Escamilla Ortiz, Abilene Cirenia¹; Serrano Pérez, Josefina²

Language: English/Spanish [Versi?n en espa?ol]
References: 2
Page: 141-142
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The holistic model explains the ability to use a biopsychosocial model that considers cultural and existential dimensions. It is a medical concept according to which all aspects of the patient's needs must be considered, including psychological, physical, and social. This approach reflects the belief that health is more than the mere absence of disease and supports comprehensive prevention strategies and achieving higher levels of mind, body, and spirit.¹ This concept was developed at the World Health Organization in Europe and aligned with the biopsychosocial concept of Engel's holistic model of the 1970s, which describes that man must interact with the environment, that problems will arise from this loss of balance and that a comprehensive approach must be taken, which also implies management of the doctor-patient relationship. Diagnosis should be clinical and include biological, emotional, cultural, and psychosocial aspects. Within this same model, it is postulated that a single cause does not produce the disease but is multi-causal since it is said that the causality of all phenomena is multiple.²

In general, the family physician is the one who follows up with the patient, mainly focusing on prevention. That is why, in some countries, the term "integrative medicine" is used, combining evidence-based medicine with complementary medicine. This prevention should not only be the responsibility of family physicians but surgeons should be involved in the patient's entire environment, as this will lead to better results in their procedures. For example, when the surgeon explains to his/her patient what complications may occur if smoking is not stopped at least one month before surgery or if antibiotic prophylaxis is not carried out when indicated.¹

In addition, special comprehensive pre- and post-surgical services should be available to reduce anxiety and stress caused by an impending surgical procedure. It has been shown that reducing these factors has been associated with better surgical outcomes for patients, including fewer complications and a speedy recovery. Mind-body techniques decrease stress, pain, and even less blood loss during the surgical event, translating at the end of the road into fewer days of stay, less use of medications, and more.¹

Some studies show that the use of acupuncture in the postoperative period reduces nausea, vomiting, and adrenal response.¹

Finally, a review of surgical specialty programs and curricula revealed that the topic is not included, and we believe it should be since surgeons traditionally focus only on their surgical procedure and not on the patient's environment.

Holistic medicine requires a team approach, and the surgeon must be part of this team. Therefore, we must begin to involve both residents and surgeons already trained and make them see that it is not just a matter of knowing technical skills. We must begin to break paradigms.

REFERENCES

1. Atayoglu T, Buchholz N, Atayoglu AG, Caliskan M. Is there a place for a holistic approach in surgical training? Arab J Urol. 2014; 12: 21-24.

2. Elio-Calvo D. Los modelos biomédicos y biopsicosocial en medicina. Rev Med La Paz. 2023; 29: 112-117.

AFFILIATIONS

¹ Editor of Surgeon General. ORCID: 0000-0001-5635-5845

² Head of the Center for Educational Innovation in Medicine and Clinical Simulation. Mexican School of Medicine of La Salle University, Mexico. ORCID: 0000-0002-0451-5285

CORRESPONDENCE

Abilene Cirenia Escamilla Ortiz, MD. E-mail: escamillaoa@amcg.org.mx