The Integral Model: Answering the Call for Whole Systems Health Care

There has been a revolution in medicine over the past century. Enormous successes can be heralded, from advances in public health to the recent developments in molecular biology, neuroscience, biomedical engineering, and pharmacology. Of course, not all the changes have been good. Indeed, there are many indications that medicine in the 21st century is in crisis. Millions of Americans are without medical coverage and the costs associated with health care continue to spiral upward, making it harder and harder for people to get the help they need. Iatrogenic (medically induced) illness is another significant challenge with the large number of new treatments, resistant strains of microbes, and work overload of many health professionals. Economic pressures reduce the amount of time clinicians can spend with patients, which also contributes to burnout among many on the front lines. It is clear that science and technology have resulted in vastly improved understanding, diagnosis, and treatment of disease. But the emphasis on science and technology to the exclusion of other elements of healing has also served to limit the development of a model that humanizes the health care encounter. Far too often, modern medicine ignores the importance of the personal and interpersonal dimensions of our experience. Compassion is rarely a selection criterion for medical training and bedside manner is not featured in the core curriculum of most academic health care programs. Physicians are often taught to avoid or suppress the emotions that are connected to states of disease and healing—the patient's and the physician's. For patients and professionals alike, the biomedical model often fails to offer a system that embraces the vast potentials of healing—ignoring or negating completely the possibility for human growth and development in the face of illness.1 And yet, we are meaning-making creatures. As Kaiser Permanente's recent “Thrive” advertising campaign accurately reveals, we are calling for something deeper in our lives, both individually and collectively, as we confront the complexities of illness, disease, and aging. Although there is ample reason for concern about the challenges facing health care today, crisis can also lead to breakthrough and transformation.2 Indeed, we see this happening already. A fresh breeze is blowing through many corridors of our hospitals and clinics. Patients and clinicians alike are demanding that the heart and soul of healing be reinstated. There are many positive developments that speak to an emerging new model for health care—one that acknowledges multiple dimensions of living, healing, and curing—dimensions that go beyond reduction of symptoms. One name for this new model is integral health care. An integral perspective promotes our capacity to thrive, even under the most adverse circumstances. As emergency room physician, William Benda, MD, writes: “Integral Medicine proposes to be the next step in health care, one that incorporates all dimensions of healing, from physical to spiritual, and ecological to cosmological. This evolution is not only necessary but inevitable and fundamental to solving the conundrum that is our current health care system.”3p33 The purpose of this essay is to give an overview of this emerging new model—and to consider specific ways to apply an integral perspective in your own life and work.