Dehumanized health care – Santiago Cammi

Incendio de un hospital by Goya

Health care has become dehumanized and medicine has lost its soul. Touch has been replaced by machines and the carefully interested listening of anamnesis has been displaced by an uninterested directed questionnaire.

This is partly manifesting as a health crisis in the medical profession, a BMA report on mental health and well-being in the medical profession shows that:
– 80% are at high or very high risk of burnout, driven mostly by exhaustion.
– 40% are currently suffering from a broader psychological or emotional condition.
– One in three use alcohol, drugs, self-medication or prescribing as a way to cope with a mental health condition.

These professionals are in charge of our health, unhappy, overworked and underslept. This correlates with the experience of patients, they feel rushed, unappreciated and uncomfortable. Professionals in these conditions are more likely to make mistakes, increasing the monetary and health cost. Also, the interpersonal relationships between the participants of the health system worsen over time, to the point of verbal and physical abuse.

The problem lies in the design of the system. First, the goal is to cure pathologies, not prevent them. This leads patients to consult when it’s too late to prevent illness. Leading the staff to treat diseases that are more advanced and complex and in greater volume. Leaving them exhausted and burnout. Being more cost-effective to prevent disease by promoting health.
An example being, promoting a healthy lifestyle to prevent obesity and thus the number of heart attacks in a given population.

Part of the problem lies in the incentives, the revenue of health care providers is determined by the volume of services provided. This incentivizes the institution to run as many tests and treatments as possible. Leading to unnecessary interventions that increase morbidity.

The system is designed to fix machines, doctors see interacting systems of the human body, not a person. Health worker ends up working to maximize bed tourn over, becoming machines with input- outputs mindset. Since the metric we are using for performance is manly the volume capable of treating, the system maximizes for that end.

The implementation of information technologies has only exacerbated the problem. Keyboards and screens have further distance between patients and doctors, eye contact becomes rare and the flow of conversations becomes continually interrupted. Doctors find themselves hours on end filling paperwork, contributing to their burnout.

It does not have to be this way, we should be implementing a human-center design, where the views of participants are incorporated. Utilizing technology in innovative ways to facilitate human connection, lessen the work of professionals and changing the incentives from that of volume to the value added to the patient’s health.

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