A Patient-Centered vs. A Disease-Centered Model

Patient-Centered_logo.jpg

The term “complementary and alternative medicine” (CAM), as it pertains to a category of medical systems, encompasses a sundry of healing modalities whose unifying philosophy reaches beyond the seemingly static horizon of conventional medicine.  Specifically, these medical systems aim to recognize and treat patients as unique, whole individuals by incorporating a medical ideology centered on wellness and self-healing, which unsettles the reductionist and materialistic view central to modern medicine (1).

This idea of wellness embodies prevention at the most basic level, encouraging individuals to become active participants in their health journey by taking advantage of their inner resources and seeking balance with the world around them (1).  This is in stark comparison to the “magic bullet” mentality of modern medicine, which prescribes both preventative and treatment measures that can endorse a high-risk lifestyle despite its impinging consequences.  The idea of patient-centered and disease-centered models of care separates these two medical systems, though both aspire to offer successful therapeutic methods. 

Patient-Centered Medicine

According to Micozzi (2015), common characteristics of CAM that encourage a patient-centered model include a wellness orientation, a reliance on self-healing, the role of bioenergetic mechanisms, nutrition, and natural products to support healing, and an emphasis on individuality.  Micozzi uses homeopathy as an example of individuality in treatment because of its emphasis on specific symptoms and symptom complexes exhibited by each individual patient versus an overarching declaration of a specific disease or disorder. 

Functional Disorders

Symptoms, known as functional disorders in CAM circles, are viewed as a means to an end that direct the practitioner to better understand what the patient is experiencing.  Unlike conventional medical practices, symptoms do not determine a pathological diagnosis but point to what is out of balance in the body.  CAM practitioners see functional disorders as precursors to disease, rather than the result of disease, and seek to restore the body to balance versus just removing the “offending” symptom.

All Things Exist in Relationship

CAM acknowledges that all things exist in relationship, and the hasty relief of a symptom or the removal of a defective tissue, organ, or otherwise may not completely solve the problem.  To quote Hippocrates, “all things are in sympathy,” and it is important to recognize that an individual is infinitely greater than the sum of its parts.  The goal is to encourage self-healing through external manipulations that help mobilize the body’s inner healing resources (1).  Additionally, employing the power of the mind-body connection to restore balance can dramatically affect one’s health (1, 2).  All of these methods help and empower an individual to engage in and take responsibility for their health, which is therapeutic in and of itself.

Disease-Centered Medicine

Allopathic medicine, or biomedicine, has been wrongfully been called the “scientific” form of medicine; however, the objectivism, reductionism, positivism, and determinism that define its philosophy has limitations. 

Inherently, biomedicine is based on objective and reproducible observations of mechanics, generally examined in an isolated fashion.  However, this reductionist practice cannot fully account for the social, mental, physical, and spiritual aspects of a living organism (3).  Chronic disease can now be linked to certain personality traits and social dysfunction that may not be reproducible on an experimental level (3).  Despite the subjective nature of these types of influences, the demonstrable response or outcomes triggered by these types of behavior cannot be ignored.

Consequently, the intrinsic and extrinsic influences of a patient may profoundly affect the healing outcome.  Recent studies on gene regulation have demonstrated that certain CAM healing modalities can produce positive physiological responses, indicating a strong correlation to the mind-body connection (1).  In fact, evidence exists that a patient’s spirituality can significantly affect coping, healthcare outcomes, stress management, and resiliency (2).  Thus, denying demonstrable healing responses for the sake of empirical science can no longer remain the standard of contemporary biomedicine. 

Therefore, it is imperative that any given medical system, whether CAM, conventional, or integrative, seek to better understand and answer the needs of patients by focusing on the individual, not the disease, and by supporting self-healing intrinsically and extrinsically versus defending fixed ideas of science and medicine.  

References

1. Micozzi, M. S. (2015). Fundamentals of complementary and alternative medicine (5th ed.). St.             Louis, Missouri: Saunders (W.B.) Co.

2. Puchalski, C. M. (2013). Integrating spirituality into patient care: An essential element of person-centered care. Polish Archives of Internal Medicine, 123(9), 491-497. Retrieved from             http://pamw.pl/en/issue/article/24084250

3. Cloninger, C. R. (2013). Person-centered health promotion in chronic disease. International             Journal of Person Centered Medicine, 3(1), 5–12. http://doi.org/10.5750/ijpcm.v3i1.379