The Physics of Family Medicine as Basis for Training of Family Physicians in West Africa

Abstract

The biopsychosocial model is a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the social to the subatomic particle using the General System Theory. The aim of this paper was to bring to the attention of doctors the thinking that underpins the unique training of family physicians as specialist in West Africa. A review of relevant literature was done using internet search engines on the subject. Qualitative analysis methods included collation, theme identification and triangulation. Result revealed a major hindrance in the advancement of Family practice in West Africa as a discipline is the insistence on describing it in the terminology of traditional biomedical medicine. The traditional biomedical medicine, the doctor fits the patient's illness into a precise class linking the symptoms and signs with organic pathology and identifying single external causes. He explains the patient's illness in terms of his own worldview during the consultative process by taking a domineering stance on the assumption that he, the doctor has sufficient knowledge and skills about the positive health outcome of the individual patient. On the other hand, Family Medicine interprets symptoms in terms of its own method and objectives. Interpretation of the patient (patient-centered method) rather than the symptoms (disease-centered method) is the crux of clinical competence in family practice. This method is consistent with Einsteinian physics rather than Newtonian physics which are the basis of traditional biomedical medicine. In conclusion, the value of the biosychosocial model is not the discovery of a new scientific law, but the application of medical knowledge to the needs of each patient for which the family physician is adequately trained. This forms the basic science background for the training of family physician in West Africa as envisaged by the founding fathers in the 1980s..

Keywords: Biopsychosocial model, Dualism, Reductionism, Clinical practice, Training, family medicine.

The Nigerian Medical Practitioner Vol. 51 (6) 2007: pp. 119-122