The Growing Slow Medicine Movement
Career Path : Healthcare
You may have heard about the slow food movement. Originating in Italy, it is a reaction against industrialized agriculture and fast food, returning to the old-world values of community and the environment. The concept of slow medicine operates along similar lines, resisting the instant medicalization prescribed by the pharmaceutical industry in favour of gentler measures and increased consultation with patients before taking action. Instead of rushing to prescribe drugs or surgeries, caregivers would spend more time listening to the patients and their families, or simply waiting and observing symptoms.
âMedicine is far from an exact scienceâ
Anyone who has lost a loved one due to questionable aggressive treatments such as chemotherapy can appreciate the appeal of more closely considering alternatives. A recent post by British Medical Journal editor Richard Smith stated that âonly 11 per cent of 3,000 health interventions have good evidence to support them â¦ a third of activity in the U.S. health system produces no benefit â¦ half of all angioplasties are unnecessary â¦ four-fifths of new drugs are copies of old drugs.â There is a growing consciousness about potential conflicts of interest in the pharmaceutical industry and that doctors donât always make the right decisions. Slow medicine doesnât dispute that urgent health problems will always require quick attention but rather, suggests a thoughtful, considered and evidence-informed approach to both acute and chronic care.
Dying with dignity
The term slow medicine, as coined by Dr. Dennis McCullough, refers mostly to compassionate care for aging parents. It encourages physicians to think twice when considering treatment that may have high risks and limited rewards for the elderly, âdeath by intensive care.â Our medical system is designed to prolong life, respond quickly to crises, and provide heroic interventions. This assembly line mentality of efficiency and high productivity is not always aligned with the best interests of frail seniors. Patients in their 80s or 90s may not have the resilience to bounce back from such treatments, which may accelerate a prolonged decline and dependency. Slow medicine shares with hospice care the goal of comfort rather than the cure, providing patients the choice to say no to hospitalization, surgery or medication. It is a family-centred attention to quality and emphasis on social interchange that stresses a proactive and preventative approach for relatives to rescue the elderly from standard medical care.
The fact that slow medicine is a cheaper alternative to high-tech remedies lead some to worry that it could backfire by justifying official policy that limits costly treatment to the elderly for the benefit of the bottom line. Still, exhausting diagnostic tests should be justified, aligning with pharmaceutical quality assurance, and medical programs constantly re-evaluated. Starting medications at lower doses before being gradually increased recognizes that what works for a 75-year-old can prove disastrous to a 95-year-old. The slow medicine concept is gaining momentum among the medical community and increasingly pharmacies, promoting breathing exercises, for example, as preventative treatment for hypertension, and integrating pharmaceutical quality control with the broader needs of the community.
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