While in California recently for a convention which has a great deal to do with my research interests and pastimes, I had the pleasure of visiting Disneyland with some dear friends. I am into counseling- specifically addictions and career counseling; and I couldn’t help but notice something at Disneyland that would really benefit the fields of counseling and healthcare in general: obsessive attention to detail which results in a high-quality experience.
The level of detail in the Disney experience is so painstaking that much of it fades from one’s consciousness. The staff are called cast members, because you are immersed in a show- a show full of scenery and design. The architecture at Disneyland is designed to immerse guests in specific environments- from the breathtaking canyons with vintage garages of Cars Land, to the proportionally smaller windows and architectural features on the second and third stories of buildings that make them appear taller. For healthcare or counseling, this translates to intentional consistency and vigilant person-centered care. While we spend more and more of our money, as Americans, on healthcare; much of it state-of-the-art; prevalence of chronic disability and disease has never been higher. This is due in part to conflicting messages from healthcare entities about things like what we eat, how we prevent and treat illness, mental illness, addiction, and the people who contract them.
Imagine a healthcare system where its participants were immersed and invested in living the longest, healthiest, most fulfilling lives they could. Imagine if healthcare professionals were as obsessed with that vision as the most informed, responsive patients. While leaving Disneyland one night, I noticed two pathway lights whose fluorescent bulbs were flickering. The following night, the bulbs had already been changed. There is no room for an ignored light bulb on Disneyland’s 510 acres. With combined overhead and profits upward of 30% of healthcare costs, you would think we could keep all the bulbs lit. What does it mean to keep bulbs lit in our healthcare systems?
First, a continuum of care should be expected, not just encouraged. The latest research emphases in medicine are on meeting the varied, holistic needs of people from general practitioner to specialist to dietitian to other life domains like career, family, recreation, and self improvement. We could incentivize prevention and self improvement using a combination of strategies to engage patients- to immerse them in living well. We could set expectations for all practitioners that they communicate with other members of a person’s treatment team, and that informed consent is treated as helpful- not just a rubber stamp for status quo treatment. The main thing that needs to happen, however, is a culture shift. Human services professionals must be part of a system that encourages innovation and professionalism. Citizens must be part of a system that encourages self care and self improvement using evidence and research, rather than profits and marketing. Public policy will need to enable vigilant providers and patients, rather than focusing simply on cost analysis and disease management. It is time for culture to change: if self-improvement and a focus on holistic care were a greater part of public discourse, policy debates about health insurance- an unnecessarily, ridiculously large portion of our economy; would be unnecessary and moot.