Whole person care: encompassing the two faces of medicine

• Published in: Canadian Medical Association journal (CMAJ) 2009-04, Vol.180 (8), p.845-846
• Main Authors: Hutchinson, Tom A, Hutchinson, Nora, Arnaert, Antonia
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Biological products; Care and treatment; Clinical Medicine - standards; Combined Modality Therapy; Health aspects; Health care; Holistic Health; Humanities; Humans; Interprofessional Relations; Medical personnel; Medicine; Mental Healing; Methods; Patient Care - methods; Patients; Physician-Patient Relations; Practice; Roles; Services; Total Quality Management; Treatment Outcome
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.081081

The contrast in the health care worker's roles in curing and healing are equally striking. In the curing mode, the physician, through his knowledge and expertise concerning disease, clearly has more power. That is why the patient consulted him in the first place. In the healing mode the power shifts toward the patient. It is within the patient that healing will occur and it is the patient who will make the healing journey. The physician's role is accompaniment. To do this effectively the physician needs to be able to put part of himself in the patient's shoes and thus adopt the wounded healer role.4 The epistemologies in the curing and healing roles are also very different. In the curing mode the basis of knowledge is scientific and this is expressed in the current requirement of evidence-based practice. In the healing mode this approach is not helpful. Since the essence of the facilitation of healing is the relationship of one person to another, the physician's role in healing has to depend on his particular gifts and characteristics as a person and on the particular gifts and characteristics of the patient. Art rather than science is required to enable the physician to make the best intuitive use of himself in the healing relationship with the patient. The dynamics of the interaction would be different with every physician-patient pair, a complete contrast to the standardized requirements of science. Physicians and other health care workers need to relearn1 an important skill: how to retain a broad enough awareness to encompass simultaneously the needs of both curing and healing in stressful clinical situations. We might hope that this is the purpose of teaching hospitals and clinical clerkships where students can see this process in action in a clinical setting. This does undoubtedly occur, but because medicine itself is unclear about these 2 roles and has tended to opt for curing at the expense of healing3 we have found that students' experiences in hospital can hinder, rather than foster their development as facilitators of healing.6 It is not only students, but faculty as well who need to learn how to encompass these 2 roles.