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What this article highlights to me is the importance of treating patients based on their quality of life. It also suggests that how we define health is becoming obselete. People simultaneously have more diseases, but feel better. According to WHO [1] one is only considered healthy if they have complete physical wellbeing. The addition of social and mental health goes some way to address this, but I think someone automatically being "unhealthy" when they have a chronic disease is a shortcoming of the definition.
Additionally the WHO definition requires "complete" [1] wellbeing. The addition of this single word dramatically cuts the number of 'healthy' people, because very few of us are completely well in all aspects of our lives. However we wouldn't necessarily define ourselves as unhealthy based on these factors. I'd argue that this narrow definition of health could add to the over investigation, diagnosis and medicalisation that we often see.
By defining health around a patient's quality of life rather than disease status we can address several of the issues brought up in the article. It is discussed in this article that more intervention doesn't necessarily lead to improved outcomes. However if we base our idea of health, and therefore our basis of treatment, on a patient's quality of life we begin to intervene only when a procedure or test would improve a patient's quality of life, be that short or long term. This may begin to negate that disparity between intervention and outcomes. By aiming for the WHO definition of health we over-act and under-achieve.
As medicine improves people will live longer and survive increasingly severe illness, but long term chronic illness will inevitably go up as a result. The measurement of chronic illness, however, isn't necessarily a useful statistic. How our patients feel is much more important. It's a much better judge of how well we are doing our jobs, and a better judge of the health of the population. After all, what's the point if the patient doesn't feel better?
The definition of health - quality of life?
What this article highlights to me is the importance of treating patients based on their quality of life. It also suggests that how we define health is becoming obselete. People simultaneously have more diseases, but feel better. According to WHO [1] one is only considered healthy if they have complete physical wellbeing. The addition of social and mental health goes some way to address this, but I think someone automatically being "unhealthy" when they have a chronic disease is a shortcoming of the definition.
Additionally the WHO definition requires "complete" [1] wellbeing. The addition of this single word dramatically cuts the number of 'healthy' people, because very few of us are completely well in all aspects of our lives. However we wouldn't necessarily define ourselves as unhealthy based on these factors. I'd argue that this narrow definition of health could add to the over investigation, diagnosis and medicalisation that we often see.
By defining health around a patient's quality of life rather than disease status we can address several of the issues brought up in the article. It is discussed in this article that more intervention doesn't necessarily lead to improved outcomes. However if we base our idea of health, and therefore our basis of treatment, on a patient's quality of life we begin to intervene only when a procedure or test would improve a patient's quality of life, be that short or long term. This may begin to negate that disparity between intervention and outcomes. By aiming for the WHO definition of health we over-act and under-achieve.
As medicine improves people will live longer and survive increasingly severe illness, but long term chronic illness will inevitably go up as a result. The measurement of chronic illness, however, isn't necessarily a useful statistic. How our patients feel is much more important. It's a much better judge of how well we are doing our jobs, and a better judge of the health of the population. After all, what's the point if the patient doesn't feel better?
World Health Organisation . WHO definition of health. [ONLINE] Available at: http://www.who.int/about/definition/en/print.html. [Accessed 16 March 16].
Competing interests: No competing interests