Rethinking our basic concepts of health and disease

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Medical students' concerns chat their education is not preparing them to he the doctors they could be can be traced in part to inadequacies in the basic concepts of health and disease they arc taught, which prevent them from learning how to most effectively meet the challenges and exigencies of patient care. The author proposes an alternative theoretical perspective on the biological foundations of medicine by describing two divergent models of health and disease. The first, reductive isolation, represents the dominant theoretical approach to health and disease in contemporary medical education and practice. It emphasizes quantification and measurement and aims to peer beneath variability, subjectivity, and the infinite variety of patient's experiences to something universally definable, measurable, and objective. The second model, ascendant interrelation, takes as its starting point a special and prototypical property of the living organism, metabolism, in which the organism has an identity that transcends the material of which it is made, and in which such characteristics as form, whole-ness, self-generation, and integration dominate. Medicine and the teaching of medicine must use both these models; the tools of reductive isolation are necessary but must be applied with a view to the larger and more complex reality of the patient as addressed by ascendant interrelation. Alone, reductive isolation does not offer an adequate perspective on the health of the whole human being, just as the wcll-functioning of the eye cannot be adequately explained without reference to seeing. In short, patients are more than their diseases: complex factors in their lives must not be overlooked as contributors to their illnesses or keys to healing. Can medical edu-cation provide a theoretical framework that will not only tolerate but encourage such an approach?.

Original languageEnglish (US)
Pages (from-to)676-683
Number of pages8
JournalAcademic Medicine
Volume70
Issue number8
StatePublished - 1995
Externally publishedYes

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basic concept
Disease
social isolation
Health
Medicine
medicine
health
chat
Medical Education
quantification
Medical Students
patient care
subjectivity
Cations
medical student
Patient Care
education
Teaching
illness
Learning

ASJC Scopus subject areas

  • Medicine(all)
  • Education
  • Public Health, Environmental and Occupational Health
  • Nursing(all)

Cite this

Rethinking our basic concepts of health and disease. / Gunderman, Richard.

In: Academic Medicine, Vol. 70, No. 8, 1995, p. 676-683.

Research output: Contribution to journalArticle

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