A new model of care to return holism to family medicine

Jonás,

doi:10.12788/jfp.0110

Cited by 5 publications

(10 citation statements)

References 14 publications

(13 reference statements)

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“…However, current healthcare strategies routinely neglect social determinants of health, missing opportunities to reduce the burden, expense, and environmental effect of chronic disease. An integrative healthcare framework offers a potential solution 23…”

Section: Reducing Demand For Health Servicesmentioning

confidence: 99%

“…Evidence based approaches such as yoga, acupuncture, massage, and mind-body practices are particularly useful for pain reduction and more appropriate than medications (especially opioids) for chronic pain 25. As part of primary care, these approaches offer opportunities to intervene upstream in health promotion and disease prevention 23. While these behavioural and social determinants are not the sole responsibility of healthcare services, helping patients better engage and manage them could go a long way towards reducing the need for more expensive and environmentally damaging interventions later.…”

Section: Reducing Demand For Health Servicesmentioning

confidence: 99%

“…An integrative healthcare framework offers a potential solution. 23 Integrative healthcare is the delivery of non-pharmacological and lifestyle approaches to disease prevention and treatment in coordination with conventional treatments of chronic disease. 24 Smoking cessation, reducing use of drugs (including alcohol), and better dietary habits, activity levels, and stress management can prevent or mitigate many chronic diseases.…”

Section: Institutional Structures To Drive High Value Carementioning

confidence: 99%

“…25 As part of primary care, these approaches offer opportunities to intervene upstream in health promotion and disease prevention. 23 While these behavioural and social determinants are not the sole responsibility of healthcare services, helping patients better engage and manage them could go a long way towards reducing the need for more expensive and environmentally damaging interventions later.…”

Section: Institutional Structures To Drive High Value Carementioning

confidence: 99%

See 3 more Smart Citations

Net zero healthcare: a call for clinician action

Sherman

McGain

Lem

et al. 2021

BMJ

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Section: Reducing Demand For Health Servicesmentioning

confidence: 99%

Section: Reducing Demand For Health Servicesmentioning

confidence: 99%

Section: Institutional Structures To Drive High Value Carementioning

confidence: 99%

Section: Institutional Structures To Drive High Value Carementioning

confidence: 99%

See 2 more Smart Citations

Net zero healthcare: a call for clinician action

Sherman

McGain

Lem

et al. 2021

BMJ

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show abstract

“…Integrative health care is part of a larger type of whole-person primary care we have recently described as Advanced Primary Care [ 16 ]. Briefly this model begins with the basic transaction with the patient, the encounter, and the therapy, but then surrounds that transaction with three additional circles of care that enhance or enable whole-person care.…”

Section: Examples Of Whole-person Modelsmentioning

confidence: 99%

The Case for Whole-Person Integrative Care

Jonas

Rosenbaum

2021

Medicina

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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.

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Defining comprehensiveness in primary care: a scoping review

Baughman,

Nasir,

Ngo

et al. 2023

J. Prim. Health Care

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Introduction The term comprehensiveness was introduced into the literature as early as the 1960s and is regarded as a core attribute of primary care. Although comprehensive care is a primary care research priority encompassing patient and provider experience, cost, and health outcomes, there has been a lack of focus on consolidating existing definitions. Aim To unify definitions of comprehensiveness in primary care. Methods The PRISMA extension for scoping reviews was followed, hierarchically filtering ‘comprehensiveness’ MeSH terms and literature-defined affiliated terms. Snowballing methods were used to include additional literature from known experts. Articles were systematically reviewed with a three-clinician team. Results The initial search populated 679 607 articles, of which 25 were included. Identified key terms include: whole-person care (WPC), range of services, and referral to specialty care. WPC is the extent which primary care physicians (PCPs) consider the physical, emotional, and social aspects of a patient’s health. It has been shown to positively impact clinical costs and outcomes, satisfaction, and trust. Range of services encompasses most health problems to reduce unnecessary spending on specialty care and promote continuity. Referral to specialty care is utilized when PCPs cannot provide the necessary services – balancing depth and breadth of care with the limitations of primary care scope. Discussion This scoping review unified the interrelatedness of comprehensiveness’s main aspects – whole-person care, range of services, and referral to specialty care – framing a working, evidence-based definition: managing most medical care needs and temporarily complementing care with special integrated services in the context of patient’s values, preferences, and beliefs.

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A new model of care to return holism to family medicine

Cited by 5 publications

References 14 publications

Net zero healthcare: a call for clinician action

Net zero healthcare: a call for clinician action

The Case for Whole-Person Integrative Care

Defining comprehensiveness in primary care: a scoping review

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