Let patients take responsibility for their own concept of well-being
Since Tommy Douglas created the framework for medicare in the 1960s, everything in health care has changed—everything that is, except the system. Who can provide care; the options for care; the types of services; even the types of illnesses have all changed, but the most significant change is the ability of people to participate in their own care.
Health is about more than treating illness. It is about prevention, holistic care, and wellness. It is about people striving to become all they are capable of within a personally-defined balance of mental, physical, spiritual and emotional well-being. It’s time to empower a system that supports each person as the manager of his or her personal journey to wellness.
We need a new working model for people and their providers, a system where people are managers rather than patients. Of course, to accommodate this new paradigm, the traditional doctor/patient relationship must evolve. In my book Journey to Wellness I use four concentric circles to demonstrate graphically the various levels of a truly people-centred healthcare model.
The central circle, or nucleus of the model, is the informed person with the health needs. Like a cell nucleus, the informed person manages the system. Ultimately she or he is responsible for her or his well-being, and all other levels of the model are accountable to them or, in the case of an incapacitated person, accountable to their primary caregivers.
The second circle represents the Health Coach. In a traditional illness model, this coach has usually been the doctor, but that should not be assumed in these new relationships. Actual health is a 24-hour-a-day job. Only a small percentage of life’s health decisions require a physician’s professional expertise! The coach can change with every health issue, and the first responsibility of the manager – the patient or cargivers - is to select such a coach. For most health issues, the coach becomes whomever listens and communicates most effectively - whoever can help process all the information while inspiring the highest level of trust.
The third circle represents all the support options available to the coach and the patient. Initially, the coach herself is chosen from this cirle of support. Then the funding and quality of healthcare will be selected from this circle. Choice is a fundamental principle of a people-centred system and it is essential that the manager retain the right to—and responsibility for—selection of her or his own health support team.
The outer circle represents all the legislation, principles and Acts needed by an informed, empowered population to set the rules and guidelines for stakeholders in healthcare.
The key difference in this people-centred model is that the individual, not the provider, is the manager. This shift in responsibility is already steadily bringing change to the foundations of health, healthcare and health systems. Now it is time for a responsive Canadian health system to go beyond treating illness and ‘taking care of’ patients, to actively help people take responsibility for their own personally-defined wellness balance. The goal then becomes a goal beyond healthiness: becoming all that one is capable of being.
Canadians are ready and able to move to the next stage of this journey to wellness which Tommy Douglas started 40 years ago. An empowering working model is the foundation of any truly people-centred healthcare system.
Dr. R. Vaughn Glover (DDS) is the president and founding member of CAPCH. His book Journey to Wellness presents a people-centred vision outlining the many pieces of a health system that would inform and empower the individual.