In the inaugural issue of the Annals of Family Medicine, the lead editorial focused on the need for a new paradigm for the primary care disciplines. The present intellectual framework taught in our medical education system fails to address the web-like interactions of multiple comorbidities for chronically ill patients.
The power of organ-system medicine and the scientific research based on this model have brought us to the doorstep of the 21st century where, despite huge advances in disease detection, pharmacology, and surgical interventions, we are ill-equipped for the century’s greatest challenge–an aging population with ever-increasing rates of (largely preventable, often reversible) chronic disease. The dominance of the existing heuristic (rule of thumb and experience) and reductionist model has fragmented medical care into specialty and sub-specialty care, which drives costs upward and conflicts with the need for a comprehensive, integrated approach to chronically ill patients with multiple comorbidities.
In Grumbach’s insightful editorial, Chronic Illness, Comorbidities, and the Need for Medical Generalism, he opens: “It is said that when students enter medical school, they care about the whole person, and by the time they graduate, all they care about is the hole in the person. Current medical education inculcates many of the dominant values of modern medicine, reductionism, specialization, mechanistic models of disease and faith in a definitive cure.”
He suggests that the dominant paradigm now being taught is most applicable in the context of acute illness (e.g., trauma and infection). However, the dominant illnesses of the 21st century are and will be the chronic diseases (e.g., diabetes, heart disease, arthritis, and dementia, among others). In this context, the reductionist model fails to address (what he believes is) the most germane issue: “Cure is rarely possible, but improved functional status with amelioration of symptoms of pain and dysfunction and longer life (health span) through a thorough understanding of secondary prevention is possible.” The intellectual framework and filter taught and then used by primary care practitioners will, from here on, be called the intellectual matrix.
At Bodhi, We Change Lives with a functional medicine approach. We do that by focusing on the causes of disease rather than just the symptoms.
No matter what condition or disease you are battling in your life, we are confident can help you feel well again. Contact us today to book a consultation or call us at 1.888.271.8877 to discuss your wellness.
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PS – If you missed other articles in our series on Functional Medicine, be sure to read:
Why Functional Medicine
The Importance of Improving the Management of Complex, Chronic Disease
A Critical Problem
The Increasing Economic Burden
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