From surviving to thriving
- A definition of health limited – de facto – to physical health, healthcare systems focused on efficiency, and healthcare professionals dedicated to curing have been challenged.
- Social and mental wellbeing should be – de facto – part of the definition of health, healthcare systems should be holistic, and healthcare professionals should be dedicated to caring.
- We have an opportunity to create the future of health, healthcare and health professionals.
- Giving health and wellness a pivotal role in all human matters will allow humans not only survive but thrive.
The Old Normal
“It is not the strongest of the species that survives, nor the most intelligent, but the one most adaptable to change.”
Adapting to change is a basic characteristic of species that survive. That’s why we have ‘normal’. Let us look at health, healthcare and health professionals through this normal.
Health in the ‘old normal’ was a term used almost exclusively to refer to physical health, which was often taken for granted, at least for those not suffering from any acute or chronic health issue.
Healthcare was about efficiency driving healthcare: short encounters with healthcare professionals looking at symptoms. It was about going to the doctor when not feeling so well, getting referrals for tests, making sense of the test results, and getting treatment and prescriptions that with more or less success would restore ‘health’.
Healthcare professionals had to examine patients in short slots, one after the other, often having just a snapshot of the patients and treating more symptoms than patients. And, they were ‘there’ but these healthcare professionals were ‘invisible’, taken for granted.
A similar story can be told for education, schools and teachers, I believe.
During the Transition to the New Normal
During the COVID-19 pandemic, which is still ongoing, we have not yet found a new normal to accommodate to, so things are in some sort of preliminary stage to which we see no point in adapting yet. During this transition period, let us look again at health, healthcare and health professionals.
Like in the fairy tale of the milkmaid and her pail, we are realising that without health – which would be the milk in this fairy-tale analogy – the rest of our plans and dreams cannot be realised. Without health, we cannot go to work or to school, we cannot travel, go on holiday, we cannot see our relatives, we cannot go shopping, we cannot go to the gym, you name it.
Healthcare is about managing the pandemic. It is about trying to get an epidemiological grasp of the virus and protect the population from getting the virus in the first place, get appropriate treatment in the second place, and prevent the disease in the third place. Hygiene measures were re-introduced and people were reminded about the importance of proper hand-washing habits. Social distancing was also introduced to prevent the virus from spreading, and hospitals were challenged to allocate beds, resources, protocols and procedures to prioritise COVID-19 patients. Emergency and campaign hospitals were built in many cities and countries to add capacity. The space and resources for ‘the rest of the healthcare cases’ were reduced or rationed and many stopped accessing healthcare services for issues they believed to be less relevant, or feared getting additional complications for their ongoing diseases. We are still talking only about physical health although from the beginning myself and many others started raising our voices about the importance of serving these other conditions and also the mental and social consequences of the pandemic, both direct and indirect. We started raising our voices because social distancing measures have brought to the surface the problems of social isolation and loneliness affecting an increasing number of people, especially in the older age groups. The same measures also have severely affected those who had underlying mental health problems and who as society we were pretending did not exist, and affected many more, with the symptoms of anxiety and depression increasing significantly. However, neither social wellness nor mental health issues are solved with teleconsultations and prescriptions, and the scarcity of resources is imminent.
During the COVID-19 pandemic, healthcare professionals were no longer invisible. For a while they were called heroes, but heroes are not supposed to feel tired or scared. Then they were forgotten, taken for granted again. The first waves were also marked by citizens clapping and being grateful to healthcare professionals. Professionals were called to face ethical dilemmas and put themselves and their families at risk, at the beginning without adequate protection measures, and then because their own immune systems were hijacked by fatigue, stress and sleepless nights.
We do not want just yet to consider the current situation as the ‘new normal’. We are looking for the positive impact of the pandemic on our lives, including the reduction in emissions and the positive impact on global warming; the positive impact of flexibility on the workplace and technology-enabled remote working and schooling; the convenience of internet shopping; etc. but also at the negative aspects of it, including the financial impact that remains to be seen, and of course, the social and mental health consequences in the medium and long term, including the impact of sustained home-office, among others, and the fact that, as we all know, the longer the tunnel is, the more different the landscape and the weather at the other end will be. How do we take this pandemic and design the new normal?
Towards a New Awesome
“The best way to predict the future is to create it.”
Health is physical, mental and social wellbeing and not the mere absence of disease, as defined by the World Health Organization. It always was, from the time of ancient Greece.
Healthcare can be enabled and amplified by technology at least to facilitate access and add comfort. Healthcare can be effectively delivered outside hospital wards and outside doctors’ offices. Patients can choose how to access healthcare and how to engage in healthier lives with technology. Patients, once passive recipients of healthcare, have now been engaged in understanding the basics of epidemiology, the impact of the frequency of testing on the number of positive cases, the impact of their own behaviour and that of their co-citizens regarding the public health measures. Mental and social health, however, is not measured by test results. Mental and social health issues are not cured with pills nor are prevented with vaccines.
Healthcare professionals are human beings, they have been more exposed to the pandemic than their fellow citizens. Their role has been recognised and appreciated. Even though often they are called to treat patients in what I call ‘astronaut suits’ to protect themselves, most have engaged in some sort of telemedicine applications, with teleconsultations, symptom checkers and other healthcare innovations finding their way into mainstream healthcare delivery. Some have even introduced robots. The role of healthcare professionals, especially when it comes to understanding complex data, unstructured data and associations that they know little about, for example, because of the recent history of the virus, can be enhanced with technology; machine learning and artificial intelligence algorithms can support healthcare professionals.
Humans Excel to Thrive
“If you are always trying to be normal, you would never know how awesome can be.”
Let’s try awesome. What is awesome health? What is awesome healthcare and what are awesome healthcare professionals?
Awesome health is physical, social and mental wellbeing. It is intellectual and occupational wellness that recognises humans’ creative abilities and looks for ways to expand knowledge through stimulating activities, which also means using technology to take on repetitive and low-value tasks. Awesome health encourages people to find fulfilment and contribute meaningfully with their skills and strengths, with a special mention to all healthcare professionals. It is emotional wellness, and with it, the understanding and acceptance of one’s emotions to manage life challenges. This will be especially important as we face the societal and financial changes that will follow this COVID-19 pandemic and other upcoming aftermaths for which we have to build resilience, confidence and trust. It is physical wellness through habits that nurture our bodies and boost our immune systems. It is social wellness and being able to maintain strong and diverse relationships and engaging in healthy social initiatives including the arts (again re-forgotten). Awesome health includes integrative and preventive solutions like ‘arts on prescription’. The power of the arts to play a major role in health promotion has been confirmed by WHO and the arts on prescription programmes are being used in several countries already and are a good starting point.
Awesome healthcare is certainly beyond hospitals and doctors’ offices. It is everywhere. It is at home, at school, at the office, in cities, in villages and on the go. It is in supermarkets and shops, in restaurants, with friends and in hotels. It is during holidays and during the work time, when we eat and when we sleep. It is embedded with life, not dissociated from it. It is not a special chapter to take care of when everything else keeps going.
Awesome healthcare professionals are human beings. They are enhanced with technology so that they can provide care and be what the word suggests: healthcare professionals, or ‘professionals caring’. Caring for patients is knowing them, recognising their symptoms but also their lifestyles and their life circumstances. The domino effect of one symptom and one intervention that impacts another symptom, another organ, another aspect is more preventable. It is having the knowledge and the expertise to provide 360° of healthcare, with their expertise and specialisation but coordinated with other healthcare professionals for the better health and wellbeing of patients, when they get sick but also so that they do not get sick. Being able to actually deliver health. It is care enabled by artificial intelligence if it can be, but it is care certainly enhanced with emotional intelligence, as well as social and spiritual intelligence.
Where Do We Start Creating This Awesome Future?
Let’s start by accepting the consequences of staying true to the definition of health, as physical, social and mental wellbeing.
Let’s define healthcare as delivering on these multidimensional aspects. Wellbeing starts with healthy habits such as nutrition and physical activity that impact our physical but also mental and social health. Take dancing, for example, as a physical activity that also has an impact on social and mental wellbeing. Healthy nutrition habits also impact sleep and mental wellbeing by acting upon our energy and irritability.
Let’s define healthcare professionals as the professionals contributing to our physical, social and mental wellbeing, and supporting us in engaging in healthy habits, and that would include psychologists and social workers, teachers, dance teachers, music teachers, art therapists and all those professionals adding to our physical, mental and social wellbeing. Let’s start the training of the healthcare professionals of the future, and of the patients of the future. Let’s equip as many as possible to proactively manage physical, mental and social wellness and to reduce as much preventable issues as possible.
Let us predict the future by creating it. Let us try awesome. Continuously improving is thriving. Giving wellness a space in human living, in schools, in universities, in families, at the workplace, at the supermarket, at restaurants, with friends. Giving health and wellness a pivotal role in all human matters. So that humans not only survive but thrive.
Conflict of Interest