MED | BIOPSYCHOSOCIAL MODEL

THE BIOPSYCHOSOCIAL MODEL

Rudolf Virchow

  • Father of modern pathophysiology

  • hypothesized/thought that every pathology arises from a damaged cell, paving the way for the work of Robert Koch and Louis Pasteur

  • By identifying the origin of disease with a malfunction at the simplest structural and functional level of organisms, the cell, this new paradigm allowed us to conceive of new ways to target the causes of disease, for instance by pharmaceutical interventions.


“Biomedical Model”

  • An illness is always explained with one or more physical malfunctions at a lower level of organization.

  • Reductionist perspective

  • Reduces humans to just a checklist


INFECTION = invasion of parasites

METABOLIC DISORDER = gene mutation

PSYCHIATRIC DISORDER = imbalance with neurotransmitter


  1. Illnesses are always reducible to a physical, biological disease.

  2. Health is merely the absence of physical signs of disease.


Reductionist - all higher level phenomena and processes can be explained at a lower level


Criticism of the “Biomedical Model”

  1. Illness is a condition of the whole person.

  2. Objectifies the patient as a passive target of therapy.

  3. Fails to account for ill patients that do not present with any physical or biological sign of dysfunction.


CASE IN POINT:  Burnout accepted as a diagnosis by WHO in 2019


George Engel

  • Criticized the “biomedical model”

  • Proposed a new model which is the “biopsychosocial model”


“Biopsychosocial Model”

  • Biological, Psychological, Social

  • Aims to introduce the concept of downward causality or top down causality.


BIOLOGICAL

  • Genetic makeup

  • Pathophysiological aspect

  • Physical health

  • Organs

  • Injury

  • Parts involved

PSYCHOLOGICAL

  • Thoughts

  • Emotions

  • Behaviors

  • Coping Skills

  • Mental Health

SOCIAL

  • Culture

  • Religion

  • Environment

  • Stigma 

  • Ex. breadwinner, baker, tennis player


CARE PLAN

Terminology

Sign - can be measured

Symptom - the patients perception on their well-being


Assessment 

  • Objective findings (signs & symptoms)

Diagnosis

  • The identification of the nature of illness or other problem by examination of the symptoms.

Planning

  • What should the patient’s status be?

  • What should the patient know about their disease?

  • The patient should be able…

Intervention

  • What steps should be administered to help signs and symptoms?

  • What can be done to further prevent injury?

Evaluation

  • Are the goals achieved in the planning part?

  • Did the patient maintain a stable status?

  • Does the patient know their condition/disease?

  • Does the patient know how to prevent further complications?