Rationale: There is a need for medicine to deliver more whole-person care. This is a narrative review of several models of whole-person care and studies that illustrate the business case for whole-person models in primary care. Objectives: To provide an overview of what whole-person care models exist and explore evidence to support these models. Study Selection: Representative whole-person care models widely used in the United States are summarized and evaluated. Selected studies focused on outpatient primary care with examples from programs that integrate the delivery of conventional medical care, complementary and alternative medicine, and self-care within the context of social and cultural environments. Methods: Pubmed search conducted December 2020–February 2021. Two iterative searches using terms for “Whole Health Veterans Administration,” “integrative medicine,” “integrative health,” “complementary and alternative medicine,” and, as they related to the outcomes, of “health outcomes,” “cost-effectiveness,” “cost reduction,” “patient satisfaction,” and “physician satisfaction.” Additional studies were identified from an initial search and the authors’ experience of over 50 years. We looked for studies of whole-person care used in general primary care, those not using a single modality and only from United States practices. Results: A total of 125 (out of 1746) studies were found and met our inclusion criteria. We found that whole-person models of primary care exist, are quite heterogeneous in their approaches, and routinely report substantial benefits for improving the patient experience, clinical outcomes and in reducing costs. Conclusions: Evidence for the benefit of whole-person care models exist but definitions are quite heterogenous and unfocused. There is a need for more standardization of whole-person models and more research using whole systems approaches rather than reductionistic attempts using isolated components.
In 16 years of practice, I had never seen a patient light a cigarette or pour a glass of wine in front of me. Yet, that occurred at the very onset of the COVID-19 era, a time that has shattered any preconceived notions of what I might experience during a clinical visit. The COVID-19 pandemic has forced many physicians to approach patient care in completely different ways. While many have been providing care in hospitals, many more of us have had to stop seeing patients in person, shift to telemedicine, and consider other ways to improve the health of our patients. The rapid changes we have had to make in the last year have demonstrated the resiliency of our profession. This is a critical time to refocus and make sure that health care is person-centered, encompasses all modifiable health determinants, and helps individuals achieve health rather than primarily manage disease.
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