be concerned from not only a health perspective, but a fiscal one. This isn't just about universal health care - it's far beyond this. The second point is that yes, Dorothy, we're not in a passive medical system anymore. The information and research is out there. Many common chronic issues that are taxing our health care system have self-care focused approaches to care. In my world as a physical therapist, many if not most of the common running injuries can be dealt with effectively via self care strategies - no costly diagnostic assessments, no passive modalities, just good education and mentoring. And how about number 3: what we've BEEN doing isn't working. Much like the scene from the movie "Network", people need to stand at their windows and shout "I am fed up with this and I am not going to take it any longer". Competent self care involves a client-centered approach that is both science- and evidence-based and utilizes the latest knowledge that has evolved out of the medical and sports science research. As I truly believe, knowledge is, indeed, power. If only we'd use it.
Let's take a scenario that is all-too-common in our world. From the statistics I presented earlier, a great percentage of our population in the US are overweight. We know that this is a health risk. So let's assume that you are part of that population and decide that you need to change your lifestyle. Fabulous! The hard part is over … or is it?
You ponder the options for increasing your activity level. Maybe walking would be good? Or how about running? It only requires some running shoes and I have been doing it since I was one year old. Nothing new to learn. Get out the door and go.
Running is a popular activity. In 2006, there were 11 million runners in the US with a total of more than 100 runs per year. From 1986 to 2006, the number of road race finishers went up 187%, and marathons such as NYC have shown an 11% increase over the last five years! So I think that it's safe to look at running as a "typical recreational activity" in this country.
Now, the bad news. Various reports would indicate that there is a 30 to 79% injury rate among runners. A decade ago, Runner's World magazine reported that 60% of all runners will sustain an injury in any given year that will limit their training. These are not good numbers. Apparently something that is being done in training is working against a vast number of runners, not for them.
So now you're in the medical system … facing the woes that we find there. First of all, the provider may send you for some costly diagnostic tests - which in many cases, simply aren't supported in the literature as a first line of defense. Then you are faced with the over-utilization of services that are, at times, owned by the same people that are referring you to them. Then they might choose to not refer you to anyone - because rest and the pharmaceutical industry are the solution. Then if you do get to someone who might be able to help you, are their practice patterns, the "stuff" they use, actually clinically relevant or supported by any sort of good scientific evidence?
As I always say, the plural of anecdote is not data - and much of what we see clinically is just anecdote.
Now a problem that is in most cases simply the result of the body's inability to adapt at a rate that is consistent with the rate of application of stimuli … has become a huge medical fiasco. Too many services, too few providers utilizing any form of clinical guidelines, and an acute issue that now becomes a chronic one.
Many simply choose to quit the sport, to quit being active, stating that they were told that "maybe they weren't able to run". Many move forward with pain in the runs as what they consider "part of the deal of being a runner". And all of this is preventable. If only we become better consumers of our training, our fitness, our health.
This may sound like a harsh series of events, but welcome to my world. I see this on a daily basis, believe it or not. It makes me sick on a daily basis. Why? Because the long-forgotten aspect is that health and medicine are all about the patient.
"Despite spending 50 percent more on health care than any other country in the world, America ranks 15th in preventable death, 24th in life expectancy, and 28th in infant mortality." [Critical Condition....PBS documentary] |
