We need a health system that meets the needs of the person/patient

AIMS Journal, 2016, Vol 28 No 4

BMJ 2015; 351 doi: dx.doi.org/10.1136/bmj.h4448 (Published 17 August 2015)

‘“Over one billion people worldwide do not get the care they need.” Health care traditionally focused on meeting the needs of the person/patient. The advances resulting from medical technologies has shifted the focus of consultations towards specific diseases and their specific interventions. As a consequence the personal experience of illness is ignored, resulting in the medicalization of day to day experiences and the inevitable rise in overdiagnoses and harmful interventions.

‘Medicine needs a value shift – refocusing on what really matters – the person/patient. Most people are healthy most of the time, as White et al have shown in the 60s, community health follows a Pareto distribution, i.e. 80% of the community is healthy or at least healthy enough not to need medical care, 16% require primary, 3.2% secondary and 0.8% tertiary care. The need to refocus on the person/patient is especially important with rise of chronic illness in an aging population. Person/patient-centered consultations are complex, having to navigate at times competing needs without there being any one correct strategy, however, we need to acknowledge that the consultation is production unit of healthcare – the place where decisions are made about the use of limited healthcare resources.’