What does “Taking a holistic approach” mean? - Part 2

Last time, we established that “holistic” means taking the whole-person into account. Let’s talk about how holistic approaches can vary depending on the diagnosis and prognosis.

For every diagnosis, you should consider the prognosis. What’s likely to happen, i.e., what are the possible consequences? How likely are the consequences? When are the consequences likely to happen? How does the outlook change depending on the intervention? Let’s explore two different diagnoses, and apply this framework:

1. High cholesterol:

a. What are the possible consequences? High cholesterol can contribute to atherosclerosis, which can cause heart attack, stroke, and other problems.

b. How likely are the consequences? Various risk models use different inputs. Often the inputs give estimated risk on the order of 1-20% over ten years.

c. When are the consequences likely to happen? The process of atherosclerosis can take decades to cause serious consequences.

d. How does the outlook change depending on the intervention? Lowering cholesterol and adopting healthy habits can reduce your risk for heart attack and stroke, often in the neighborhood of reducing risk by 5-10%.

2. Sepsis from bacterial blood stream infection:

a. What are the possible consequences? Left untreated, this usually leads to death.

b. How likely are the consequences? Almost a certainty.

c. When are the consequences likely to happen? Depending on various factors, this can progress within hours to days.

d. How does the outlook change depending on the intervention? Aggressive treatment in the hospital can be curative.

How does “taking a holistic approach” apply to these two diagnoses?

For the first – you have time and patience on your side. You can try different approaches – including focus on lifestyle, and potentially trying medication. You can carefully consider risks, benefits, and burdens of medications. You’re dealing with lowering your long-term risk of a bad event, for example from 10% to 5%, and open-mindedness and creativity is welcome. A holistic approach involves nuance, understanding, and care over a timeframe of decades.

For the second – Outcomes are much more certain, imminent, and severe. Time is not on your side. You’re dealing with a life-threatening, imminently dangerous problem. A holistic approach involves quick, decisive action in effort to save the whole person.

These two scenarios present two ends of the spectrum in terms of what modern medicine understands and routinely treats. Many physicians train extensively in the hospital where the “command and control” mindset is necessary for situations like bacterial blood stream infections. A disconnect often happens when the “command and control” mindset is applied to diagnoses such as high cholesterol that call for patience and understanding.

Correct diagnosis is foundational. Once the diagnosis is established, seek to understand the prognosis, timeframes, and treatment options in order to make holistic, whole-person choices.

Stay tuned for more information on our next blog entry!