25 April 2021: Everybody agrees that integrated health care is the best way to address illness and enhance wellness. But actual prostate cancer care is divided into narrow splinters of excellence. That’s what I and 99% of the prostate cancer survivors I have met worldwide experienced. It was up to us to stitch together the pockets of excellence provided by specialists. And for most of us there were lots of gaps.
This week I’ve found some sensible suggestions about why integration is so absent from most health care, particularly in areas like prostate cancer treatment and recovery. Here are a few hypotheses.
- The system prefers neat, clear solutions to tangled interdependence.
- Anything to do with sex is taboo, or at least too difficult to talk about.
- There are challenges about proving (or even claiming) professional standing in such areas.
- Maybe it is all about the money.
Preferring clear-cut solutions
Clinicians tend to focus on solvable problems. So say four smart and experienced professionals, themselves grappling with cancer. They are also educated in matters of health care, human sexuality and occupational therapy. Their views were published last week in a podcast on Curious Conversations about Sex. I see the benefits of this scalpel-sharp clinical focus on solutions – leading for example to brilliant cancer treatment options such as my own amazing robotic-assisted laparoscopic surgery. “My treatment team focused on my survival, not my living” said one on the podcast. And the bottom line is we do want our clinicians first to secure our survival.
I would add that it is not just clinicians who want certainty – most of their patients also just want them to get the cancer out. People just diagnosed with cancer aren’t always good at listening to the what-ifs and complexities of recovery after treatment.
But then, if we survive the cancer, all the challenges of living with our new bodies and relationships do inevitably emerge. And that is where an integrated ecosystem of health care is needed. My recovery process needed attention to diet, exercise, sexuality, physiotherapy, relationships with loved ones and spiritual adjustment. But none of these were recommended by my clinicians and they couldn’t even refer me when I specifically asked.
I hope the world’s enforced experience of radical uncertainty in the last couple of pandemic years might help us all face up to complexity. It’s time to stop limiting ourselves to problems that can be neatly boxed and solved.