INFLUENCE OF CONCEPTUAL MODELS ON TODAY'S HEALTH CARE:

THE PHYSICIAN AS DR. GOODWRENCH
Copyright 2001

By

Bill Stroud, Ph.D.



Most of us are aware of the debt our culture owes to ancient Greece.  We are indeed the offspring of Western civilization.  However, another influence has shaped our times as well:  we are also children of the Industrial Revolution. We eat, live and breath the impact of Britain's shift to an industrial economy in the eighteenth century, a time in which  Western culture became almost manic building machines that build machines that build machines.  

This shift to mechanism has influenced us beyond an interest in economics and industry ; we tend to see almost everything according to a mechanistic model.   (The new buzz word for this phenomenon is paradigm shift.) Even religion did not escape the impact of mechanism; Deism was born from the tendency to see the entire universe as a complex machine, with God being the Grand Mechanical Engineer.  (With Deism, Providence was trivialized; trust in divine intervention gave way to confidence in the dependability of the laws of Nature.)

Our present healthcare system reflects an interesting combination of our Greek heritage and our adventure with industrialization.  The early Greeks viewed man as essentially a physical body (soma) inhabited (almost unwillingly) by a totally different mental reality (psyche).  It was only a short move to interpret the physical component as the machine in which a ghostlike element resided.  And Eureka! Our medical men came up with a rather descriptive term, "psychosomatic" (psyche + soma), portraying the body as a mechanism somewhat driven by a mental agent.   But this mechanistic model  of man, like most paradigms and mindsets, has lead us into some  bizarre conceptions.

We see our illness as tantamount to our body being broken and, consequently, requiring a medical "mechanic"  to "fix" us.  Our physicians have become Dr. Goodwrenches who prescribe adjustments, oils and even  replacement parts (a true aftermarket for Mother Nature).  Repair has become the mindset instead of  prevention.

Now we certainly need repair at times.  If our appendix ruptures, we'll surely want a surgeon.  However, the mechanistic model has become a real problem for our culture.  For instance, when you tell your spouse that it's time for you to have a physical, you probably mean that you want to go see if something needs fixing?  Who today goes to his or her physician to see if they are on the right track for making sure that something doesn't break in the first place?

What if we paid our physicians to keep us well instead of simply repairing us after we are broken?  (I'm told that in China the good doctor is paid so long as the patient stays well.)  And why haven't the insurance companies realized that staying well is the least expensive way to keep medical expenses down.  

There is an irony in the whole matter:  Most physicians will agree that the body is marvelously made for responding to attacks made on its wellness.  It has a tendency to marshal its various systems to fight any infringement on its integrity as a holistic system.  But it looks to the inside for its defense, preferring to take care of itself than depend on outside help.  (Most external regimens such as synthetic drugs, like most "do-gooders," bring  harm as well as help.)

Perhaps we need a new model, a new way to view the body and health.  Maybe we need the model of husbandry, one which views the body more as a plant than as a machine.  A plant needs nourishment, a continual support of its systems.  A plant needs to be fed more than it needs to be fixed.  It's life is a process of growth within a natural adjustment to its environment.  It can be stepped on and crushed, of course, and, consequently, need a splint  Most of the time, however, if it isn't neglected in its care and feeding, it will stand straight and fulfill its natural tendencies toward growth and fruition.

     With good nutrition,  preventive care,
     We hardly need so much repair.