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What's Really Making Americans Sick?

Many countries enjoy better health than the U.S. thanks to different choices in care delivery

This article origianlly appeared on Al Jazeera on February 7, 2013.

By Namratha Kandula

Tears fell quietly down my patient's face. I was explaining that, given her continuing and worrisome high blood pressure, we were going to increase her medications. But Sylvia's concerns were not the same as mine. She explained that her grandson had been shot and killed two weeks ago. "He was a good boy," she said. "My heart is broken."

Doctors are not trained to respond to a statement like that. When your patient's heart is broken from sadness, when her body hurts from the emotional and physical toll of stress, what should a doctor do next? Write a prescription for more blood pressure medicine? Tell her to eat less salt and lose some weight? This is what the US medical system has trained me to do - but it is not working.

In January, the Institute of Medicine released, "US Health in International Perspective: Shorter Lives, Poorer Health". The report confirms that Americans have been dying at younger ages than people in almost all other developed countries. Americans have worse health than our counterparts in other wealthy nations - even though the US spends far more per person on health care.

The IOM report used large studies and data sets to investigate why the US is falling behind. But let's consider another source of evidence: Patients are speaking and telling their stories. They have the answers, and possibly the solutions - if, doctors, health care leaders and elected officials can learn to listen.

The phrase "patient-centred medicine" often gets tossed around in healthcare - and too often, is used to mean that the doctor gives the patient the treatment he or she wants. But I would argue that, more profoundly, patient-centred medicine also means listening to what patients are saying about what is making them sick.

Read the complete article here.

- Namratha Kandula is an assistant professor at Northwestern University's Feinberg School of Medicine. 

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