Introduction
For many years, physicians and medical practitioners have relied on the biomedical model in the diagnosis of diseases. According to the biomedical model, health is freedom from pain, disease, or defect (De Vito 2000). This means that the normal human conditions should remain “healthy”. The biomedical model tends to overlook the crucial role played by individual subjectivity or social factors (Pringle 2006). Also, the model does not take into account the fact that disease diagnosis comes about as a result of doctor-patient negotiation (Annandale 1998). The biomedical model is also limiting in the sense that it does not consider society in general. In addition, the model does not also take into account the issue of disease prevention (Blaxter 2004). It is important to note that many diseases that are common in first world countries like Type 2 Diabetes and heart disease are highly dependent on an individual’s beliefs and actions (Marmot & Wilkinson 2005).
The medical model of health has dominated the medical field for a very long time. It gained prominence in the 19th century and to date, it still holds considerable power. Its main assumption is that illnesses can be categorized and treated objectively. The health of an individual is recorded in the form of case histories and seems to objectify the individual. The biomedical model of health was popularized by Christopher Bourse. Under this model, diseases, as well as congenital disabilities and injuries are often regarded as “deviations from the natural functional organization of the species” (Asada 2007).
Strengths and weaknesses of the biomedical model
Although there are quite a several health care models that are in use today, individuals have to choose the kind of model that would want to be identified with. Such a choice is normally based on two key considerations namely, the feelings of the individual I question, as well as the benefits and limitations of the model (Wade 2004). Accordingly, there is a need to examine the benefits and limitations of the biomedical model. A lot of people will infer that the biomedical model is the most effective and efficient model that health care workers should be using, based on a number of arguments. Ewles and Simnett (2003) contend that the main concern of a patient is to both control and cure the diseases affecting him/her. In this respect, the biomedical model provides clear directions regarding this issue. According to Sade (1995, p. 144), the biomedical model is based on a knowledge base that is objective, proved, and that has been derived from a scientific experiment. Thirdly, because the model is mainly focused on the ideas, it goes without saying that the doctor should take full control of the various forms of healthcare provided to patients (Anthony et al 2004). Consequently, any disagreement or confusion over the management of an illness can be easily overruled by a doctor. Kazarian and Evans (2005) have noted that such disagreement or confusion could emanate from the client/patient, or even some of the health care workers.
Also, health practitioners have been using the biomedical model for a long time, and for this reason, it is well understood and non-threatening to healthcare workers and the patients as well (Downie, Fyfe & Tannahill 1990). Moreover, because the biomedical model limits itself to the physical domain, as such, it tends to ignore the less objective psychosocial areas. Although the foregoing arguments have managed to stand the test of time, it is important to note that alternative perspectives are increasingly being raised by both patients and health care workers as regards the biomedical model. One of the weaknesses of the biomedical model is the expectation that nurses shall assume the role of humanizers of care (Fava & Sonino 2008; Helman 2003). Sadly, this expectation is rarely fulfilled. Secondly, the biomedical models result in patients being labeled with a certain diagnosis, as opposed to being identified as persons. This does not go down well with the majority of the patients.
Another drawback of the biomedical model is that it emphasizes a lot on high technology, resulting in the loss of human care. Again, this is fast becoming a source of dissatisfaction to both patients and health care workers alike. The biomedical model has also been heavily criticized for concentrating decision-making and information in the hands of doctors (Helman 2003). There is a need to ensure that patients are also able to access information as regards their health. To a certain extent, patients should also have a say on how such information will be managed. A growing body of evidence has also demonstrated that healing can also be gotten from nurturing holistic care, not to mention that it can also lead to a very positive effect on a patient’s health outcomes (Pearson, Vaughan & Fitzgerald 2005). This calls for a review of the priorities and structures that defines the current health care system. According to Pearson et al (2005), the biomedical model fails to recognize the crucial role played by nurses in as far as the healing process is concerned because all the decisions and powers have been bestowed on doctors. There is a need to ensure that nurses are constantly in contact with patients as this has a strong impact on the overall wellbeing of patients. Sadly, the crucial role that nurses play in the healing process is rarely appreciated, and this devalues the human perspective of health care.
Social Model
The social model of health is popular with a sociologist. It is mainly concerned with the social distribution of illness and health among various groups (for example, the rates of death differ from one social class to another) (Barrows 1998). In this case, the social model of health is mainly concerned with the social and environmental causes of health. The social model of health provides a holistic and distinctive understanding and definition of health that transcends the reductionism and limitations linked to the biomedical model of health (Yuill, Crinson & Eilidh 2010). The social model of health is more of a preventive approach (Bartlett 2001, p. 15). Although the biomedical view has dominated the medical field for a very long time, doctors are increasingly recognizing the significance of such social influences of health as lifestyle and stress factors.
Unlike the biomedical model of healthcare, the social model considers the psychosocial components for cure and care, and for this reason, it is quite popular with healthcare workers and patients alike. According to Kazarian and Evans (2001), although the biomedical model has been very influential in medical practice and research, on the other hand, it has been seen to deemphasize the crucial role played by lifestyle, personality, prevention, and outcome of illness. In contrast, the biomedical model has facilitated the development of effective methods of disease treatment, in addition to minimizing responsibility and blame on individuals “victimized” by diseases (Yuill et al 2010).
The social model explores the issue of health from a holistic point of view. In addition, it also dwells on the whole person about the focus of care, while the biomedical model is mainly concerned with the body (Fawcett, Newman & McAllister 2004). The social model also has a wide knowledge base that includes traditional wisdom and social sciences, whereas the biomedical model is mainly based on biomedical knowledge. In a social model the customer takes an active role in the process of disease diagnosis and treatment while in the biomedical model, the patient occupies a passive role. The goals of intervention in the social model are on the well-being of the patient, other than merely curing the illness.
The social model of health is opposed to the scientific pretensions and neutrality of the biomedical model. It views the scientific method is just one of the many ways of assessing health. The model recognizes that illness and health have a social background and that how society is organized determines our experiences with health (Black and Mooney 2002). Based on the social model view, health has a cultural, historical, as well as social context. Therefore, to understand it, we have to acknowledge this first (Gillespie and Gerhardt 1995: 82–3).
Previously, government agencies have been relying on the biomedical view of health but they are now slowly realizing that there is a social context to health and that the kind of health that we as a population experience is dependent on various social factors (Fawcett 2004). For example, in Scotland, policymakers have already acknowledged that our mental and physical well-being has an impact on our housing, the kind of work that we do, the environment in which we work and live, and our education as well (Larkin 2011). Health care practitioners in Canada have also recognized that lifestyle, health care organizations, biology, as well as our physical and social environments impact greatly our overall wellbeing (Seedhouse 1986). In Northern Ireland, the Department of Health maintains that unemployment, low levels of education, poverty, environmental conditions, and poor sense of the community all have a role to play in causing and/or worsening poor health in the community (Corretta 2003). What this appears to suggest is that the social model of health is increasingly gaining support among policymakers as the health model of choice, in place of the Biomedical model possibly because it gives policymakers room to tinker with and intervene on the nation’s health.
Conclusion
For a long time, the biomedical view of health has dominated western thinking about health. The biomedical view objectively categorized diseases and illnesses and the process ends up objectifying the health of an individual. It is mainly concerned with treating the illness, while the social model is preventive. The social model appears to be gaining a lot of prominence among various health care professionals due to its holistic approach. An increasingly higher number of doctors have now recognized the significance of economic, social, cultural, and environmental factors in not only the development of health conditions but also in their treatment as well.
References
Annandale, E 1998, The Sociology of Health and Medicine: A Critical Introduction, Polity Press, New York.
Anthony M K, Brennan P F, O’Brien R & Suwannaroop N 2004,’ Measurement of nursing practice models using multiattribute utility theory: relationship to patient and organizational outcomes’, Quality Management in Health Care, Vol. 13, pp. 40-52.
Asada, 2007, Health Inequality: Morality and Measurement, University of Toronto press, Toronto.
Bartlett, Ben, ‘Implications of the social determinants of health research’, CARPA Newsletter, vol.33, 2001, pp.13-19.
Barrows, D C 1998,’The community orientation of social model and medical model recovery programs’, Journal of Substance Abuse Treatment, Vol. 15 no. 1, pp. 55-64.
Black, M & Mooney, G 2002,’ Equity in Health Care from a Communitarian Standpoint’, Health Care Analysis, Vol10, pp.193-208.
Blaxter, M 2004, Health, Polity Press, Cambridge.
Corretta, P 2003, Social Research: Theory, Methods and Techniques, Sage, London.
De Vito, S 2000,’On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again’, Journal of Medicine and Philosophy, Vol. 25 no. 5, pp. 539-567.
Downie, R, Fyfe, C & Tannahill A 1990, Health promotion. Models and values, Oxford University Press, Oxford.
Ewles, L & Simnett, I 2003, Promoting health. A practical guide, Bailliere Tindall, London.
Fava, G A & Sonino, N 2008,’The Biopsychosocial Model Thirty Years Later’, Journal of Psychotherapy and Psychosomatics., Vol 77, pp. 1-2.
Fawcett, J 2004,’ Conceptual Models of Nursing: International in Scope and Substance? The Case of the Neuman Systems Model’, Nursing Science Quarterly, Vol. 17 no. 1, pp. 50-54.
Fawcett, J, Newman, D M & McAllister, M 2004,’ Advanced Practice Nursing and Conceptual Models of Nursing’, Nursing Science Quarterly, Vol 17 no. 2, pp. 135-138.
Gillespie, R & Gerhardt, C 1995, Social dimensions of sickness and disability, in G. Moon and R. Gillespie (editors) Society & Health: An introduction to social science for health professionals, Routledge. London.
Helman, C 2003, Culture, Health and Illness. 4th Ed., Butterworth, Heinemann, Oxford.
Larkin, M 2011, Social aspects of health, illness and healthcare, OUP, Maidenhead.
Marmot, M & Wilkinson R G 2006, Social determinants of health (2nd ed), Oxford University Press, Oxford.
Kazarian, S S & Evans, D R 2001, Handbook of cultural health psychology, Academic Press, New York.
Pearson, A, Vaughan, B & Fitzgerald, M 2005, Nursing models for practice, Elsevier Health Sciences, London.
Pringle, D 2006,’Nursing Practice Models: Time for Change’, Nursing Leadership, Vol. 19, No. 3, pp. 1-2.
Sade, R M 1995,’A theory of health and disease: The objectivist-subjectivist dichotomy’, The Journal of Medicine and Philosophy, Vol. 20 no. 5, pp. 513-525.
Seedhouse, D 1988, Ethics: The Heart of Health Care, John Wiley, London.
Wade, D T 2004,’Do biomedical models of illness make for good healthcare systems?’, BMJ, Vol. 329 no 1398.
Yuill, C, Crinson, I & Eilidh, D 2010, Key concepts in health studies, Sage Publications Ltd, London.