In this article, Havelka et al point out that the biomedical model was a valid model while infectious diseases caused by one factor prevailed and were the main healthcare problem for humanity, but now that chronic, lifestyle & non-infectious diseases with multiple influencing factors are the main health issue it is no longer effective or appropriate as the default model for healthcare. They are in favour of the biopsychosocial (BPS) model and say its implementation is taking too long. Their criticisms of the current biomedical model are:
- the dehumanisation between healthcare staff and patients
- continual improvement of increasingly advanced medical techniques leading to a rise in expenditure where only rationing of healthcare would allow for the continuation of technology-led healthcare (as opposed to psycho-social led)
- reductionist i.e. reduces people to the smallest component -their cells- and separates mind and body in order to do this despite evidence to the contrary
Havelka et al see the benefits of the BSP model as lying in techniques to control pain, provide stress relief to strengthen immune responses, and modify risky health behaviour. Also the implementation of programmes to improve quality of life for chronic, disabled, terminally ill or elderly patients; together with improved identification of individuals falling into these categories.
They reviewed criticisms of the BPS model and found that some people think it is a biomedical model with social and psychological factors just overlaid, I suppose suggesting it’s not a very complex model and that the theoretical basis isn’t clear. Another is the lack of common or agreed terminology, a view shared by other authors, such as Sherwood (2011) with regards to the MoCA model. The lack of agreed terminology within occupational therapy itself is known to cause problems (Boniface (2012)). Havelka et al state that the precise cause & affect between the bio-, psycho- and social factors isn’t properly understood (Ogden 1997). This could be a reason why a more specific model with unified terminology hasn’t been proposed to date? Just a thought…
This article tended to repeat the same points and could have made them and backed them up with sources more succinctly; it felt like the same point was explained every time they needed to introduce a new source. In other words the points weren’t linked as intricately as they could have been, however the text was translated into English so it may not be a true reflection of the flow of the original author’s text.
Boniface G (2012) ‘Defining Occupational Therapy Theory’ in Boniface G, Seymour A (eds) Using occupational therapy theory in practice Chichester: John Wiley
Havelka M, Lucanin J and Lucanin D (2009) ‘Biopsychosocial Model – The integrated approach to health and disease’ Collegium Antropologicum 33(1): 303-310
Ogden J, Journal of Health Psychology, 2 (1997) 21-29
Sherwood W (2011) An Introduction to the Vona du Toit Model of Creative Ability Revista Terapia Ocupaional Gallcia (A Coruňa) September 2011. 8(14) Online at: http://www.revistatog.com/num14/pdfs/sherwood.pdf [Accessed on 22.01.16]
The biomedical model of health and disease dominates in current medical practice. The model attributes key role to biological determinants and explains disease as a condition caused by external pathogens or disorders in the functions of organs and body systems. Such an approach has its historic justification and has proved effective in the control of massive infectious diseases. However, now that chronic non-infectious diseases prevail, its efficacy has not only become questionable, but also the issue has been raised of its economic justification. The extension of biomedical approach and attribution of equal importance to psychosocial factors have become an imperative in the improvement of treatment efficacy and disease control, together with humanisation of relations between health staff and patients. A new biopsychosocial model has been suggested, that takes into account all relevant determinants of health and disease and that supports the integration of biological, psychological and social factors in the assessment, prevention and treatment of diseases. It does not diminish the significance of biological factors, but extends a rather narrow approach. The biopsychosocial model served as incentive for many studies of how psychological and social factors influence the development, course and outcome of a disease, giving rise to the development of interdisciplinary field–particularly the fields of health psychology and psychoneuroimmunology. Their contribution to better understanding of the impact of psychosocial factors on health stimulates greater interest of medical theory and practice in more holistic approach to a patient. However, the changes of the old, organ oriented approach are still too slow and too narrow.