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Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare?

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ABSTRACT

Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs. The approach may be well grounded economically, but in the care of patients, “value” has ethical and philosophical connotations. The restriction of value to an economic meaning ignores the importance of health and, thus, leads to misunderstandings.

We postulate that a new understanding of the nature of health is necessary. We present the Meikirch model, a conceptual framework for health and disease that views health as a complex adaptive system. We describe this model and analyze some important consequences of its application to healthcare.

The resources each person needs to meet the demands of life are both biological and personal, and both function together. While scientific advances in healthcare are hailed, these advances focus mainly on the biologically given potential (BGP) and tend to neglect the personally acquired potential (PAP) of an individual person. Personal growth to improve the PAP strongly contributes to meeting the demands of life. Therefore, in individual and public health care, personal growth deserves as much attention as the BGP. The conceptual framework of the Meikirch model supports a unified understanding of healthcare and serves to develop common goals, thereby rendering interprofessional and intersectoral cooperation more successful. The Meikirch model can be used as an effective tool to stimulate health literacy and improve health-supporting behavior. If individuals and groups of people involved in healthcare interact based on the model, mutual understanding of and adherence to treatments and preventive measures will improve. In healthcare, the Meikirch model also makes it plain that neither pay-for-performance nor value-based payment is an adequate response to improve person-centered healthcare.

The Meikirch model is not only a unifying theoretical framework for health and disease but also a scaffold for the practice of medicine and public health. It is fully in line with the theory and practice of evidence-based medicine, person-centered healthcare, and integrative medicine. The model offers opportunities to self-motivate people to improve their health-supporting behavior, thereby making preventive approaches and overall healthcare more effective.

We believe that the Meikirch model could induce a paradigm shift in healthcare. The healthcare community is hereby invited to acquaint themselves with this model and to consider its potential ramifications.

No MeSH data available.


Distinction between health and diseaseHealth results (left) whenever the two potentials together are larger than that needed to satisfy the demands of life. When they are smaller than the demands of life (middle), disease occurs. When the potentials are reduced, health may result again, provided the demands of life have decreased even more (right). In this case, the subjects usually say that they are healthy.
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FIG3: Distinction between health and diseaseHealth results (left) whenever the two potentials together are larger than that needed to satisfy the demands of life. When they are smaller than the demands of life (middle), disease occurs. When the potentials are reduced, health may result again, provided the demands of life have decreased even more (right). In this case, the subjects usually say that they are healthy.

Mentions: Health requires that individual resources match the demands of life. This means that every person must be able to respond satisfactorily to the demands of life and possible changes. Since these resources are needed not only at a specific time but also in the long-term future, they are called potentials. Each individual is equipped with two types of potentials, a biologically given potential (BGP) and a personally acquired potential (PAP). The BGP is the gift of nature everyone receives at the time of birth. It represents the biological basis of human existence. After birth, this potential decreases continuously and reaches zero at the time of death (Figure 2). Diseases and accidents may reduce it transiently or permanently (Figure 3). The term PAP is used to describe all the physical, mental, and spiritual abilities an individual can acquire during his or her lifetime. It is also the site of individual responsibility for health. After birth, the PAP increases rapidly. Thereafter, growth slows; it may continue, though, if a person invests in the development of abilities and inner growth. Efforts to develop the PAP are important investments in an individualĀ“s future health. In a personal crisis, the PAP may decrease but recover, more or less, once the crisis is overcome. For example, alcohol or drug addiction will decrease the PAP, transiently or for life. In responding to the demands of life, the two potentials always act together. Notably, the PAP can compensate to some degree for deficiencies in the BGP. This is particularly needed as a person ages.


Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare?
Distinction between health and diseaseHealth results (left) whenever the two potentials together are larger than that needed to satisfy the demands of life. When they are smaller than the demands of life (middle), disease occurs. When the potentials are reduced, health may result again, provided the demands of life have decreased even more (right). In this case, the subjects usually say that they are healthy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383372&req=5

FIG3: Distinction between health and diseaseHealth results (left) whenever the two potentials together are larger than that needed to satisfy the demands of life. When they are smaller than the demands of life (middle), disease occurs. When the potentials are reduced, health may result again, provided the demands of life have decreased even more (right). In this case, the subjects usually say that they are healthy.
Mentions: Health requires that individual resources match the demands of life. This means that every person must be able to respond satisfactorily to the demands of life and possible changes. Since these resources are needed not only at a specific time but also in the long-term future, they are called potentials. Each individual is equipped with two types of potentials, a biologically given potential (BGP) and a personally acquired potential (PAP). The BGP is the gift of nature everyone receives at the time of birth. It represents the biological basis of human existence. After birth, this potential decreases continuously and reaches zero at the time of death (Figure 2). Diseases and accidents may reduce it transiently or permanently (Figure 3). The term PAP is used to describe all the physical, mental, and spiritual abilities an individual can acquire during his or her lifetime. It is also the site of individual responsibility for health. After birth, the PAP increases rapidly. Thereafter, growth slows; it may continue, though, if a person invests in the development of abilities and inner growth. Efforts to develop the PAP are important investments in an individualĀ“s future health. In a personal crisis, the PAP may decrease but recover, more or less, once the crisis is overcome. For example, alcohol or drug addiction will decrease the PAP, transiently or for life. In responding to the demands of life, the two potentials always act together. Notably, the PAP can compensate to some degree for deficiencies in the BGP. This is particularly needed as a person ages.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs. The approach may be well grounded economically, but in the care of patients, “value” has ethical and philosophical connotations. The restriction of value to an economic meaning ignores the importance of health and, thus, leads to misunderstandings.

We postulate that a new understanding of the nature of health is necessary. We present the Meikirch model, a conceptual framework for health and disease that views health as a complex adaptive system. We describe this model and analyze some important consequences of its application to healthcare.

The resources each person needs to meet the demands of life are both biological and personal, and both function together. While scientific advances in healthcare are hailed, these advances focus mainly on the biologically given potential (BGP) and tend to neglect the personally acquired potential (PAP) of an individual person. Personal growth to improve the PAP strongly contributes to meeting the demands of life. Therefore, in individual and public health care, personal growth deserves as much attention as the BGP. The conceptual framework of the Meikirch model supports a unified understanding of healthcare and serves to develop common goals, thereby rendering interprofessional and intersectoral cooperation more successful. The Meikirch model can be used as an effective tool to stimulate health literacy and improve health-supporting behavior. If individuals and groups of people involved in healthcare interact based on the model, mutual understanding of and adherence to treatments and preventive measures will improve. In healthcare, the Meikirch model also makes it plain that neither pay-for-performance nor value-based payment is an adequate response to improve person-centered healthcare.

The Meikirch model is not only a unifying theoretical framework for health and disease but also a scaffold for the practice of medicine and public health. It is fully in line with the theory and practice of evidence-based medicine, person-centered healthcare, and integrative medicine. The model offers opportunities to self-motivate people to improve their health-supporting behavior, thereby making preventive approaches and overall healthcare more effective.

We believe that the Meikirch model could induce a paradigm shift in healthcare. The healthcare community is hereby invited to acquaint themselves with this model and to consider its potential ramifications.

No MeSH data available.