Implementing the patient-centered medical home in complex adaptive systems

The notion that the medical professions are grounded in sound social and philosophical commitments to human well-being and advancement is the very foundation of medicine since time in memoriam. Caring is the essential work of all health professionals, since most patients have no medical condition explainable by the mechanistic biomedical model. Health, illness, and disease, and biomedically defined disease distributions in the community follow a Pareto distribution (aka the 80/20 split) (i.e. only a minor percentage require tertiary hospital interventions). This chapter unravels important failures inherent in current medical education approaches – the misconceptions about science, the limitations inherent in the prevailing worldviews, the shaping of attitudes and behaviors resulting from social interactions in health professional institutions, and the impact of the lack of flexibility within health professional institutions. Positing that health is a personal dynamic balanced state, represented through a somato-psycho-socio-semiotic model, is the basis on which principles for a patient-centered educational approach are developed. Such a new curriculum would embrace the complex adaptive systems principle – focusing on the interdependencies between teachers and learners, allowing the curriculum to emerge over the course based on learners' clinical exposures and experiences, fostering a critical engagement with the multifaceted knowledge base of the disciplines, and most importantly, building the necessary resilience for handling, individually and collectively, the emotional demands of caring.

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Person-centered medicine from a complex adaptive systems perspective

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v2i1.711 ◽

2014 ◽

Vol 2 (1) ◽

pp. 85 ◽

Cited By ~ 2

Author(s):

Joachim Sturmberg

Keyword(s):

Medical Care ◽

Healthcare System ◽

Complex Adaptive Systems ◽

Adaptive Systems ◽

Health Issues ◽

Patient Centeredness ◽

Patient Centered ◽

Health And Illness ◽

Complex Adaptive ◽

Illness And Disease

Miles and Mezzich have proposed person-centered medicine as the way forward to overcome the rapidly escalating crisis of dehuminisation of medical care and the healthcare system at large. The crisis in medical care is caused by a Zeitgeist characterised by 2 themes – conquering disease and profit maximising activities. Overcoming this crisis requires a change of the prevailing worldview and its reductionist thinking about discrete diseases to a worldview that recognises the complexities arising from the interconnections and interdependencies between all facets of a person’s life – his health and illness and disease trajectories. As Kant said: each man has his particular way of being in good health.This paper presents 5 themes that argue for a complexity based framework to achieve a person/patient-centered understanding of health and healthcare: (1) health, illness and disease are complex adaptive states that impact personhood; (2) healthcare must grow health; (3) healing results from personal sense-making and must be fostered; (4) complex adaptive systems thinking allows an exploration and understanding of personal and community health issues and (5) person/patient-centeredness results in an effective and efficient healthcare system.A person/patient-centered focus, the person/patient at the centre of concern, will result in a seamlessly integrated healthcare system. Such a system will show great diversity between communities, each having emerged as a result of best adaptation to local circumstances. Such a system will have substantial benefits – for the person (in terms of staying healthy) / patient (in terms of regaining his health), the community and the economy.

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Medical Education

Advanced Research in Adult Learning and Professional Development - Advances in Higher Education and Professional Development ◽

10.4018/978-1-4666-4615-5.ch002 ◽

2014 ◽

pp. 55-69

Author(s):

Joachim Sturmberg

Keyword(s):

Medical Education ◽

Health Professional ◽

Complex Adaptive Systems ◽

Adaptive Systems ◽

Medical Condition ◽

Well Being ◽

Tertiary Hospital ◽

Patient Centered ◽

Semiotic Model ◽

Complex Adaptive

The notion that the medical professions are grounded in sound social and philosophical commitments to human well-being and advancement is the very foundation of medicine since time in memoriam. Caring is the essential work of all health professionals, since most patients have no medical condition explainable by the mechanistic biomedical model. Health, illness, and disease, and biomedically defined disease distributions in the community follow a Pareto distribution (aka the 80/20 split) (i.e. only a minor percentage require tertiary hospital interventions). This chapter unravels important failures inherent in current medical education approaches – the misconceptions about science, the limitations inherent in the prevailing worldviews, the shaping of attitudes and behaviors resulting from social interactions in health professional institutions, and the impact of the lack of flexibility within health professional institutions. Positing that health is a personal dynamic balanced state, represented through a somato-psycho-socio-semiotic model, is the basis on which principles for a patient-centered educational approach are developed. Such a new curriculum would embrace the complex adaptive systems principle – focusing on the interdependencies between teachers and learners, allowing the curriculum to emerge over the course based on learners’ clinical exposures and experiences, fostering a critical engagement with the multifaceted knowledge base of the disciplines, and most importantly, building the necessary resilience for handling, individually and collectively, the emotional demands of caring.

Download Full-text