The new medical model: a renewed challenge for biomedicine

Fuller, Jonathan

doi:10.1503/cmaj.160627

Cited by 90 publications

(29 citation statements)

References 6 publications

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“…Medical training is traditionally built on a model of sequential practice: presentation → history → examination → differential diagnosis → investigations → diagnosis → treatment. This approach assumes the diagnosis to hold sufficient truth to explain the presenting problem(s) and to successfully inform treatment …”

Section: Uncertainty In Diagnosismentioning

confidence: 99%

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Child with multiple problems: Clinical complexity and uncertainty

McDowell

2018

J Paediatrics Child Health

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When practising neurodevelopmental–behavioural paediatrics, responsibility rests with the individual clinician to interpret research evidence in their daily work. This is not necessarily an easy task. Children do not usually present with single, easily definable problems. Complexity and uncertainty are present from the outset due to heterogeneity inherent in the diagnoses available, patterns of comorbid problems and the unique challenges of each child's social context. This article examines the resulting clinical challenge and offers potential responses. Rather than striving to eliminate uncertainty with strategies such as extensive assessment, the goal is to work effectively and efficiently within the limits of what can be readily known. Suggested strategies address complexity by considering the components of what is going on (biological, developmental, transactional) as hypotheses shared within each child's system of care. These hypotheses can then be tested and revised systematically as further information arises along the journey of treatment and longitudinal care.

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Section: Uncertainty In Diagnosismentioning

confidence: 99%

“…This approach assumes the diagnosis to hold sufficient truth to explain the presenting problem(s) and to successfully inform treatment. 1 However, like the blind men and the elephant, 2 each diagnosis in NBP may provide only partial information. Specifically, these diagnoses may inform only part of the clinical picture.…”

Section: Uncertainty In Diagnosismentioning

confidence: 99%

Child with multiple problems: Clinical complexity and uncertainty

McDowell

2018

J Paediatrics Child Health

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“…1 This burgeoning field has featured in several recent issues of CMAJ, most notably in Jonathan Fuller's latest article, "The new medical model: a renewed challenge for biomedicine." 2 In this article, Fuller shows the value of philosophy in clarifying and describing "the new medical model," and articulates the metaphysical, epistemological and ethical ideas that form the core of contemporary medical thought. In so doing, Fuller brings to light problems inherent to the new medical model, which in turn create challenges in clinical practice.…”

Section: The New Medical Model: Why Medicine Needs Philosophymentioning

confidence: 99%

The new medical model: why medicine needs philosophy

Chin‐Yee

2017

CMAJ

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“…This orientation is consis tent with a medical model that still places biomedical diseases at the centre. 2 Although G.L. Engel's rival biopsycho social model was once touted in the pages of major journals, 3 it has been somewhat displaced by newer humanistic movements like narrative medicine and personcentred medicine.…”

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confidence: 99%