Advocating for Anti-Cancer Care in the US
Advocating for Anti-Cancer Care in the US
I can sum up 20 years of frustration from seeing women (and men) not get the health care they need in one sentence:
We need health care, not the SICK care we currently have in the United States.
The World Health Organization speaks loud and clear in their latest Cancer Report:
“We cannot treat our way out of the cancer problem.” “More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”
Is that not the clearest statement you’ve ever heard? And yet, I have yet to hear a patient say their doctor or therapist gave them preventive care or advice over drugs or diagnostic testing.
Our country’s health care system is so paralyzed by “curing” instead of preventing, that we have found ourselves in the worst state of health care in recorded history. Read my short post below that discusses the predicted soaring rising cancer rates alone. Chronic disease rates are higher than ever, and science supports we are one of the worst countries in the world for taking care of our own. The press writes, “Americans pay more for “bad” medicine.”
Our health care costs more and delivers less. Why do we put up with it?
The answer is: We should not put up with substandard care that:
- neglects women in pain
- has the highest first day death rate for infants and the highest mortality rate for mothers in the developed world
- and hardly ever addresses the root causes of disease, clearly stated by the WHO: 1) smoking, 2) inactive lifestyle, and 3) poor nutritional habits.
My Short Story: What Fires Me Up about Health Care Should Fire You Up Too
My advocacy for preventive care began almost 20 years ago, in the school of medicine at the University of North Carolina at Chapel Hill. At that time, I was told to visit the school of public health if I wanted to learn about prevention. Well, I did that. I earned credit hours in the school of public health doing graduate level research for the Governor’s Council on Health and Physical Fitness.
Fast forward 20 years. Ironically, I am back at Chapel Hill again completing doctoral studies in the school of medicine. Why? Because I believe that health care can be changed and that each one of us has a role in making that happen. And yes, I love Chapel Hill and support their school of medicine.
Health care still looks pretty much the same as it did when I graduated with my masters degree in physical therapy almost 20 years ago – it looks like a train wreck.
Patients can’t get the services they need, can’t afford the services they need, or are denied the services they need. I end up seeing patients months or years after they should have already been in my office for physical therapy. I am astounded by the condition of individuals because they have failed to receive physical therapy that was obviously needed.
People are in pain and are exasperated with a system that has failed them, and that yet ironically labels them as the failure instead (for example: ever heard of “failure to progress” in childbirth? An easy way to blame shift the failure of the system and call it “failure of the mother.” ).
If you are in pain or hurting, you are not the failure, our health care system is.
We are stuck in the “fix it when it is broken” phase of medicine, even though we as a collective industry already know that chronic disease, once it has manifested itself in an individual, is VERY hard to treat with any level of success. The old maxim, “an ounce of prevention is worth a pound of cure,” must have escaped the notice of medical schools all across this country for the last 100 years, because we fail sharply and often at treating chronic disease.
Overall, this article has brought up many relevant points – it underscores the need for early referral, early intervention, and referral for healthy promotion and lifestyle counseling. If I as a PT am supposed to carry out the vision statement of my professional body, American Physical Therapy Association, which is to “transform society by optimizing movement”, then I am obligated to continue to advocate for the expansion of PT services to include reimbursable health promotion and lifestyle education for those people who have cancer, especially women (who are disadvantaged by the system). I am obligated to advocate for anti-cancer care. I am obligated to do right by my patients. The current health care system does not do that. It underutilizes PT and limits your access to preventive care.
Americans deserve better health care. We all deserve the chance to live free from cancer because we’ve had the proper preventive care and education, received in a low-cost, low-tech way that PT’s are experts at. We deserve to receive detailed, individualized information about our health and the best way to exercise for your needs; again, something that PT’s are experts at doing. We need interprofessional conversation between health care disciplines, and a return to valuing the feminine characteristics of caregiving and nurturing in health care. Where did the “care” in health care go? I rarely experience it as a patient myself; and, most of my patients report the same lack of caring from other health care providers.
Advocating for Anti-Cancer Care: What We Can Do
The only way to receive better health care, is to ask for it.
Start questioning the decisions and recommendations of your health care provider. Ask why you need a drug or diagnostic test. Ask for scientific evidence that supports their prescription. Their unwillingness to answer these questions or respect your independent research on matters that effect your health, is a huge red flag.
Remember: You have the right to hire and fire your health care provider. Ask the tough questions, and if they are worthy of caring for you, they will answer them with enthusiasm and respect and consider you the leader in your own health care, not a follower who just obeys “doctors orders.”
The Yoga of True Health Care
I have a vision of what health care might look like if we truly did have a preventive system of care. I might call it the “yoga of health care,” and it would look something like this:
You would visit your health care provider, be it a doctor of medicine (MD), doctor of physical therapy (DPT), family nurse practitioner (FNP), or other primary care provider (yes PT’s should be primary care providers in musculoskeletal and neuromuscular care; for example, they lower risk of disability from back pain, reduce cost, lower risk of surgery, and produce happy patients), who would respect your inquiry and concerns and genuinely appreciate your input about your health and well-being.
They would not speak down to you or any other provider, be it nurse, tech, or aide, or pretend as if they are your intellectual superior. You would have low-cost, readily available preventive care that would drastically reduce your risk of chronic disease, many types of cancer, and your overall out-of-pocket health care expense.
That is my “yoga of health care” dream. It isn’t complete or perfect, it is evolving. But it is a heck of a lot better than what we have right now in America.
Read the Cancer Post by Ginger Garner.
Sources
- Chronic Diseases and their Risk Factors. World Health Organization. http://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf. Last accessed February 3, 2014.
- APTA Vision Statement. http://www.apta.org/Vision/. Last accessed February 3, 2014.
- van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth. 2013;111(1):13-18. doi: 10.1093/bja/aet123; 10.1093/bja/aet123.
