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The Problem with Too Much Medical Care

elephantWhile only 7.3% of adults aged 18 to 44 have Multiple Chronic Conditions (MCC), almost nine times as many 65 or older do (61.6%). And that can lead to something straight out of John Godfrey Saxe’s 1872 poem, The Blind Men and the Elephant.

That’s because Multiple Chronic Conditions usually call for multiple medical specialists, and, like the blind men in the poem, too many focus on their own areas of specialization and fail to see the whole elephant. This narrow view can produce wide-ranging consequences.

“Once you get three, four or five and six diseases, several things happen,” says Dr. Mary Tinetti, chief of geriatrics at Yale School of Medicine. “[A]lmost guaranteed, trying to get one of those diseases under control is gong to make one of the other diseases worse.”

 

More than one-third of people over 55 take five or more prescription drugs, 53% of them from more than one healthcare provider. Individually, each drug can save or improve lives. But “[t]he risk of adverse events increases exponentially after someone is on four or more medications,” Dr. Michael Hochman of the University of Southern California’s Keck School of Medicine warns.

In 2014, adverse drug effects sent almost 1.3 million Americans to US emergency rooms. About 124,000 of them died. As many as half of those deaths – 62,000 of them – were preventable.

Another consequence is what Dr. Victor Montori, of the Mayo Clinic, calls the “burden of treatment.” As Dr. Tinetti explains, “The more we ask people to do, the more overwhelmed they get and the less they are likely to do.” MCC patients will often begin to skip taking their meds, keeping their doctor appointments, doing their PT exercises, or performing other health tasks. So, paradoxically, overtreatment can lead to undertreatment.

Fortunately, communication can make both of these problems preventable: Communication between your specialists and your primary care physician. And communication between you and your pharmacist and doctors.

Communication between your medical providers can widen the focus from the elephant’s leg or tail or tusk to the elephant itself. Communication between you and your pharmacist can identify potential drug interactions and side effects. And communication between you and your doctors can help lighten the burden of treatment – by narrowing their focus to what troubles you the most.

Before you can communicate your priorities to your doctors, you’ll need to define them to yourself. What’s most important to you: Longevity? Function? Social activities? Pain or symptom relief?

Ask yourself:

  • Which relationships and connections are most important?
  • What brings you the most enjoyment and pleasure?
  • In taking care of yourself, what’s most important to you now?
  • What do you hope your health care can do?
  • What would you like to be doing more of? How often have you been doing it? How does your health get in the way?
  • What healthcare causes problems for you? What kind of problems?
  • What tradeoffs are you willing to make?

This is why our thorough three-part assessment of your physical, psychosocial and mental status covers your health care regimen, your reactions to it, and your living and health priorities; in other words, your wants as well as your needs. And why our holistic senior care approach makes sure all aspects of your care reflect those wants, needs and priorities.

To learn what a difference this holistic approach can make, please call or contact us to arrange a comprehensive consultation