The Biopsychosocial Model, Research Paper Example

Historically, western medicine has defined good health as being absent from pathological forms of disease. These pathological forms of disease would be categorized as bacterial, fungal, viral, or other such forms that could cause physical detriment to the body and render it ‘sick’. This particular way of reasoning did not resonate with many healthcare providers because there was an obvious distention between the mind and body, therefore leaving gaps in the treatment options for various patient complaints and the ways in which these treatments could successfully be handled much quicker and more successfully if another plan of treatment could be implemented. This thought process led to the theory of the biopsychosocial model of health and illness.

The biopsychosocial model concentrates on bridging a gap between the biological systems, psychological systems, and sociological systems that are part of the patient’s environment which all interconnect to determine how the patient’s body will respond to a disease process over the course of the short term and long term (Santorelli, 1999). It focuses on being in good health in addition to a good quality of life with strong positive relationships. The treatment options for the biopsychosocial model of health and illness do not focus strictly on physical treatment, but on a more multidimensional aspect of treatment in order to bring balance to all aspects possible within the patient’s environment. Probably the most important point to note in the difference between the two models is that not everything in the biopsychosocial model is quantifiable. This is a bit different than the biomedical model used by most physicians when interviewing patients during the examination process and will be explained in more detail in the following paper.

Basic Theory of the Biopsychosocial Model

There are seven key points to the biopsychosocial model that vary from a traditional medical model and focus on the entire person instead of strictly on a disease and its effect on the physical body. The first is that an alteration in biological chemicals inside the body does not directly correlate to an illness. Also, the mere appearance of a biological difference does not automatically correlate with a certain disease process. Third, there are psychosocial variables which are more important elements in the course of a disease and its progression than have been prior discussed. Likewise, a patient becoming ‘sick’ does not necessarily equate to a physical condition (Borrell-Carrio, Suchman, & Epstein, 2004).

Five, the success of treatment is determined by other factors in addition to biological factors. There is also something known as a placebo effect which often treats a problem better than pharmaceutical drugs. Six, the relationship between a patient and medical provider will have an impact on the outcomes of treatment. Lastly, patients are influenced by the way they are studied and scientists, in turn, are influenced by the patients (Borrell-Carrio, Suchman, & Epstein, 2004).

Biomedical vs. Biopsychosocial Models

While the two models, the biomedical and biopsychosocial have many differences, there is a foundational similarity between the two. Both models seek to understand the problem with a patient, albeit in different ways. That is not to say either model is wrong, but each model is unique in its own interpretation of the patient’s symptoms and history and how the model is utilized to help the physician understand how best to treat the patient’s condition to achieve the most long lasting and accurate results.

It seems to this author that the biopsychosocial model would be best used for conditions that the patient might have had for a lengthier period of time. These conditions would have normally manifested in different ways and possibly resulted in an offspring of other secondary conditions. Many times, as in the case of high blood pressure, there can be several variables which could coincide to cause this condition to become worse or generate other conditions in addition to the primary complaint.

There could be a hypothetical situation in which a 911 call is placed to a dispatcher and emergency medical personnel are sent into the patient’s home to investigate the situation. The patient could have been complaining of chest pains. Of course, this would be a potentially dangerous situation to the patient and would need to be immediately taken care of as far as having the patient transferred to the nearest emergency room. However, in the meantime, if the EMT personnel have any experience in the use of the biopsychosocial model, it is possible they would be able to realize whether or not the patient was undergoing legitimate acute myocardial infarction or a result of an anxiety attack triggered by other environmental stressors that might mimic chest pains similar to a heart attack.

Because every situation is not quantifiable, it is necessary, IF the patient is not obviously having a full blown heart attack to attempt to calm the patient for a few moments and attempt to speak with the patient. If the EMT personnel speak with the patient on a friendly and caring level and attempt to be soothing and supportive, calm and comforting, often they will have the ability to calm the patient and the chest pains will subside for the time being. Thus, the anxiety attacks will have passed for this particular period. Of course, the patient still should be taken to the nearest emergency room and have tests performed to ensure a heart attack was not the culprit. While in the emergency room, however, the patient should also speak with the physician about the anxiety issue (the EMT should make sure this is documented in the medical records) in order to have the physician understand the matter and possibly be able to offer suggestions about helping improve the problems with anxiety. Often, a matter of changing the direct physical environment will help with stressors that are not evident but will cause results no person could have ever known possible and this will help in a positive way to increase mental health in persons who might be suffering from anxiety or depression that has manifested in some form of physical disorder.

Another example of how the biomedical and biopsychosocial models vary could possibly been noticed in a patient who was Type II diabetic and obese. This same patient might present to the physician with a complaint of pain in the legs. Typically, if the physician was using a biomedical model only, the physician would review the medical history and notice the obesity factor and the diabetes factor. These would be intertwined because the patient most likely developed diabetes from being overweight at some point in his life. Hence, if the diabetes was severe enough, prescription pharmaceuticals were most likely prescribed to control the condition and also a diet and exercise regimen was also most likely recommended to help with the weight issue in order to control glucose levels. The important note in this case is that one of the side effects of many diabetes drugs can be neuropathy or the patient simply could be developing one of the many secondary conditions caused from diabetes.

Diabetes can lead to neuropathy and other issues with the extremities. The problem of being overweight for an extended period of time can also lead to secondary conditions with bones and joints, thus setting the stage for arthritis later in life. Rather than the physician simply dismiss the pain in the extremities as another problem to be solved by a pharmaceutical drug, the physician should use the biopsychosocial model as part of the interview process and talk with the patient to understand how much exercise the patient is getting on a weekly basis. It is important to communicate the seriousness of exercise and maintaining a proper weight so other problems are hopefully avoided. It is also important for the physician to discuss specific low impact exercises that will be beneficial to the patient due to the pain he is already experiencing. The physician may also want to speak to the patient about alternative therapy options such as compresses or pool exercises for the problems with the pain in the extremities. A prescription may indeed need to be written, but communication is vital to understand if there is such a need as another prescription will set the patient up for yet another round of side effects and another set of conditions that may spawn from the use of this medication to combat the secondary conditions caused from the diabetes which was caused from the obesity.

Conclusion

As we can see, a pattern may be formed in the case of applying the biopsychosocial model to a patient’s medical interview if a physician will take the time and effort to learn more about the patient in the hopes of uncovering the true problem and not strictly what is on the surface (Borrell-Carrio, Suchman, & Epstein, 2004). Many times, what is on the surface is a culmination of something that began long ago and has gone undetected until secondary conditions finally brought about a condition the patient could no longer ignore and finally sought help. While this model is not going to be used one hundred percent of the time in the physician’s office or the healthcare environment, it is an important tool in the diagnosis of disease and disease processes. It is a helpful tool in uncovering hidden problems and will aide in the decrease of overprescription of medications, especially antibiotics and pain medications, for problems that might be best solved with other forms of therapy or alternative medicines. Each patient and circumstance is different and the biopsychosocial model enforces this aspect as well. It is important to keep open and honest communication at all times, for both the physician and the patient, in order to achieve the best care possible.

References

Borrell-Carrio, F., Suchman, A., & Epstein, R. (2004). The biopsychosocial model 25 years later: Principles, practice, and scientific inquiry. Annals of Family Medicine, 2(6), 576-582.

Santorelli, S. (1999). Heal Thy Self: Lessons on Mindfulness in Medicine. New York: Bell Tower.