Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The difference between health care and disease management

Natasha Deonarain, MD, MBA
Physician
September 14, 2013
Share
Tweet
Share

It’s no secret that America is suffering from a huge crisis in healthcare. As we watch the sun rise on Obamacare, doctors, patients, insurance executives, hospitals, small businesses and legislators alike stand agape. No one seems to have found a simple, logical solution.

The solution is in fact very simple. It’s so ridiculously simple, it might make one laugh. And, believe it or not, it’s also amazingly cheap.

But because of its simplicity, it will also be the most difficult thing for America to implement. The disease-focused paradigm that’s been spoon-fed since the 1940’s and helped build a $2.8 trillion dollar “health care” industry will stand in its way, because it requires a profound change in our belief systems.

Let’s examine this idea from its beginnings and follow it to its logical conclusion.

Our beginning lies in our ability to first clearly define and understand the terms “health care” and “disease management.”

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” That sounds easy enough to understand. But let’s move on to today’s entry point to health care.

Most people would go to a doctor for a health check-up. When they go to a doctor’s office, what is the first thing the patient will likely experience? Most physicians are trained to begin by taking a set of vital signs (blood pressure, temperatures, weight, etc.). The physician would then talk to their patients about any symptoms they’re experiencing. If the patient has symptoms, the doctor matches those symptoms to a disease classification system. He will then order tests to prove the presence or absence of disease.

If there is no disease on symptomatology, blood or image testing, what does the doctor conclude? Likely, the doctor would conclude that his patient is healthy by virtue of the fact that there was no disease detectable.

But go back to the definition of health by the WHO. Do these actions of a doctor actually fit with this definition of health?

It seems that searching for the absence of disease does not serve well as a definition of health. And yet this is exactly what physicians have been well-trained to do. In fact, doctors hold the default entry point to the determination of our health status — the proverbial health check-up.

Let’s return to a doctor and his or her training. Once a patient has been found to have a disease, how would that doctor typically treat his or her patient if the symptoms were significant to the patient? Most people would say that the doctor will recommend some sort of prescription to alleviate his patient’s symptoms; either an over-the-counter or dispensed drug. In the action of recommending a prescription (and perhaps some lifestyle changes to go with), what is that doctor doing?

By definition, the doctor has found a disease to diagnose, and is now managing the disease. In other words, the doctor is an expert at “disease management.”

If we look at medical training, it begins in a cadaver lab with the study of anatomy in dead people. From the reference point of death, a doctor then graduates over the years to studying diseased “specimens” in the hospital.

ADVERTISEMENT

Once in practice, the doctor then continues to examine more and more disease. If the person comes in without disease, the doctor is trained to find a diagnosis that he can begin with, by virtue of his training. It’s relatively foreign to most physicians to begin inside a paradigm of optimal health, despite a patient’s disease labels, and continue “health care” without recommending any prescriptions, tests, procedures or specialty referral (disease-management).

So, after this analysis, we return to our basic question. If a conventional doctor is an expert at disease management and the definition of health is not merely the absence of disease, but this doctor works to determine the absence of disease … why are we convinced that we need to see a doctor as the entry point to make sure that we are all healthy?

Wouldn’t it make much more sense to see a different health practitioner, one who works inside a paradigm of health despite clinical diagnoses, before we see the expert at disease management?  What then becomes our definition of health, right here in the US, with its fast failing health care system?

Changing this singular belief system has the potential to shave billions of dollars off a disease-focused health care industry, obliterate the “shortage of physicians” crisis, and correct epidemics of modern day, chronic disease. It can be done in the course of a blog. But, it will also be the singular most difficult thing to actually accomplish in America.

A ridiculously simple solution is right at our fingertips. There’s no need to panic, as we all are doing right now. All we require is a basic differentiation between the terms “health care” and “disease management” and then we can put each “player” into their respective roles which best fit their expertise. Mastering this concept is the first step.

So here’s a quick self-check to see where you stand on this matter.

A 52-year-old male comes in to his doctor with mild joint pains in his knees, hips, low back and shoulders. He does not take any medication nor does he have any other symptoms or diseases. Assuming all his tests are normal, what is the first prescription his “health-focused” doctor should write (based on evidence)?

Your answer will help you determine the paradigm that you operate within, and also whether you are indeed a health care provider, or a disease management expert.

Natasha Deonarain is founder, the Health Conscious Movement. She is the author of The 7 Principles of Health and can be reached on Twitter @HealthMovement

Prev

What does it mean to be a doctor and a patient?

September 14, 2013 Kevin 11
…
Next

MD vs NP: Principles for a civil online discourse

September 15, 2013 Kevin 136
…

Tagged as: Primary Care

Post navigation

< Previous Post
What does it mean to be a doctor and a patient?
Next Post >
MD vs NP: Principles for a civil online discourse

ADVERTISEMENT

More by Natasha Deonarain, MD, MBA

  • Why doctors should write poetry

    Natasha Deonarain, MD, MBA
  • The inhumanity of medical residency programs

    Natasha Deonarain, MD, MBA
  • Young doctors can set themselves up to be financially free

    Natasha Deonarain, MD, MBA

More in Physician

  • Why heart and brain must work together for love

    Felicia Cummings, MD
  • How pain clinics contribute to societal safety

    Olumuyiwa Bamgbade, MD
  • Why frivolous malpractice lawsuits are costing Americans billions

    Howard Smith, MD
  • How AI helped a veteran feel seen in the U.S. health care system

    David Bittleman, MD
  • Why physician strikes are a form of hospice

    Patrick Hudson, MD
  • How a doctor defied a hurricane to save a life

    Dharam Persaud-Sharma, MD, PhD
  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The difference between health care and disease management
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...