Medical Model Vs Social Model of Health - Essay Example

of the of the Concerned 22 August 2009 Medical Model Vs Social Model of Health The WHO definition of health comesclosest to the comprehensive concept of health that can be achieved by the individuals and is aimed by the health care provider. It stands for complete physical, social and mental well being, i.e., being healthy in all the dimensions of life and not just being disease free (WHO, 1948). Health care models - introduction Health care is broadly based on two models of health - the medical and the social model. Medical model of health is essentially, what an average person relates to and expects when visiting a health care practitioner after having developed the signs and symptoms of an illness. The doctor or the health care provider elaborates a detailed history leading to the development of such clinical manifestations in order to determine the causative factors. Differential diagnoses are arrived at and the treatment is started to cure the illness and terminate the disease process. Social model of health doesn't provide 'cures' for the illnesses based on vital signs and clinical and laboratory data. It presents a broader overview of the factors that may influence the health of the individuals. Infact, this model more efficiently embraces the spirit of the definition of health as given by the WHO. This means that the social model does not assume a person healthy if there is no physical or laboratory abnormality present. It tries to correct and align the fundamental health issues such as the social, cultural and biological environment of the individuals, which almost always, even only indirectly, lead to significant health repercussions. For example, in a patient of coronary heart disease, it would look at the risk factors in context of life style features that can be targeted and modified to reduce the progression and severity of the disease such as cessation of smoking, incorporating more physical activity in to the daily routine, curb alcohol and fat rich food intake, avoiding stressful activities etc. This model tries to identify the psychosocial hindrances to successful management and compliance of the treatment plan. As per this model, the patient actively participates in his or her treatment plan, unlike the medical model in which the doctor or the health care provider is the sole authority and the patient has to just passively follow the instructions of the doctor in order to be healthy. Comparison of medical and social model of health Prevention of diseases - While the medical model concerns itself primarily with the treatment or eradication of a disease, the social model concentrates more on how the disease can be prevented in the first place. It does not accept that a normal health means the absence of disease. In focuses on education and the awareness levels of an individual and the community and tries to educate its individuals about the preventive aspects. Although patients of amoebic gastroenteritis or worm infestations can be easily cured with drugs, they can be simply prevented by teaching the individuals to wash hands regularly and before eating. The social model will also try to remedy the causative factors such as inadequate system for garbage and excreta disposal, poverty leading to a lack of access to soap and water and unhygienic cultural practices. Cost-effectiveness - Since the social model attempts to remedy multiple factors like psychological, cultural and environmental, initially it appears as if this may require substantial investments in terms of infrastructure. Whereas, the medical model focuses only on an individual who can be conventionally treated at a much lesser cost. However, in the long term, this may not be so. A malaria control programme does not simply include the administration of antimalarial dugs and symptomatic management of cases. It will encompass building mosquito proof residential complexes, filling up of open water ditches and introduction of larva eating fishes among others. This may entail higher costs in the beginning but yields richer returns in the long term in the form of a healthier population. Teaching the patients to maintain clean surroundings is a relatively inexpensive manoeuvre and involves active participation of diseases. Individual's & Community participation - Social model of health actively encourages individual and community participation in maintaining their own health. It does so by first recognising those practices in an individual's life, which determine their health status, and well-being. It then targets these practices in order to achieve health in all the spheres as given in the WHO definition. A patient presenting with chest pain will be clinically assessed by the 'medical' doctor, investigated by blood tests and ECG etc. and treated as per the aetiology of chest pain. A social model will be giving special attention to psychological factors such as an aggressive personality or overambitious stressful life and other lifestyle factors and the patient will be advised to modify these factors. Modifications will be suggested in a way that it is easier for the patient to adhere to the treatment plan and maintain a good compliance (CDHN). Disability- This deserves a special mention as the medical model has often been criticised for labelling the impairment as the problem among the disabled people and thus the difficulties experienced by them are attributed to their lack of rehabilitation. This makes the disabled people passive receivers of medical care. The social model, on the other hand, acknowledges that the difficulties faced by the disabled people are due to inherent faults within the society, which first creates impairment and then discriminates against the disabled people. It stresses on the active involvement of the disabled people in the society, preventing discrimination and aiding their psychological, social and financial rehabilitation. In mental illnesses and disability, the bio psychosocial model is, by necessity, integrated into the management as mental health problems cannot be cured solely with medications. Psychotherapy and behaviour therapy are often required. On the other hand, explanation of the aetio-pathogenesis and availability of treatment of many psychiatric disorders has reduced the social stigma attached with the disease and the importance of medical model cannot be underemphasised (Shah, P & Mountain, D, 2007). Scientific and remedial model - Usually, when a patient seeks medical attention, his interest lies in getting on-the-spot mitigation of his suffering. Traditionally, this is what medical science has been all about. A doctor can diagnose a disease and after starting therapy, a patient may expect alleviation of his suffering in due course of time. That is why the medical model has been in popular practice for so long as it provides immediate or near-immediate cure. In addition, there is nothing unscientific about it as most of the therapeutic regimens nowadays are evidence based and supported by extensive research. However, the social model appears to be a little more rational than the medical model. For example, a patient with a sexually transmitted infection such as gonorrhoea can be cured based on the medical model. However, unless the sexual behaviour and safety practices of the individual are not addressed, there is a likely chance that the patient will keep on getting repeatedly infected himself and will infact, pass on the infection to other sexual contacts too. Thus, herein lays the importance of educating the sexually active population about devices to protect themselves from diseases, framing laws to facilitate screening of chronically infective people and so on. All these measures act in the long term and although not immediately evident, they are very important if health care goals are to be achieved. Community and individuals' needs and lifestyle are to be kept into consideration when formulating healthcare plans. The younger population world over is looking at health with a holistic approach ( Kefford, CH, Trevena, LJ, & Willcock, SM 2005) Discussion Thus, although the medical model appears to be short-sighted and less comprehensive than the social model, both of these are to be integrated to achieve the goals of providing best possible health care to a society and its individuals. The medical model cannot be just written off and it's an important clinical and investigation based health model on which the health care system is structured. The social model adds other dimensions to this model and any health care plan synergistically based on both of these models is likely to give the best results rather than adopting one model in isolation. Dependency on the medical model, which further encourages dependency on the health care practitioner, will fall short of a wholesome effort. Infact, ethics pertaining to health care should not be narrowly based on the medical model of health but extend far beyond it (Pamela, G & Nan, G 1999). References: 1. Kefford, CH, Trevena, LJ, & Willcock, SM 2007,' Breaking away from the medical model: perceptions of health and health care in suburban Sydney youth', Medical Journal of Australia. vol. 183, no. 8, pp.418-421 2. Pamela, G & Nan, G 1999,' Transcendental Health Care Ethics: Beyond the Medical Model', Ethical Human Sciences and Services. vol. 1,no. 3, pp. 243-253(11) 3. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948 4. Shah, P & Mountain, D 2007, 'The medical model is dead - long live the medical model', British Journal of Psychiatry, vol. 191, pp. 375-377 5. The Social Model of Health http://www.cdhn.org/documentbank/uploads/Inscape%20Briefing%20Paper%201%20-%20Social%20Model.pdf. Viewed 21 August, 2009 Read More