Major depressive disorder and the depression in bipolar disease *cannot be
"cured" by going for a hike*. These are chronic, debilitating diseases,
that impact an individual, their families and our society in horrific ways.
There are worse than many other chronic diseases, because they are diseases
of brain and behavior.
I understand the point that you are trying to make about the transactional
model, but, unfortunately, you are perpetrating an obsolete myth
that individuals with psychiatric disease could just get better by "pulling
themselves up by their bootstraps." Modern neuroscience research has shown
us, probably more than anything else, that these are as serious as diseases
of the heart, liver or kidney, but once again, the stigma of these diseases
persist. And they are diseases, not "disorders."
I would agree that the draft DSM-5 has attempted to split psychiatric
diagnoses into too many potential CPT codes for reimbursement - edged on by
idiots (IMHO) like Dr. Drew Pinsky of TV fame, who pushed to have "sex
addiction" included in DSM-5 as a disease.
Maybe we should suggest that PTS or TBI can be cured by exercise - this is
a laughable notion.
Kind regards - Gerry Higgins, Ph.D.
On Thu, Mar 8, 2012 at 1:03 PM, Tom Munnecke wrote:
> re: things not happening being the most important.. yes, a very big
> topic. It gets to the core of prevention and health. If someone cures
> their depression by doing lots of hiking, rather than getting a
> prescription for an antidepressant, there is no transaction, no DRG, no
> income for anyone (except perhaps a shoe company). There are no "outcomes"
> to assess, and no way to know if this prevented a heart attack, diabetes,
> or whatever. So how does one do a cost/benefit analysis of hiking?
> The transactional model of health care is based on the things done - RIM
> talks about everything starting with an activity. The elegant solution -
> dissolving problems before they are manifest - is not visible to the
> My "bucket list" of things to do for VistA that never got implemented was
> a system I called "pendex" or pending index of things expected around a
> patient. This state would be held in a container I called an "ensemble" -
> or people, things, knowledge, and agents seeking to accomplish some health
> care goal, which I called a "transformation." Ensembles were a way of
> decoupling the architecture from the organization chart or agency - a way
> of moving to a model of personalization.
> Alas, the world seems to be moving away from this concept into
> mega-turbo-hyper centralization :(
> Full post: http://www.osehra.org/blog/proposal-create-imaging-group-osehra
> Manage my subscriptions:
> Stop emails for this post: