Monday, 12 November 2012

Self-care vs. self-management

So, it's self-care week this week! I get the feeling that many people use the terms self-care and self-management quite interchangeably. I didn't really think about this until I listened to Medical Matters podcast on Radio 4, where a GP was giving self-care a hard time. Reading a lot of the literature produced for this week as well I have begun to realise that there are important distinctions between the two, and that they are far from indistinguishable.

Self-management is specifically for long-term health conditions while self-care applies to acute ailments. Self-management is about coping with long-term health conditions, managing the emotional and practical issues they present. Self-care focuses more on treatment- most people with LTCs would be lucky if their was a treatment for their condition!

The reasoning behind self-care seems to be where self-management was several years ago - a cheap solution. The benefits of self-management are now widely accepted beyond pure health economics, and into patient experience territory. My impression seems that self-care is being sold for financial reasons above others, which is unsettling.

17 minutes into Inside Health, Dr Margret McCarthy talked about self-care - it is clear she was not a fan! She commented that it focused on "wasting resources" and quoted some Department of Health work which found that thousands and thousands of appointments were "unnecessary". With a slight hint of mockery, she suggested this was all supposed to "empower patients", and raised the interesting issue of who funds Self-Care Week (pharma!). The reasons she gave against promoting self-care are valid, but certainly do not apply to self-management. It's not about using your doctor less - that is a happy by-product of having more satisfactory appointments in the first place and managing emotional that contribute to physical symptoms such that appointments are less needed. Self-management still teaches to consult doctors about new symptoms for example.

I hadn't really considered the distinction between the two before, and will certainly not be interchanging them in the future! That is not to say that I am against self-care - I fully appreciate the sentiment behind the campaign in times where resources are finite and there may be an over-dependence on the NHS for minor ailments.

UPDATE: My thoughts on the distinction between the two have been reinforced having listened to this video by Care Minister, Norman Lamb, who puts self-care into context of national and European policy. Self-care clearly has a significant difference to self-management at a policy level!

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