Summary – Public health: Prototypes for Patient-Centred Healthcare in Europe
Workshop: Public health: Prototypes for Patient-Centred Healthcare in Europe
Dr Ellis Huber, President Berufsverband Präventologen e.V. (Germany)
Dr Stefan Schmidt-Troschke, CEO Gesundheit Aktiv e.V. (Germany)
René de Winter, President European Federation of Patients’ Associations for Anthroposophic Medicine
Dr Huber gave an overview of the two main “health revolutions” since the end of the 19th century:
- towards the end of the 19th century the focus of the first “health revolution” was on the promotion of public health, on the environment
- in the 20th century the focus was on individual cure and care, the result of the extension of health systems.
Now, in the 21st century, we are heading for the third revolution: the focus will be on creating networks. The still widespread division of labour (through specialisation) and hierarchy should be transformed into interdisciplinary teamwork including all healthcare professionals. At the moment workers in the field often focus on their own specific disciplines, such as youth care, care for the elderly, poverty relief etc. and of course the various domains of medicine. In the future these disciplines should work closely together, since many health problems are rooted or closely related to other areas. E.g. depression, high blood pressure, backache, psychiatric problems etc. are often rooted in other areas than the physical body. The third health revolution should focus on health promotion (and prevention).
Health promotion means:
- Development of a “healthy” public health policy
- Creating of health supportive environments
- Strengthening of community actions
- Development of personal skills among the members of the public
- Reorientation of health services
The aim of health care should be the support of the autonomy of the individual and social belonging, also when a person is physically, emotionally, and/or socially handicapped. The health system of the future should be a social organism in which Value & visions, Education & research, Funding and Health infrastructure and Systems of care are closely related, to guarantee optimal health for all. Education should aim for the development of competency, Community actions to social inclusion and Health supportive environments to support of individuals (“I am not alone”, solidarity).
Dr Stefan Schmidt-Troschke showed how good health care should be based on co-creative models: informed active patients, prepared and pro-active clinical teams and a health care system that is focused on the reliable delivery of self-management support.
He briefly touched on the differences between conventional and CAM approaches to health care, showing that integrative medicine is striving to embrace the best of all worlds. Two prototypes of health care delivery were discussed: based on the Plane tree principals (in which the human interaction between patients and professionals are central) and the care approach currently followed in the Filderklinik in Filderstadt/Germany.
Integrative medicine was described as the basis of co-creative medicine to achieve optimal health and healing, in which the following elements play a role (source: Academy of Integrative Health and Medicine):
- Relationship between practitioner and patient
- Focuses on the whole person
- Informed by evidence
- Use of all appropriate therapeutic approaches, healthcare professionals and professions.
Feedback from the participants
- System will be very hard to change. How long will change take? Why don’t we start health education in schools?
- How can we get integrative and conventional medicine to work together (create added value)?
- If we really want society to be healthy, we also need employers to create healthy environments.
- The question “Why is the patient unwell?” should be tackled from a wider perspective (= interdisciplinary). We should help patients to become aware of the facts that make him feel unwell.
- We should be aware that the impulse for changes in health care delivery has to come from a relatively small layer within society. For many people, for whom life is a daily struggle, the future of health care is not a first concern.
Conclusions/ Next steps
- Health care of the future is interdisciplinary.
Start small scale initiatives among medical and non-medical professionals to develop teams.
- Integrative medicine is a part of future co-creative and co-productive medicine.
Support initiatives of visionary professionals in this field.
- Patients have a central role in health care: self-organisational processes and responsibility for one’s own health, needed to be able to participate in the delivery of health care, are supported by education and the development of life skills; this leads to including patients’ concepts and ideas in the delivery of integrative medicine.
- Start discussions on how to best support the development of health competences among patients/citizens and how to include this in the delivery of health care.
- Citizens’/patients´ preferences for integrative health and medicine need to be incorporated in the legislative and regulatory frameworks of the European Union and its member states, based on the principles of human dignity as enshrined in European law.
- Delivery of integrative medicine and co-creation are best realised in small-scale health care delivery initiatives within society.
Support the start of small-scale health delivery initiatives (cooperation between patients and interested professionals?)
Report: René de Winter
14 November 2016