WHAT IS PATIENT CENTERED SPINE CARE?
PATIENT CENTERED SPINE CARE
In medical school we are taught how to care for patients based on the individual presenting disease; one set of drugs/treatments for a particular disease. Most standard treatments today are based on this “disease-centered” model. For example, we may treat a patient’s high cholesterol with a statin drug in an attempt to prevent heart disease. The problem is that the human body is a complex web of systems and influences. Fixing one problem without taking the whole patient into consideration can have detrimental effects. For example, a statin drug used to lower cholesterol and decrease the risk of heart disease can cause a pre-diabetic patient to develop diabetes, which then increases that person’s risk for heart disease.
When we focus on one individual disease in isolation, we often miss the causes and treatments that might make the whole patient healthier. On the other hand, “Patient-Centered” medicine takes into account how all of the systems (outside factors, internal factors and “diseases”) overlap and influence one another. If we take a step back and we as physicians partner with the patient to work on dietary and lifestyle changes, rather than just medication, they may lower their risk of BOTH heart disease and diabetes. Not to mention they may sleep better, which will help decrease their stress hormone, which will help them lose weight, which will lower their risk of heart disease and diabetes. Along the way, improving their personal relationships and work performance, which will lower their stress hormone, which lowers their risk of heart disease and so on.
“Patient-Centered” spine care works the same way. It looks at the patient’s spine related complaints, and takes into consideration how the many factors influence each other. For example, a patient with lumbar stenosis that causes pain in their legs preventing them from walking very far may be overweight, which can cause sleep apnea. Sleep apnea in turn leads to poor sleep quality, which causes an increase in stress hormone, which can lead to a higher risk for heart disease and diabetes as well as increased weight and depression. If the patient ends up needing surgery for their lumbar stenosis, they are then at increased risk for surgical complications and poorer outcomes because of their sleep apnea, obesity, heart disease, diabetes and depression. When we treat the entire patient using the “patient-centered” model, we take all of these factors into account and not only do we end up with better surgical outcomes, we help the patient improve their overall health and wellbeing.
“Patient-Centered” medicine takes the 30,000 foot view, taking into account all of the factors that influence a patient and their health and focuses treatments on improving not just the individual disease, but the patient’s overall wellness.