The biomedical model of medicine has been around for centuries as the predominate model used by doctors in the diagnosis of disease. The model focuses on the physical processes of disease and does not take into account psychological or social factors in the cause and treatment of illness. (Unit 1 page 88) Healthcare can originate from many sources and is often promoted in the home on a daily basis with the emphasis on prevention. (Unit 1 page 76) However when we think about the provision and receipt of health care often the first people we think of are doctors and nurses.
These individuals are widely accepted as having the medical expertise and work within the biomedical model. They apply scientific knowledge that they have gained through lengthy formal training in an attempt cure the disease or ailment. Access to health care is essentially free of charge in the United Kingdom and the majority of individuals in this country will have benefited from medical intervention by medical experts. In many ways this is a successful approach.
The strength of the biomedical model is that it researchers the cause of each illness rather than assume there is an identifiable explanation for the illness. It can be argued that knowledge of the origin of an illness is a way in which it can be prevented. The biomedical model has been successful in attempting to make its knowledge superior and legitimate to other forms of medical knowledge. Many health problems may benefit from the biomedical model, for example childbirth which with the aid of medical knowledge can prevent the death of both mother and child.
In a recent study by Pinder on how people experienced living with chronic illness, particularly Parkinson’s Disease (PD), she identified that PD sufferers actively seek to achieve control over their lives in order to maintain some sort of normality not only for themselves but for those around them. As normality is different for each individual each individual’s priorities will be different and change over time. (Ruth Pinder, 2003, page 114 to 122) For example, Mrs F’s priority is that of maintaining her career and social life.
She is able to do this having learnt from experience the pattern of her symptoms and relies on accurate planning and timing of her work and social demands in order to achieve the control she needs over her life. Nonetheless she has achieved this without the assistance of medical experts working by way of the biomedical model. (Ruth Pinder, 2003, page 115) Normality in the life of any PD sufferer is particularly difficult to achieve due to the unpredictability of both the disease and the effects of the drugs prescribed.
For example, Pinder describes the life of Mr I as characterised by unpredictable and often violent yo-yoing. Mr I describes the situation “One day I may be nine-tenths of the day free, although that’s very rare, and another much less. There’s nothing I can do about I”. (Ruth Pinder, 2003, page 117) Information is important to PD sufferers if they are to make informed choices about the management of their condition and to feel in control of their lives. Conversely it seems that information is not as readily available as most suffers would like from the health professionals.
For example, Mrs P describes how her doctor told her “nothing at all”, and of her confusion between what turned out to be side effects of the drugs she was taking. She describes spending a great deal of time in book shops trying to find the information that her doctor had not supplied her with and she describes feeling her illness much easier to come to terms with when she knew exactly what was happening. (Ruth Pinder, 2003, page 118-119). The need and search for information experienced by the chronically ill with their personal experience, often leaves them experts in their own condition.
Although there appears to be a steady move by some health professional working with the biomedical model in accepting these people as experts, there still appears to be a lack of equality between health professionals and patients in terms of decisions and preferences concerning their treatment. In the same way there can be disagreement between the preferences of the patient and Health Professional in a child birth situation.
The majority of UK births take place in hospitals, resulting in the child being born in unfamiliar urroundings and among strangers, often with a lack of information and support form Health Professionals before, during and after the birth (Lesley Doyal, 2003, Chapter 14). Health Professionals have been trained to view their role in childbirth as “active management of child birth” often intervening to monitor the situation where the birth is progressing normally and where there is no indication of problems. This is despite the fact that there is not always evidence that such procedures benefit either the mother or the child.
Again the lack of information from Health Professionals often leaves mothers feeling they should allow medical staff to take the lead as fear and uncertainty makes them unable to voice their preferences and make their own decisions. Consequently the biomedical model is criticised due to its one sided approach in focusing on identifying and curing the disease, without looking at the patient as a whole, their emotional health and well-being as well as physical symptoms.
In both incurable chronic illness and in an uncomplicated childbirth, both situations should only be managed and patients should be fully informed of details and alternatives to enable them to inform the Health Professional of their preferences. Developments in obstetrics can and do save lives, and some patients are reassured by the Health Professional taking control of chronic illness drug management, pro-active intervention in delivering children or the use of high tech equipment to monitor conditions.
Nevertheless, a great many feel they are pushed into procedures or routines that are not necessary and in the case of childbirth could be harmful. Taught to treat all births as potentially a risk to mother and baby, Health Professionals may deny women a chance to deliver their child where and how they choose, and with the information and emotional support they would like. Many sufferers of chronic illness experience fear and uncertainty and rely on groups such as the Parkinson’s Disease society in order to re-gain control and receive emotional support.
The main criticism in these two examples seems to be that Health professionals should only help if needed or asked to, neither does the biomedical model allow them to attempt to provide information so that people can make their own informed decisions, or receive the emotional support they both need and want. The criticisms appear to be justified in many cases and Health Professional need to work in partnership with other organisations and Health Care Providers in order to enable them to treat the whole patient as Social and motional situations appear to have an impact on the ability to deal with physical health issues.
In conclusion the underlying facts show that those working with the biomedical model, with a high degree of success can and do cure illness and save lives. (Unit 1 Page 89) Although the biomedical model has been criticised and challenged it still does not change the fact that it is the predominant approach to health care.