Medical Model PDF

Medicine Social Chapter 2: Medical Model School of Public Health, Tongji Medical College, Huazhong University of Science and Technology Yong Gan Conception, Characteristics, and Distinctions of social medicine...

Medicine Social Chapter 2: Medical Model School of Public Health, Tongji Medical College, Huazhong University of Science and Technology Yong Gan Conception, Characteristics, and Distinctions of social medicine Medical Medical psychology sociology Preventive Social Clinical medicine medicine medicine Health Community management medicine  Recap What research contents of social medicine are (1) Social health status assessment (2) Social factors associated with health or illness (3) Social health strategies and measures Q1: What do you think constitutes a medical model? Q2: What is health? In your opinion, what are the factors that influence health? Outline PART 1 Concept, Characteristics, and Functions of Medical Model  1. Concept of Model The meanings of the term "model": prototype, exemplar, pattern, standard. The term "model" refers to a theoretical diagram or explanatory approach for studying natural or social phenomena; it can also denote a conceptual system or way of thinking. The concept of a model: A model refers to the abstraction of certain characteristics from an object, forming a standard representation of that object. It serves as a guide for observing, thinking, and solving problems.  Section 1: Concept of Medical Model The Concept of Medical Models：The medical model is the essential summary of humanity’s understanding of key medical concepts such as views on health and disease, derived through the practical experience of combating illness and understanding the processes of human life. Dialectics of Nature The view of nature and methodology with medicine as the object represents a qualitative change in the development of medicine: it reflects the essential characteristics and developmental laws of medicine. Medical View:The study of the attributes, functions, Core structure, and developmental laws of medicine. Medical View Medical Model Methodology Behavioral norms of medical practice activities Medical scientific research and medical practice are both conducted under the guidance of medical perspectives and epistemology.  Characteristics ◆ Sociality of the emergence of the medical model ◆ Universality of the medical model's existence ◆ Broad applicability of the medical model's impact ◆ Dynamics of the medical model development  Role of the Medical Model Advancing the Development of Medical Theory Guiding the Improvement of Medical Practice Promoting Innovation in Medical Education PART 2 Evolution of the Medical Model  Section Two: The Evolution of the Medical Model Nature Biomedical model philosophical medical model 1 2 3 4 5 Spiritualism Bio-psycho-social Mechanistic medical medical model medical model model  Three Eras in the Evolution of the Medical Model Empirical Medicine Era (Spiritualism Medical Model, Natural Philosophy Medical Model) Experimental Medicine Era (Mechanistic Medical Model, Biomedical Model) Modern Medicine Era (Biopsychosocial Medical Model)  1. Spiritualism medical model This model reflects the ancient belief that human life and health are gifts from gods or deities, with diseases and disasters seen as divine punishments or retributions from the heavens. Doctor = Shaman/Healer Common treatment methods: Trepanation Induced vomiting Purgation Divination Incantations and prayers  The Spiritualism Medical Model was the first structured medical system in human history. It was an indispensable stage in the development of scientific medical models, preserving and transmitting early human medicinal knowledge, while inspiring and empowering ancient peoples with the courage and strength to overcome disease. 2. Nature philosophical medical model It refers to a simple, dialectical, and holistic medical concept that links health and disease with the natural and social environments of human life, observing and reflecting on these connections. Typical examples: Ancient Greek medicine, Traditional Chinese Medicine theories, and India's "Three Elements" theory.  With the development of social productivity and advancements in science and technology, humanity gained a preliminary understanding of health and disease, recognized the relationship between human health and the environment, and formed rudimentary rational generalizations. Ancient Greek physicians=Philosophers For example: Hippocrates "On Nature and Man": The fundamental elements of water, fire, earth, and air correspond to human phlegm, blood, black bile, and yellow bile. Human health, disease, and temperament are the result of changes in the proportions of these four humors. Traditional Chinese medicine established the theory of Yin-Yang and the Five Elements in pathology, as well as the external causes known as the "Six Excesses" (wind, cold, heat, dampness, dryness, fire) and the internal causes called the "Seven Emotions" (joy, anger, worry, thought, sorrow, fear, shock). The Huangdi Neijing (Yellow Emperor's Inner Canon) asserts that the normal functioning of life reflects a balance between Yin and Yang. Disease occurs when internal and external factors disrupt this Yin-Yang balance in the human body.  3. Mechanistic medical model Bacon: "Study nature through experimental methods." Philosophy must be inductive, experimental, and practical, and it must be based on scientific observation and experimentation. Only observation and experimentation are true scientific methods. Descartes: "The living body is nothing more than a complex machine." Under the influence of the mechanistic model of medicine, significant progress was made in medical science: Harvey: Discovered blood circulation Morgagni: Each disease has its corresponding lesion in a specific organ Schleiden: Discovered plant cells; Schwann: Discovered animal cells; Virchow: Proposed the theory of cellular pathology The mechanistic model of medicine simply explains that life activities are akin to machine operations, and maintaining health is equivalent to maintaining the machine. It introduced medicine into the era of experimental medicine and played an important role in promoting the development of modern medicine. Drawbacks: It overlooks the fact that, in addition to having machine-like aspects, the human body also possesses biological complexity and social complexity, leading to a one-sided and mechanistic view of the human body. Significance and Impact 1）It broke away from the influence of speculative philosophy and religious theology; 2）It introduced experimental methods into the field of medicine, gradually turning medicine into an experimental science; 3）It promoted the development of biomedical disciplines; 4）It advanced the development of surgery; 5）Its influence was greater on Western medicine and less significant on Eastern medicine. 4. Biomedical model Concept: It refers to understanding health and disease from a biological perspective, reflecting a medical view and approach that considers the intrinsic connections between the cause of disease, the host, and the natural environment. The Spread of Bacteriological Infectious Theory of Disease Ecological Model Diseases Causation Host Pathogen Environment Representative Theory 1.Dualism: There should be a reasonable division of labor in studying the human body and the human mind, with no attention paid to the patient's psychosocial conditions. 2.Reductionism: Further breaks down the human body into different systems and uses physical and chemical methods to study and explain the causal relationships of functional changes.  The biomedical model posits that every disease must and can be traced to specific physiological or pathological changes within the body. Doctors diagnose patients based on symptoms and laboratory tests, and then provide appropriate treatment according to the pathological and physiological changes of the disease.  Limitations Engel: "The biomedical model is incomplete as it only considers biological factors while ignoring others. Its focus is solely on the body and disease, neglecting the patient. The modern medical view of disease makes it incapable of addressing the mental and emotional needs of patients." The biomedical model isolates individuals from their social and environmental contexts, emphasizing that life activities are a unified whole in terms of structure, function, and information exchange. It overlooks the social nature of humans, their complex psychological activities, and subjective consciousness, placing disproportionate emphasis on biological factors in health. This limitation restricts a comprehensive understanding of health and disease by medical professionals. PART 3 Biopsychosocial Medical Model and Health Perspective  1、 Background of Its Emergence 1.The Shift in Disease Spectrum and Causes of Death Noticeable changes in lifestyle pace and behavioral patterns have significantly altered the spectrum of human diseases. Infectious and parasitic diseases, once the leading causes of death, have been steadily declining. In contrast, the incidence and mortality rates of chronic non-communicable diseases are rising year by year. Lifestyle and Socioecono Psychological Behavioral mic Factors Patterns Conditions Top Ten Causes of Death among Beijing Residents in 2017  2、The rising demands for healthcare People‘s demands for healthcare are becoming increasingly diverse, with changes positively correlated with socioeconomic factors, cultural education, and other aspects. People are no longer satisfied with just disease prevention and treatment. They now seek to improve their quality of life, extend longevity, enhance health, ensure proper nutrition, adapt socially, maintain psychological balance, and cultivate a healthy mindset. This signifies that people's healthcare needs have evolved beyond basic life-sustaining services and have risen to meet higher psychological and social health demands. Engel Coefficient Lifestyle Requirements Healthcare Needs Status Impoverished Areas ≥60% Reach basic warmth and fullness Extreme disparities Low levels (medical treatment for Marginally Adequate Areas 50%-60% Survival illness) Moderately Well-Off Areas 40%-50% Development Awareness of health maintenance Relatively Affluent Areas 30%-40% Focus on quality of life Higher levels Wealthy Areas