Getting to the Root Causes of Patients' Problems

摘要

Q: How is looking at the root cause of a person's problem a unique way of thinking in our medical world? Mark E. Holthouse, MD: In the United States, we are good at using the acute-care model, which is a reactionary model. Typically, we wait for a patient to come in with a problem that has already occurred. This works well for things such as trauma, heart attacks, and strokes that are happening at the time of presentation. With chronic disease we need a new model, one that is aimed to answer the why? not merely the what? {of the diagnosis) a person has. This starts by identifying the root causes upstream from the patients' symptoms. Clinicians have to look beyond International Classification of Disease-10 codes that describe how we get paid and have very little to do with health—and, instead, try to access—from a systems biologic approach—what started a person's medical problems and how they have turned into a disease. Finally, clinicians need to focus on the reversal of chronic disease as opposed to simply managing it, which is also what we tend to do in this country.