The need for a new medical model: A challenge for biomedicine.

Abstract

At a recent conference on psychiatric education, many psychiatrists seemed to be saying to medicine, "Please take us back and we will never again deviate from the 'medical model.' " For, as one critical psychiatrist put it, "Psychiatry has become a hodgepodge of unscientific opinions, assorted philosophies and 'schools of thought,' mixed metaphors, role diffusion, propaganda, and politicking for 'mental health' and other esoteric goals" (1). In contrast, the rest of medicine appears neat and tidy. It has a firm base in the biological sciences, enormous technologic resources at its command, and a record of astonishing achievement in elucidating mechanisms of disease and devising new treatments. It would seem that psychiatry would do well to emulate its sister medical disciplines by finally embracing once and for all the medical model of disease.

Conceptions of health: A cross-cultural comparison.

“…In reaction to the criticisms voiced against the reductionist view of the biomedical model and to the constructivist literature suggesting that people construct their own conceptions of health, multidimensional health models have been developed (Baumann, 1961;Engel, 1977;Laffrey, 1986a;Schlenger, 1976;Smith, 1981). Instead of conceptualizing health on a single health-illness bipolar continuum, health has been represented on more than one dimension.…”

“…Some individuals may give more weight to certain dimensions, while others focus on other aspects. By representing health on more than one dimension, theorists hope to encompass the different health perspectives found among members of the general population (Alonso, 2004;Engel, 1977;Smith, 1981).…”

“…One major objection lies in its reductionist nature (Alonso, 2004;Engel, 1977;Tripp-Reimer, 1984). By focusing exclusively on the absence of disease, it fails to represent the general population's perspectives on health (Goins, Spencer, & Williams, 2011;Hufford, 1992;Laffrey, 1986a;Mansour, 1994).…”

“…The biomedical model conceptualizes health and illness as two opposite ends of a continuum. Being represented on a single bipolar dimension, they are seen as mutually exclusive states: being healthy means not being sick (Engel, 1977;Larson, 1999;Newman, 1991;Saylor, 2004;Stein, 1990;Tripp-Reimer, 1984;Turner, 2000). Accordingly, healthpromoting strategies are geared towards the treatment of illness (Alonso, 2004;Laffrey, Fong, & Loustau, 1985;Larson, 1999;Newman, 1991;Smith, 1981;Turner, 2000).…”

“…Numerous health conceptions are discussed in the scientific literature, the biomedical model being one of the dominant perspectives on health (Alonso, 2004;Engel, 1977;Laffrey, 1986a). The biomedical model conceptualizes health and illness as two opposite ends of a continuum.…”