Social Medicine vs. Biomedical Medicine

[aaronjw]

Curious to know what people here think are more important to overall population health (note, health is different than healthcare) and why you the way you do.

 

Social medicine is also referred to as Social Determinants of Health.

 

I'll provide my own insight after a few entries (if any) since I already know the differences and issues pretty well and don't wish to taint views.

[Birdy]

I don't think either can be taken as more important than another. A person of considerable means with a supportive, loving family, who had a good education, and is well-educated enough to know how to make smart choices is still up the creek without biomedical medicine if they end up with cancer.

 

Alternately, someone who grew up in an abusive home, lives in a poverty-stricken area where exploitation and drugs are rampant, and has little education is unlikely to be helped out of their addiction - and resultant health issues - by medicine alone, not without taking into account the social aspects that surround their health status.

 

I think a rounded approach that takes both physical and social health issues into account is necessary. But, of course, I'm on the outside looking in. I heard about the SWITCH project in Saskatoon a while ago, and it sounds like a really interesting approach.

[aaronjw]

Nice

 

The problem I see with a rounded approach is the fact that most of the funding still goes towards biomedical medicine which is based on an individualized healthcare model whereas SODH funding has the ability to help more people which has the potential for more efficient funding utilization rates.

 

 

 

 

I don't think either can be taken as more important than another. A person of considerable means with a supportive, loving family, who had a good education, and is well-educated enough to know how to make smart choices is still up the creek without biomedical medicine if they end up with cancer.

 

Alternately, someone who grew up in an abusive home, lives in a poverty-stricken area where exploitation and drugs are rampant, and has little education is unlikely to be helped out of their addiction - and resultant health issues - by medicine alone, not without taking into account the social aspects that surround their health status.

 

I think a rounded approach that takes both physical and social health issues into account is necessary. But, of course, I'm on the outside looking in. I heard about the SWITCH project in Saskatoon a while ago, and it sounds like a really interesting approach.

[future_doc]

http://www.who.int/hia/evidence/doh/en/

[Birdy]

Nice

 

The problem I see with a rounded approach is the fact that most of the funding still goes towards biomedical medicine which is based on an individualized healthcare model whereas SODH funding has the ability to help more people which has the potential for more efficient funding utilization rates.

 

Well, yeah. A doctor in a clinic can see a lot more patients in a shorter period of time to assess and treat strictly physical health issues. It takes longer to build a rapport and discover the issues behind the physical problems, time doctors all too often don't have. That's why I think it can't just be a rounded approach on the part of the doctors, it has to involve community workers as well, like the SWITCH program does.

 

I think it has to be a multi-pronged approach. If a patient is noncompliant with their medication, a minute or two of discussion can find out that it's because they can't read the labels, or they can't afford it and are stretching it out to make it last (I've done this myself), or they have no one to help them with figuring out their insulin dose. Maybe the patient being seen regularly for small injuries is no longer able to live on their own because of their reduced mobility, and needs to see a social worker. Maybe the patient with the terribly controlled diabetes needs to see a dietician, and a diabetes educator to help them learn to control it. The patient with the hip problems might be better helped by PT than an orthopaedic surgeon.

 

I think that the FFS model we have does discourage doctors from exploring the social medicine side of things; but I have to be optimistic in hoping that we can eventually find a way to tie these things together, to not see the patient as a collection of pathologies to be treated, but as a person with the many social factors that determine their health outcomes.

 

But, of course, that may be my overly rosy premed outlook. I'm still on the outside looking in the sliding glass doors.