The five different methodologies of how I work with patients


38 days ago by Dr David Owen


A patient asked me the other day what sort of doctor I was, I replied a 'Holistic Physician'. I realise this is a term that I might feel comfortable with but people might have very different thoughts of what it means. For me the physician bit is that I am part of a professional group that aims to heal the sick. This tradition reaches back well before the more modern pharmaceutical based role that is often associated with this title. It goes back to the early historic physicians who would work with individuals and groups to try to restore and maximise well-being. I suppose for me the extension of that is the role of the physician is not so much to heal the sick but rather to help the sick heal themselves and this role of adversary, coaching and support as a core path of the physician role is I think sometimes under-represented.

So what about the holistic tag? For me this is essential to well-being to see ourselves as balancing our well-being and physical needs, emotional and psychological needs and the environment we both have to and to some extent we chose to shape and live in. As such there are five different core methodologies to how we work with patients.

Firstly trying to help patients identify significant causation as to how unbalanced or disturbed their health is and then address it. This might be from a particular work or home stress, a dietary indiscretion but until an underlying cause has been removed patients healing is going to be slow if at all. At some stage patients who might come to me to help treat a blister and I can give you everything under the sun but if you still chose to wear your shoes too tight and you wear them inappropriately then you are going to continue to get blisters.

The second level is the realm of the symptoms. Here we see the symptoms not so much as something to be got rid of but rather a sign the body is trying to overcome something. This is the core principle behind homeopathy which see medicines that can produce similar symptoms to the one the patient has, contain some of the information they need to heal themselves i.e. the principle of 'like treating like'. This doesn’t just work in terms of medication.  If you work in terms of a psychological approach as well when we understand the symptoms we have as trying to inform us about what we might do to better overcome a particular imbalance or illness we have.

The third methodology is very much around the patient as a whole, the psychological factors often pointing towards important things to understand in relation to physical disease and interestingly sometimes dismissed and considered irrelevant physical symptoms that can be strong pointers to help people understand psychological disease. Ultimately we see patients with multiple different presenting symptoms and illnesses but from a holistic point of view there is only ever one illness and it is trying to grasp this and the balance of different components that is a core part of the work of a holistic physician. If you describe this to patients sometimes there is putting together a complex jigsaw puzzle to complete a pattern or picture as opposed to conventional medicine which is more like a flow diagram approach to healthcare.

The fourth methodology is looking at the thematical essence approach. What are the core patterns underlying the persons illnesses and symptoms over a period of time often a whole lifetime. Here each stage in a person’s life and stage in the different illnesses can inform us about what the patient needs and what patterns have to be matched in order to evoke healing response. Perhaps I can say more about this another time because it seems to be something that is undeveloped in many therapeutic systems but it does include how patients with illnesses do project this on to those around them and how in one way illnesses including psychological disturbances can be infective and infect those around you.

Finally the fifth methodology relates to that of family, community and even populations. There is always a part of every patient’s illness that informs and relates to these wider considerations although they are not always upmost in the patients awareness when they are presenting. In this context we always consider the patients family, social environment and larger social groups and even populations when we are treating them and treatment always includes partly a reflection on and an intervention at a population level.