Human health has been approached through various concepts all of which aim at promoting health. Among the different approaches used to define and pursue health are the medical model, the environmental model and the holistic/wellness model of health (Larson, 1991). This paper focuses on the medical model of health which describes health as inexistence of disease in the human body. In this paper, a critical look is given to the medical model of health by looking at some positives such as an increased understanding of disease achieved through this model. Its negatives are also highlighted especially on its failure to conceptualize and address what health really is in a holistic manner thus proving the medical model insufficient. It is however acknowledged that the medical model of health holds to a foundational concept of health that continually enables quality delivery of health care and hence it should be continued.
A Critical View of the Medical Model
According to Edlin and Golanty (2010), the main principle of the medical model of health is that “health is the absence of one of more of the “five Ds”- death, disease, discomfort, disability and dissatisfaction” (p. 5). This implies that if one is not sick or if one does not have a bodily malfunction, then the individual can be said to be healthy. This tenet can also be summarized as “absence of disease and disability” (Edlin & Golanty, 2010, p. 5). The medical model of health has an over-reliance on the anatomical and physiological wellbeing such that the body is conceptualized as a machine made of parts (organs and cells) that are oftentimes become malfunctioned due to microbial and pathogenic attack. As such, the most important aspect of medicine is to ensure that the body is in a good state of functioning by repairing the malfunctioning parts (Tones & Tilford, 2001).
MacDonald (2002) explains that the medical model of health came up as a component of advancing medicine profession coupled with a rising scientific method of explaining phenomenon. There was tendency to view disease as only affecting specific body parts thus treatment focused on correcting the malfunctioned body part. This viewpoint is still inherent in the medical model as an approach of promoting health. In fact this approach capitalizes on preventing diseases, curing, as well as limiting certain illnesses. Even in such an approach, the main focus is on body parts in individuals and the health of a population is generally overlooked. The medical model is therefore often criticized on its failure to focus on other factors that may affect health other than the body’s intrinsic problems (Naidoo & Wills, 2009). There is failure to emphasize on the social and environmental factors that are capable of affecting health negatively. In addition, psychological factors are largely ignored yet they have the capacity to affect mental health. With such disregard for social and psychological determinants of health, the medical model cannot achieve the goal of curing or preventing illnesses wholesomely.
The heightened criticism on the medical model of health emanates from a general lack of understanding and consensus on what health is by itself. Without an agreeable definition of health, it would be impossible to define a health model that would encapsulate the aspect of health promotion. Seedhouse (2001) first warns on the tendency to rely on dictionary definitions of health as these are restricted to the views of certain individuals. At the same time, Seedhouse (2001) cautions that there should be no assumptions that all human beings perceive good health as an undesirable thing since there can be cultural differences in defining disease. A certain body condition can be viewed as a disease in one culture whereas a different culture perceives the same state as normal. Such differing viewpoints of what health constitutes results into the criticism heaped on the medical model.
It is important to note that the medical model is more popular to medicine professionals who defend this concept of health as a way of retaining autonomy in the profession. This has made the medical model to be a means of attaining and reserving power in the society. In the words of MacDonald (2002), the medical profession “preserve itself…such that its activities are in part directed toward the maintenance of its powerful position within the society” (p. 50). This furtherance of power and dominance in the medical profession has not been received well as individuals are left at the mercies of the doctor. An individual’s say on his or her own health is not prioritized as the doctor authorizes the patient to follow certain guidelines (therapeutic surgery or drugs). People are denied the privilege of being in control of their own health thus portraying the medical model as insufficient in health promotion efforts. In addition to being an authoritative approach to health, the medical model is restrictive in that one has to be a certified medical doctor in order to practice. With such an ideology, the contributions of nutritionists or complementary medicine seem irrelevant in spite of the fact that they promote health.
While the medical model scores highly in understanding and treating disease from a biological point of view, it overlooks the role played by lifestyle and behaviour in promoting health. Russell (2009) thinks that the medical model has less to do with promoting health because its primary duty is to cure disease. By doctors practicing reactive medicine and disregarding proactive medicine, one can only envisage minimal gains in promotion of health. This means that the outcomes of therapeutic medicine which is promoted by the medical model are not worth the investment thereof compared to a preventive approach. It is unfortunate that the medical model does not take a person who is not having a disease as likely to be unhealthy (Duncan, 2007). As such, medical doctors can only respond to a sick case and risky lifestyle is not seen as an impendent to health. Some diseases such as diabetes and hypertension can be easily controlled by changing lifestyle but this is not the focus of the medical model.
Even as the medical model is highly criticized as failing to tackle health promotion in a holistic manner, it is has proved to be an indispensable approach to health. Its biological approach to disease has led to curing of threatening illnesses which ultimately endanger man despite robust preventive measures. In deed, anyone who has benefited from an antibiotic or any surgical procedure may confirm that the medical model is always welcome. By taking a scientific approach to understanding disease, the medical model has led to a wealth of knowledge on disease and the treatment thereof. In addition, to argue that the medical model does not address the health of the population is not right since it has been possible to conduct certain measures of population health using medical model. According to Edlin & Golanty (2010), the medical model has enabled characterization of population health in terms of incidence and prevalence of morbidity and mortality. Assuming such vital statistics would make it hard to implement any other model of health.
The medical model of health has been specific on what health is thus it has been possible to focus on specific ways of curing disease and hence promoting health. Wylie and Holt (2010) argue that other models are too broad and these do not form a good basis for understanding health. By first outlining that health is the absence of disease and nothing more or nothing less, it lays a foundation for viewing the health in a holistic view. Wylie and Holt (2010) support this argument by saying that “if health is disease absence, then we can measure it, research it using quantitative methods, build hospitals to house the technology and people concerned with improving health through treating and curing disease” (p. 122). This implies that the medical model can easily integrate with other models such as the social model to ensure health promotion.
Defining health is one of the complex issues in health promotion especially with regard to different models of health. The medical model of health however clearly outlines health as nothing more or less of absence of disease. This position raises criticism as it disregards disease prevention in promoting health while emphasizing on curing disease. It is also viewed as a way of safeguarding the medical profession by giving doctors the autonomy of practice. Even as the medical model is viewed as failing to tackle health promotion in a holistic approach, its contribution to health cannot be ignored. There is better understanding of disease due to research and it has been possible to characterize the health of populations. In deed, the medical model of health should be enhanced since it is foundational to other models of health.
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