EXPANDING SELF-C ARE
Self-care, self-care, selfcare…: have we been missing something? Simon Y Mills
My passion is to help medicine become more meaningful to the people who need it. After my medical sciences degree many years ago I chose to use plants as medicines that have always had both meaning and effect. I have since lived through various complementary medical initiatives, academic, professional and regulatory, and keep returning to the absolute importance of engaging with the story in each of our lives, and as lived in our community. I am also on the hunt for an alternative word for ‘patient’ and ‘client’ (‘valetudinarian’ – one seeking health – is good but does not easily flow!).
Herbal practitioner
Healthcare or self-care?
Summary Complementary approaches may be ideally suited to supporting self-care rather than extending prescriptive medicine, and practitioners may rediscover their role as mentors.The Department of Health may be ahead of the professions in understanding the importance of this.
© Journal of holistic healthcare
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Volume 6 Issue 2 Aug 2009
Health practitioners generally consider that their role is to treat their patients. Professionals may even measure their status by their relative autonomy to prescribe or intervene, and even complementary practitioners may share this aspiration. So consider this: graduates of the only MSc course in herbal medicine in the USA1 are not permitted in most states to diagnose or treat illnesses, nor to prescribe or dispense herbal medicines. They are indeed well educated to understand pathologies and other medical and phyto-therapeutic disciplines. However they are trained to keep these insights to themselves and to use their expertise instead to provide the best individual advice for ‘clients’ who have made a personal choice to use herbs to manage their own health. Instead of saying ‘I will treat your [ulcerative colitis]’ they say ‘If I were you I would choose these herbs to help you improve your [digestive and immune] health: you can take this list anywhere you like to find them; however we also have them available if you choose…’ The client is being supported in a self-care choice: the practitioner serves that client, as counsellor, guide, mentor,
coach or trainer. They may adopt interviewing techniques to help their clients identify their health needs more effectively: more open-ended questions, less instructions perhaps. This approach seems well suited to the role of guide (particularly in herbal medicine, so many of whose remedies are traditionally seen as supporting physiological and recuperative functions). But it also stimulates wider thoughts about self-care and practitioners’ influence on their clients’ choice-making. All healthcare systems are struggling to meet growing demands for services, so the prospect of making more effective use of professional time and facilities is a crucial strategy, particularly in chronic illnesses. It has become more widely understood that approaches that motivate patients to make long-term behaviour change are likely to be more effective than those that only patch up immediate needs. The Department of Health puts it this way: There is considerable national and international evidence to show that supporting self care results in health benefits for the people and therefore overall gain for the care system.2
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