Healthcare: People Are the Point, Not Disease
- davikath8
- Mar 19
- 4 min read
In May 2016, the World Health Organization passed a resolution on the importance of integrated people-centred health services (IPCHS), a fundamental shift in the way health services are funded, managed and delivered. According to the WHO’s website, IPCHS “supports countries' progress towards universal health coverage by shifting away from health systems designed around diseases and health institutions towards health systems designed for people.”
IPCHS “is for all countries in the world, whether high-income, middle-income or low-income. Each country’s context and health system is different, and fragmentation and poor-quality care occurs everywhere in different ways.”
Even in Alberta, Canada, people are not the point; healthcare is still disease-centred care. This problem is addressed here, not there, this condition is treated by this specialist, who doesn’t talk to any of the other specialists treating other conditions, your liver is the focus here, your kidneys elsewhere, your heart in another facility, your head somewhere between the river and the clouds.
At the cancer centre I’ve been frequently lately, the workers are so adamant about their boundaries (No We Can’t! seems to be their unstated motto), I’m surprised more people aren’t dropping dead, left, right, and centre. The rules of the system and the needs of the providers reign first and foremost.
As to being seen as a whole human, as a person and not as a bunch of conditions or as a random collection of organs, you are out of luck. But if you want any assistance at all, you allow yourself to be butchered into pieces and parceled to this or that building, behind this or that door, like you’re on some awful game show, where you could win big or go home in a casket.
Take for example a friend of mine who met a hasty death thanks to the inflexibility and insensitivity of the healthcare system and its employees.
Several physicians tried to convince her to have treatment for cancer, a cancer that would definitely kill her without treatment. The professionals told her facts as they would tell the facts to anyone, but unfortunately they weren’t talking to anyone; they were talking to a particular individual, without making any attempt to get to know her, her values and beliefs, her family members or friends, and their values and beliefs.
None of the doctors or nurses ever asked so they never knew that when this woman’s money for the month runs out, she doesn’t have food to eat.
While I don’t have a medical degree, I think not being able to buy food when you’re hungry is a pretty serious health concern. Especially for a prospective cancer patient.
None of the doctors or nurses ever asked so they never knew that this woman suffers from visual impairment and pre-existing conditions that prevent her from driving a vehicle or taking public transportation.
None of the doctors or nurses ever asked so they never knew that if a friend drives this woman to her medical appointments, neither of them can afford to pay for parking.
None of the doctors or nurses ever asked so they never knew that their prospective cancer patient lived in subsidized housing where crime is rampant, where people smoke, drink, and do drugs not just in their apartments but in the hallways, in the public areas, and in the parkade, where she has been verbally and physically threatened, where she has been robbed.
Although I don’t have a medical degree, I know that my friend’s living conditions constituted serious health concerns.
None of the doctors or nurses ever asked so they never knew that this woman is Indigenous, and all of her family members are Indigenous, so they have very good reasons not to trust the government and its institutions, not to trust social systems, including the healthcare system.
I would be diagnosed with cancer shortly after my friend, and because I am white and educated and upper-middle class, I was able to overcome my distaste of the system and its inflexibility and insensitivity to get the treatment necessary to keep me alive.
It was an act of will and determination, and there was plenty of trauma involved even for me. In addition to treatment side effects, I had to overcome my repugnance at being treated as nothing more than a diseased bit of flesh to get the medical care necessary to my survival.
My friend was unable to make the choice I made. She remained true to herself and to her own beliefs, even as she suffered, even as she died.
I just wonder what would have happened if more people than me, a loyal volunteer who had become a loyal friend, had made an effort to see the person, not just the disease. If there had been communal effort to address her problems, rather than a stubborn insistence that she was just another cancer case who must accept the facts and who must follow the protocol for treatment of her cancer, no matter who she was, or where she came from, or what was important to her.
So let us say, Good riddance, disease-centred care. Good riddance, patient-centred care. Even in countries where we pride ourselves on our development and civilization, we are still waiting for people-centred care.
Lurking behind closed doors and underneath sterile drapes, there is still too much brutishness, too much callousness.
And don’t delude yourselves: this brutishness and callousness causes injury, this brutishness and callousness causes death.
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