The current health care crisis in America has many people calling for more self-care but what exactly do “they” mean when they say self-care? Certainly no one envisions the average person performing surgery on themselves or writing out their own drug prescriptions. By the same token we can hardly imagine that the American Medical Association would define self-care in the same way that a Naturopathic Doctor would. Is self-care some scheme to get people to stop going to the every time they sneeze or stub their toe? Or is it a sinister plot by vitamin makers and health food stores to steal customers from the drug companies?
What are some of the definitions possibilities for self-care?
1. Passive self-care – This might be one favored by many conventional doctors and could involve asking questions about the diagnosis as well as the recommended treatment for a particular illness. Some doctors do not even want to entertain questions since they feel the patient knows so little about medicine that they are not qualified to challenge or question a doctor’s diagnosis or treatment.
2. Curious self-care – In this case the patient may ask some questions of their primary care physician but if not totally satisfied night seek a second or even a third opinion. This level of self-care usually kicks in when a more serious illness is diagnosed and the patient wishes to avoid an operation or an invasive treatment such as chemotherapy. The patient may also be frightened enough to ask about less invasive treatment possibilities and may actually identify some if one of the doctors contacted has taken the time to study complementary or alternative treatment modalities.
3. Inquiring self-care – This definition of self-care is similar to the previous “curious” definition with the exception that individuals in this case would do some research in order to prepare better questions, especially for the second and third opinion doctors. They may even suggest some complementary or alternative treatments but would not press for them if their doctor discouraged their use. The other distinguishing characteristic of this type of self-care is that it is mainly re-active and is not ver proactive or preventative.
4. Consultative self-care – This is the first self-care definition that includes active prevention as well as consultation between doctor and patient on how to prevent illness as well as how to treat conditions which has been diagnosed. Patients are likely engaged with conventional as well as alternative practitioners on a regular basis or have found a holistic M.D. who incorporates many medical modalities. Some medical offices now have a full range of practitioners available from which the patient can pick and choose.
5. Assertive self-care – These individuals are often called self-healers. They will usually consult a doctor only in a true medical emergency and would much rather research their condition and find one or more alternative treatments for any illness. They are also very engaged in illness prevention with some people being borderline hypochondriacs. They tend to think they will get various diseases and will take many different approaches to avoid them including restricted diets, heavy supplementation and regular tests to ensure nothing has actually invaded their body.
We can see from the preceeding definitions that self-care can be defined in many ways and we should be careful not to see these definitions as comprehensive or rigid. People may move from one category to another over time or change approaches depending on their situation. Some people may think they are engaged in prevention because the eat a “balanced” diet, don’t smoke, get some exercise and take a multi-vitamin. To help further clarify who can claim any of these definitions as their own a more comprehensive self-care definition chart is presented in Exhibit I.
Exhibit I suggests that self-care goes well beyond what happens between a person and their doctor. It involves a full range of activities that can dramatically influence someone’s overall health and wellness. Self-care includes many lifestyle changes and educational initiatives, which some people are more willing to pursue than others. This is what separates a low-risk person from a high-risk person more than any other single health factor.
The current debate about health care and health cost has centered on such things as the availability of insurance or whether prescription drugs are covered or not. There are endless debates about HMO approval of certain treatments and the lack of time doctors have to spend with patients. While these are important issues they pale by comparison with the importance and significance of the self-care issue. Fixing all of the technical, administrative and coverage issues combined would not begin to improve health or reduce cost as much as a shift in the self-care attitude of our population.
A majority of our population is in the passive or curious self-care categories. Moving them to the inquiring or consultative categories would save billions of dollars within a matter of months. This is where our efforts should be, not in the futile debate about how much drugs cost or which treatments should be covered within an insurance plan. By tinkering with the symptoms instead of attacking the root cause of our health problems we continue to five in to the pressure of the almighty dollar. The protection of profits for drug companies, doctors and certain parts of the food industry is put ahead of the health of our population everyday. The power to change this sad state of affairs does not rest with any government agency, medical association on insurance company if it lies in the hands of every person as they decide how they will define self-care.
Self Care Definition Chart
· Conventional M.D.
· Ask a few questions
· No exercise
· No nutrition awareness
· No supplements
· No meditation or emotional elements
· Trusts and depends on drugs
· Retains no information
· Takes no courses
· No check ups or tests
Curious Self Care
· Conventional M.D.
· Ask focused questions
· Very little exercise
· Little nutrition awareness
· Occasional multi-vitamin
· Listen to music to calm down
· Takes drugs when necessary
· Retains a few articles of interest
· Takes no courses
· Infrequent check-ups or tests
Inquiring Self Care
· Conventional M.D.
· Basic research
· Semi-regular exercise
· Basic nutrition program
· Regular multi-vitamin
· Could use tapes for stress control
· Avoids drugs if possible
· May have health book and computer sites marked
· May attend special workshop on illness of interest
· Basic medial checkup only
Consultative Self Care
· Alternative practitioners
· Prevention research
· Regular exercise
· Follows nutrition pyramid guidelines
· Selected supplement program
· Uses meditation, yoga or other elements
· Uses herbs instead of drugs
· Has books, articles and many computer sites marked.
· Attends many workshops for prevention purposes
· Regular comprehensive check-ups
Aggressive Self Care
· Holistic M.D.
· Aggressive prevention and treatment research
· Very regular exercise of all types
· Follows advanced pyramid guidelines (i.e. Mediterranean or Asian)
· Comprehensive supplement program
· Regular stress reduction program
· Uses herbs almost exclusively
· Has comprehensive library and numerous computer sites marked
· Attends workshops and takes courses on nutrition and other topics
· Many types of tests