Health is traditionally equated to the
absence of disease. A lack of a fundamental pathology was thought
to define one's health as good, whereas biologically driven
pathogens and conditions would render an individual with poor
health and the label "diseased". However, such a narrow scope on
health limited our understanding of wellbeing, thwarted our
treatments efforts, and perhaps more importantly, suppressed
prevention measures.
Many institutions and medical doctors have
managed to incorporate a holistic view of health in sound medical
application, primarily based on the Biopsychosocial (BPS) Model of
Health and Illness. The concept of wellness is particularly
stressed, where the state of being in good health based on the
biopsychosocial model is accompanied by good quality of life and
strong relationships.
In 1977, American Psychiatrist
George Engel introduced the major theory in medicine, the BPS
Model. The model accounted for biological, psychological, and
sociological interconnected spectrums, each as systems of the body.
In fact, the model accompanied a dramatic shift in focus from
disease to health, recognizing that psychosocial factors (e.g.
beliefs, relationships, stress) greatly impact recovery the
progression of and recuperation from illness and disease.
Engel eloquently states:
"To provide a basis for understanding the
determinants of disease and arriving at a rational treatments and
patterns of health care, a medical model must also take into
account the patient, the social context in which he lives and the
complementary system devised by society to deal with the disruptive
effects of illness, that is, the physician role and the health care
system. This requires a biopsychosocial model."
Today, individuals
are living with diseases that would have taken their lives in the
past. We see health and wellness is a broader forum. Medical
practitioners are more frequently adopting the biopsychosocial form
in their clinician practice. The following outline compares the
presentation, diagnosis, and treatment used by physicians who
follow the biomedical and biopsychosocial model:
Reason for visit: Patient complains of chest pain.
Presentation: The focus is on physical causes of disease. The physician will ask few questions on recent diet, pain history, and familial incidence, however, empirical signs and symptoms of myocardial infarction are considered paramount.
Diagnosis: The clinician will order objective lab tests and monitor vital signs (i.e. temperature, pulse, and blood pressure) that would form the sole basis of any finding.
Therapy: The doctor will prescribe a medicinal plan for the patient based on biological etiology and pathogenesis.
Reason for visit: Patient complains of chest
pain.
Presentation: The aim to ascertain psychosocial and physical
processes that may cause the chief complain, chest pain. The
physician may ask for a history of recent life stressors and
behaviors.
Diagnosis: Based on a combination of psychological
factors and standard lab tests, the clinician will form a
diagnosis.
Therapy: The physician discusses the available
interventions with special attention to behaviors and lifestyles
that could influence her pain and adherence to the treatment plan.
The patient is involved in formulating and implementing the plan,
and maintains a supportive relationship with the clinician.
GNIF Brain Blogger
