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Health Care Needs a Fundamentally New Approach

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Medicine - the present and the future:

The world of medicine today is based on scientific lines and the quality of empathy is considered desirable among health care providers rather than as a basic necessity. The bio-medical approach to health and disease has made the delivery of health care predominantly lab-oriented and mechanical. Valuable resources are spent for understanding the physical aspects of disease, while the bigger picture that includes the spiritual dimension is neglected. Increasing technological sophistication is valued more than the therapeutic potential of physician's compassion. As a result tertiary care gets preference over primary care. The society as well as the medical professionals themselves, finds physician-based primary care unattractive.

Inevitably, the consequence of this is felt in the way medicine is taught to students. An impersonal "matter of fact' approach is appropriate to teach the physical, mental and social aspects of diseases. In the absence of an academic framework to teach the spiritual aspect, students are not briefed about it and frequently fail to gain spiritual insight. Setting a personal example by practicing the "art of healing' while treating patients is an effective way of teaching the spiritual aspect. However in the academic setting there is need for this effort to be supplemented by a curriculum that is built around the core of the individual's spiritual wellbeing. The importance of cultivating and maintaining spiritual wellbeing by the physician himself so that he can practice the "art of healing' needs to be emphasized.

Conclusion:

The basis of health and the pathogenesis of diseases have subtle spiritual underpinnings necessitating an integrated mind-body-spirit model of health and disease. The importance of spiritual wellbeing of the patient, its influence on the mind and consequently on the healing process of the body have been highlighted by recent advances in psychoneuroimmunology. Disease management becomes more effective if the patient's own immune mechanisms are harnessed through the age-old "art of healing'. Medical education being a key input in disease management needs to be suitably modified to emphasize the central role of spiritual wellbeing and the value of the practice of meditation by the physicians themselves.

Modern medicine is at cross-roads. With further scientific developments modern medicine would continue to benefit from newer technologies. At the same time what is immediately required to improve the effectiveness of modern medicine and decrease health care costs would be to formally integrate the "art of healing' with the science of medicine. Incorporating the philosophy of mind-body-spirit medicine within the medical curriculum and health care structures would, in addition, place the job of the primary care physician at a higher level. Health care thus needs a fundamentally new approach to address the twin problems of escalation of costs and increasing neglect of primary care.

References: (All references accessed on June 2, 2010)

1. Seaward BL. Alternative medicine complements standard. Various forms focus on holistic concepts. Health Prog.1994 Sep; 75(7): 52-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10136081&query_hl=13

2. Seaward BL. Stress and human spirituality 2000: at the cross roads of physics and metaphysics. Appl Psychophysiol Biofeedback. 2000 Dec; 25(4): 241-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11218925

3. Brian McMullen. Spiritual Intelligence. Student BMJ 2003 March; 11:60-61

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Vijayaraghavan Padmanabhan is a Former Professor of Medicine at Madras Medical College, Chennai, India.

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