Document Detail

Clinical problem solving and the biopsychosocial model.
MedLine Citation:
PMID:  1530068     Owner:  NLM     Status:  MEDLINE    
Engel's biopsychosocial model, while unifying the sciences relevant to medicine under general systems theory, is of limited utility in organizing bedside clinical problem solving. The authors consider this issue in light of the structure and goals of the clinical encounter. The biopsychosocial model is a model for organizing the sciences relevant to medicine; however, medical/psychiatric practice poses problems both within and outside the scientific realm. Since the biopsychosocial model cannot account for clinical problems to which the methods of science do not apply, the authors seek to facilitate biopsychosocial problem solving by proposing a clinical decision-making model that complements the biopsychosocial model. Their model directs the clinician's attention to three core aspects of the clinical encounter: problems of knowledge, ethics, and pragmatics. The authors reconsider Engel's case of Mr. Glover to demonstrate the anticipatory emphasis of the model. Other clinical examples are used to demonstrate the difficulties arising from mistaking one kind of aspect of medicine for another. When these three aspects of medicine are respected equally, a biopsychosocial practice is unavoidable.
J Z Sadler; Y F Hulgus
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  149     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-10-20     Completed Date:  1992-10-20     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1315-23     Citation Subset:  AIM; E; IM    
Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas 75235-9070.
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MeSH Terms
Decision Making
Education, Medical
Ethics, Medical
Interdisciplinary Communication*
Models, Theoretical*
Physician-Patient Relations
Problem Solving*
Social Values
Systems Theory*

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