Basic Health Access

An article by Andrew Weil indicates how "The Biomedical Model is Failing Us." Despite lofty claims, the drugs promoted have not done much for mental health. Not surprisingly the biomedical model may have failed most when applied to mental health where so much is about behaviors, relationships, and other people factors. Weil points out, "In 1977, the journal Science published a provocative article titled “The Need for a New Medical Model: A Challenge for Biomedicine.” I consider it a landmark in medical philosophy and the intellectual foundation of today’s integrative medicine. The author, George L. Engel, M.D., was a professor of psychiatry at the University of Rochester (New York) School of Medicine. Determined to overcome the limiting influence of Cartesian dualism, which assigns mind and body to separate realms, Engel envisioned medical students of the future learning that health and illness result from an interaction of biological, psychological, soci...

Behaviors, situations, relationships, environments, social determinants, and other people factors shape education, health, economic, and societal outcomes. You don't change people or people factors by testing focus. You change people factors by investing in people change. People Are So Much More Than What Can Be Measured Our "intellectual" leadership has promoted measurement schemes that have failed to address outcomes. They have forced governments, schools, and health care providers to invest in measurement in ways that steal the dollars needed to invest in the professionals to facilitate behavior change. This is the lazy and ineffective choice that has been incredibly costly and distracting. Most of all humans are far too complex to be captured in measures. Adding more measures in more dimensions and with higher technology processing is a waste of time, talent, and treasure. Even in arguably the best measurement scheme (NY CABG), it is not possibl...

As an advocate it is tempting to look for "evidence" that supports your "side." An example is maternal morbidity in Texas. Advocates are happy with articles that link poor maternal outcomes to declines in reproductive funding. They are claiming the clinical intervention card. The same advocates would likely be the ones that identify disparities as a problem. This is a people factor claim. Which influence dominates?  Is it People Factor Influence or is it Clinical Intervention Influence? It is not acceptable to play the people factor/social determinant card for some studies and claim clinical intervention as a major influence at other times. You may or may not be an advocate for reproductive services in Texas. You may want to believe that cuts in funding for clinical services directly impacted maternal mortality, but this disregards the disparities that often tend to shape outcomes to a much greater degree.  People factors should consistently be dominant as ...