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The Morden Medical Model

The issues with the modern medical model?

Saul Yudelowitz BSc (Hons)

I was lead to believe that the purpose of education is to develop ones ability to think and not just follow a set of orders. While there are many valuable ideas that have been learnt from medicine, there are holes that still need to be filled. It is very common to hear that one should take a holistic approach to dealing with the patient and we should not take a reductionist approach however I found that this was typically not done by the ones who were teaching us! While the medical model has thrived at certain issues using a reductionist approach, like germ theory and gene theory it has failed miserably at addressing many chronic conditions. At university we were taught physiology of the different systems of the body but the reductionist approach became very clear when dealing with the patients symptoms. All the different systems were not taken in to account as a whole and so it was never possible to take on a holistic approach. Granted some systems were taken into account but at a very basic level and certainly not all of them! I recall the folk story attributed to Mullah Nasruddi, where five blind men each felt an area of an elephant in order to describe the animal. The description ranged from snake, palm leaf and tree. This failure to describe an elephant shows how the medical model has failed in certain areas. Our single minded approach to the belief of reductionism and causality has taught us nothing about how some people never get sick and others get well. It was in disbelief that I found myself having to focus on pathophysiology at university and not also the study of why and how people get and stay healthy. Especially that patients would come to see me for treatment on how to get healthy and stay healthy. As Sir William Osler said, we are baffled at the condition we encounter because we are trying to apply a familiar and limited map to an unfamiliar territory. Thinking of how you think which should not be confused with logic allows one to see information that was not considered before, develop order from the data, formulate a formula, develop a solution and then test the solution. The morden medical model has taken the reductionist approach to the extent that there are specialists for each different system of the body but not one specialist who can bring all the system together when looking at the patients symptoms. Getting healthy and staying healthy is having the ability for the body to adapt to the various different stresses placed on the body throughout life. In order to maintain this adaptability referred to as allostasis it is imperative to consider three systems that are intimately related to all the other systems of the body.

Musculoskeletal

Gastrointestinal

Hormonal

The musculoskeletal health gives us the ability to learn how to move correctly thereby allowing the use our joints effectively. This is the best protection that one can afford against degenerative joint disease. The way we move not only effects our joints it has a significant effect on the functionality of the viscera. A flexed lumbar spine will have an effect on digestion due to the retroperitoneal attachments in different areas of the GIT especially the large intestine that could contribute to constipation. One would need a volume of books to describe the effects of the musculoskeletal system on the entire body. Gastrointestinal health also has an intimate influence on the entire body. The functioning of the immune system is just one system; two thirds of our immune system resides in the gut. While the medical model is trying to address the obesity problem around the world, it is failing. What is of great concern is that obesity will not be the most expensive issue for health care system around the world to deal with. Neurodegenerative disease is on the increase, our hormonal system has a significant role to play here but as yet most research does not consider this. Adrenal fatigue is a very common finding and while our fight or flight system still operates as it did many millennium ago back then we had the savvy to address the increased chemical load from our adrenals however today our excuse is there just is not enough time! When our fight or flight system fires, blood moves from the cortex area of the brain to the primitive area. There are also other chemicals that influence the delivery of oxygen to the brain in the cortex during this time and so a chronic low level of inflammation is set up. Over time this chronic low level of inflammation is a major cause of neurodegenerative disease. There are so many examples of how these three systems effect the overall health of the body there is just not enough space in this article. Anyone who wants to maintain allostasis needs to take all three systems into account. This article is designed for you to think so that you can make informed choices about your health. While the medical model has thrived in certain areas, in other it is failing. Change will only come about if communities demand it. Just as some fast food outlets changed their menu to include healthy choices along side the rubbish they sell, we need to make certain changes to the morden medical model.

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