Talk:Medical model

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This article is not at all accurate and is going to need an entire rewrite. It has this weird bias against psychiatry and includes incorrect information:

  • Among critics of medical psychiatry, Laing observed that because the diagnosis of a mental illness was based on conduct or patient behavior and not on evident pathology, it (the "diagnosis") essentially contravened standard medical procedure and hence the medical model: examination and ancillary tests were conducted, if at all, only after the diagnosis was made. What is this from? Physicians and mental health professionals may conduct mental status exams, physical exams, personality tests, cognitive tests and usually do so utilizing a method of a differential diagnosis. If this is talking from a historical perspective, that is one thing - but the way it reads now, it is just wrong! Chupper 20:49, 29 September 2007 (UTC)

Actually, I agree with the original author because historically this was the case, the pathology had to be tangible and if you challenge the findings, just look at the disparity in health care coverage for those with mental illness vs those with a pathological medically (defined) illness. There is no comparison. Healthcare policy dictates that there will be a parody among the two until they can "prove" that mental illness has the potential to cause enough "pain& suffering" that physical illness does. In mental illness healthcare there is no "preventive" healthcare inclusion in the insurance, nor is there an inclusion for screening in school-age children, teenagers or seniors.Actually most insurers expect that the illness is address and cleared up and managed in 30-60 days. gesimpson7 October 21, 2007

I think you overstate the facts here. Both in historical medicine and in modern medicine, there are many examples of "physical" medical conditions that are recognized on the basis of patient report: chronic pain, for example, or migraine with aura. These do not require any tangible pathology.
In fact, with these conditions, you are more reliant on patient report than you are with many of the well-known mental disorders, like bipolar disorder. I really have no way of differentiating between a person who suffers from serious migraines and a person who just wants to lie in bed and get some sympathy for three days. When you encounter a person in the middle of a full-blown manic episode, however, it's not too difficult to identify that something is wrong, even if the precise label is elusive, and long-term solutions perhaps impossible. WhatamIdoing (talk) 22:13, 19 March 2008 (UTC)

Agree with criticism of article[edit]

I too wish to add my support to the criticism of this article, and it needs to be pulled and redone.

The author seems to be fixated on a very limited, pejorative, use of the term, and the article is more a single view opinion piece, rather than anything encyclopedic.

It is, also, factually wrong.

Using mental illness as an example, mainstream medicine has long recognized mental illness, and to somehow contend that 'holistic' equates with alternative is an affront to many physicians. Again, regarding mental illness (as that seems to be the author's ax to grind); the need for social support, physical health, exercise, talk therapy is the norm. Medications are only used when there is a specific diagnosis of a disorder with known response. Given the overwhelming biological (including pathology you can see on post-mortem--since you don't do brain biopsy's on disorders which can be readily diagnosed this isn't clinically useful) evidence from CT-PET, functional MRI, genomics, and other research modalities have contributed to understanding of disorders like major depression, Schizophrenia, bi-polar disorder, and anxiety disorders far beyond talking about levels of neurotransmitters like serotonin, dopamine, and norepinephrine.

The reason for the "medical model" of mental illness is that for specific disorders it works. It is no different from a clinical perspective than hypertension (where lifestyle changes--diet, exercise, stress reduction methods--are both first line therapy and part of care even when medications are used to treat people) and many other chronic diseases.

There are many problems in life which share features with mental illness, which don't require medical therapy. Because some of the same therapies provide relief irrespective of cause of distress (mental illness, stress, other illnesses, loss of loved one) there is a good deal of confusion between mental distress caused by having a crappy life v. mental distress due to an underlying disease (typically with a very strong genetic component). -- (talk) 16:59, 23 January 2011 (UTC)

I agree certainly that beginning the entry on the medical model with the emphasis on mental illness is silly; unfortunately, the creator of the entry cited material I plugged into the Wiki entry on Ronald Laing: I never meant to suggest that Laing invented the term "medical model"; only that his was the first proper definition I'd read.
In any case, "medical model" is a fairly recent term, although certainly the "complaint, history, examination" routine had been around for centuries. Any connection of "medical model" with "mental illness" begins only around 1911 or so, when, almost overnight, general medicine annexed the popular mental diseases of the day, dementia praecox and manic depression. [In fact, Freud, a physician (internist) and inventor of psychoanalysis, was skeptical about medical doctors taking on the "mental diseases."] BubbleDine (talk) 16:25, 17 May 2012 (UTC)
This article is a disaster and needs a full rewrite. It contains a strong anti-psychiatry theme which doesn't belong on this page, and it doesn't present a balanced POV. Ashleyleia (talk) 19:51, 25 March 2013 (UTC)

Agree and Disagree[edit]

I agree that this article is very anti-psychiatry and does not relate well to the rest of medicine. But the phrase and the idea is well out there and is frequently referred to by both antipsychaitrists (I probably have to say here that I am a psychiatrist), and other patient rights and allied professions, notably psychologists.

There more I read about it and think about it, the more able I am to see some merit in the idea. The key thing for doctors to realise, is that the 'Medical Model' is not a 'Medical' Model in the same way as the Biopsychosocial model or a social model of disease causation. I think it could probably be considered a social model, and I also consider it actually has two aspects, one relating to the training and methods of training of doctors (which is well addressed in the Physician article, and secondly the underlying philosophy and how that affects patients and others (two aspects there too?), which could be called more a Disease model or Biomedical model.

This is all personal research / thought so unless I can find published work that supports this, it will remain here. Egmason (talk) 22:04, 15 August 2013 (UTC)

Environmental model?[edit]

Adding on to the biopsychosocial model is the environmental model. Should this be included? (talk) 13:50, 16 June 2012 (UTC)

Clarity and Neutrality[edit]

Okay, I took a stab at the first half or so of the page. I made it clearer, more neutral, less contentious and (I think) more accurate. I moved some of the mental-health stuff to the psychology section. I added wording to the effect that a model is supposed to be a tool, to be judged by its utility. More links to other pages, and a reference. (Just one, sorry. All I had time for today.) I changed section on "disease" to "disease and injury" because I think most people don't think of a broken arm as a disease, but such injuries fit very nicely into the medical model.RobertPlamondon (talk) 19:01, 11 February 2015 (UTC)