Abstract
Generalist practitioners often find interacting with patients deeply satisfying and joyful; they also experience encounters that are challenging and complex. In both cases, they must be aware of the many issues that affect the processes and outcomes of patient care. Although using the BioPsychoSocial approach is an important, time-tested framework for cultivating one's awareness of patients' presenting concerns, recent developments suggest that additional frames of reference may enhance communication and relationships with patients. In this article, we describe several additions to the BioPsychoSocial approach, considerations we call “add-ons” and “add-ins”. We invite generalist practitioners and, indeed, all health care practitioners, to consider how they can improve their ongoing care of patients by personalizing these and other additions in their day-to-day work with patients.
Highlights
Based on systems theory and later complemented by patient- and relationship-centered care, the BioPsychoSocial (BPS) approach has become an important part of medical practice and medical education, especially among generalist practitioners [1,2,3,4]
Much has changed in generalist medicine since mention of the value of systems theory to patient care and publication of the seminal paper on the BPS approach [12, 13], which appeared in Science in 1977 [1]
The point of introducing these considerations is to suggest that generalist practitioners consider the BPS approach not as a model set in stone, but as [1] an inspiration for further integrating BPS concepts into practice, [2] a stimulus to promote patientand relationship- centered approaches to patient care, and [3] a means to of repositioning themselves in the space between patients’ lived experience and the culture of medicine [87]
Summary
Based on systems theory and later complemented by patient- and relationship-centered care, the BioPsychoSocial (BPS) approach has become an important part of medical practice and medical education, especially among generalist practitioners [1,2,3,4]. Motivated by our [1] mutual misgivings regarding the traditional enculturation of medical students and residents away from thinking holistically and systemically, [2] recognition of the importance of the BPS approach to generalist practice, and [3] firm belief of the approach’s positive influence on patients’ health, we suggest it is time to reconsider how generalist practitioners understand and use the approach. The BPS approach is bidirectional, and that by applying it with patients in everyday practice generalists can develop their professional identities as TABLE 1 | BioPsychoSocial add-ons: ecological and existential themes
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