Incremental Care

http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care

In this article, Gawande describes a different way to look at treatment of chronic health issues.  The approach is based on slow and steady progress and the realization that complete cure is unlikely and that progress can be slow and incremental.  There is rarely an immediate remedy and expectations are lowered.  Doctors partner with patients to measure the problem and work through plans of escalating remedies.  It involves continual measuring and adjusting.  Medical practice can at times convey an “aura of heroism”, like a surgeon operating just in time to save a life.  Data, however, shows that Primary Care (opposite of a specialist) is the area of medicine that has the greatest impact, including lower medical costs.

This approach emphasizes the importance of prevention and maintenance of health, as well as coordination among specialists for problems that have already been diagnosed.

Perhaps this approach resonates because I grew up in a household with a dad who specialized in Internal Medicine, who I believe practiced this type of medicine.  He seemed to know his patients as individuals, many who were fiercely loyal.

I have also seen this approach work well in my 20 years working in the PACE model.  This model sets up long term relationships between interdisciplinary health care professionals and individuals with multiple chronic health issues.

An incremental approach also would address the rapidly rising costs of health care.

It is also related to wellness, defined asis an approach to health care  that promotes the prevention of illness rather than treatment of disease, or health as an actively pursued deliberate effort.

It definitely is a challenge however, because it goes against the fast pace of rapidly developing technology.  Perhaps that’s the point.

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