Dr. Bertalan Mesko, PhD, the Director of The Medical Futurist Institute interviews Dr David Somekh Director if EHFF
This interview comes to us from Patreon
In this interview, I talked with David Somekh, who is leading EHFF, a non-profit organisation dedicated to improving the health of European citizens, about cultural change, the youth and patient empowerment.
With an ageing population and digital health start-ups challenging the status quo in healthcare, what are the most pressing challenges in improving the health of EU citizens?
We see the root cause of the challenge you refer to as being two-fold. Firstly, the need to systematically reform a healthcare model which is no longer fit for purpose, holding back innovation and is fundamentally flawed by being centred on institutional care, rather than care in the community.
Secondly, as people have been saying for a very long time now, ‘healthcare’ is fundamentally sickness-care; there is far too little investment in prevention, in educating citizens (greater health literacy) and changing the funding of health accordingly, even though there is scientific evidence for the benefit of such an approach.
It’s a goal that people will continue to pursue, because it makes sense, but old habits die hard. The problem with institutional systems is that they tend to be self-sustaining. The change will happen, but more slowly than we would wish.
How do you see the future of European healthcare?
I’m an eternal optimist. When I worked as a full-time Doctor and medical manager in the UK NHS 20 years ago (although I was just starting then to get engaged in EU level policy development) we felt very optimistic about the trajectory. While the impact of digital has grown hugely, genomics and other scientific advances have enriched our ability to fight diseases and to speed up some processes within the system, there are some areas that have shown little advance in twenty years, the two issues referred to above being obvious examples.
What my group sees now, however, are positive signals. The new administration in Brussels is much more orientated to health and its connection to other systems such as the environment and social cohesion, in other words, a more holistic approach, although it remains to be seen whether these principles are carried forward via action. Culture change is a slow business.
As is so often the case for people of my age, I see the real hope lying with the young; enthusiastic and digitally literate young professionals, willing to innovate and not necessarily over-awed by the authority of their elders. Young citizens wanting to protect the planet and recognising that there is also an issue of personal responsibility that comes with wanting change. Maybe (we might hope) helping a shift away from the economically influenced culture of pursuing personal gain above caring about the society that has been so prevalent in the last 20-30 years.
How can patient empowerment operate in the post-COVID world?
The principle of patient empowerment was that patients should be helped to move from a passive role in their interaction with health professionals (HCPs) to having an active, more equal role.
To facilitate this, people analysed patient empowerment as having three overlapping components:
- self-management (especially in chronic diseases), with input from HCPs as an adjunct,
- joint decision-making, and finally
- education – this means not just increasing the health literacy of citizen/patients and their families but also educating HCPs in how best to facilitate empowerment (the move for HCPs from ‘handing down the tablets’ to becoming ‘health coaches’).
What major disasters, like world wars will often do is to increase social cohesion. There are plenty of examples of this happening in local communities during the COVID disaster. Community empowerment is an extension of the empowerment principle where people come together to achieve local benefits when the normal sources of support (from above as it were) are failing them.
If this trend persists after the disruption of COVID, like the big up-tick in use of digital communication in healthcare, then we are moving in the right direction for transformational change of our healthcare systems.
Thank you for your valuable input!
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