Abstract
The biopsychosocial model is characterized by the systematic consideration of biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery. This model opposes the biomedical model, which is the foundation of most current clinical practice. In the biomedical model, quest for evidence based medicine, the patient is reduced to molecules, genes, organelles, systems, diseases, etc. This reduction has brought great advances in medicine, but it lacks a holistic view of the person. To solve the problem, we propose an early team based approach where the primary care physician leads a group of people that can help her/him address the psychosocial issues while she/he attends to the biomedical issues. This article addresses one case where the clinical ethicist facilitating a team based biopsychosocial model for the care of a patient worked as a bridge between the primary team, the critical care team, and the psychosocial team to advance the argument that good communication among the groups can lead to a true biopsychosocial model where the collaboration of the social worker, psychologist, chaplain, ethicist and the different medical teams can improve the overall patient experience.
Similar content being viewed by others
Notes
The medical team in this paper consists of physicians, nurses, advance practitioners, and pharmacologists.
The details have been modified in order to make the patient unidentifiable.
References
American Society for Bioethics and Humanities (ASBH). (2009). Improving competencies in clinical ethics consultation: An education guide. Glenview, IL: American Society for Bioethics and Humanities.
American Society for Bioethics and Humanities (ASBH). (2011). Core competencies for health care ethics consultation: The report of the American Society for Bioethics and Humanities (2nd ed.). Glenview, IL: American Society for Bioethics and Humanities.
Borell-Carrió, F., Suchman, A. L., & Epstein, R. M. (2004). The biopsychosocial model 25 years later: Principles, practice, and scientific inquiry. Annals of Family Medicine, 2(6), 576–582. https://doi.org/10.1370/afm.245.
Carey, T. A., Mansell, W., & Tai, S. J. (2014). A biopsychosocial model based on negative feedback and control. Frontiers in Human Neuroscience, 8(1), 94. https://doi.org/10.3389/fnhum.2014.00094.
Chik, I., Fischberg, D., & Bernstein, I. (2017). The impact of social work encounters on risk of ICU admission, ICU death, and CPR among hospitalized patients with cancer at end of life. Journal of Pain and Symptom Management, 53(2), 325–325. https://doi.org/10.1016/j.jpainsymman.2016.12.047.
Deffner, T., Schwarzkopf, D., & Hartog, C. (2013). How a clinical psychologist in the ICU can support patients and their relatives. Infection, 41, S68.
Engel, G. (1980). The clinical application of the biopsychosocial model. The American Journal of Psychiatry, 137(5), 535–544.
Hartog, C. S., & Benbenishty, J. (2015). Understanding nurse–physician conflicts in the ICU. Intensive Care Medicine, 41(2), 331–333. https://doi.org/10.1007/s00134-014-3517-z.
Heng, H. H. Q. (2008). The conflict between complex systems and reductionism. JAMA, 300(13), 1580–1581. https://doi.org/10.1001/jama.300.13.1580.
Kress, J., & Hall, J. (2014). Approach to the patient with critical illness. In D. Kasper, A. Fauci, S. Hauser, D. Longo, J. Jameson, & J. Loscalzo (Eds.), Harrison’s principles of internal medicine (19e ed.). New York: McGraw-Hill.
Moorman, D. W. (2007). Communication, teams, and medical mistakes. Annals of Surgery, 245(2), 173–175. https://doi.org/10.1097/01.sla.0000254060.41574.a2.
National Research Council (US) (1998) Committee on new and emerging models in biomedical and behavioral research. Biomedical models and resources: Current needs and future opportunities. Biomedical model definition. Washington, DC: National Academies Press.
Rodriquez, J. (2015). Who is on the medical team? Shifting the boundaries of belonging on the ICU. Social Science and Medicine, 144, 112–118. https://doi.org/10.1016/j.socscimed.2015.09.014.
Rose, S., & Shelton, W. (2006). The role of social work in the ICU: Reducing family distress and facilitating end-of-life decision-making. Journal of Social Work in End-of-Life and Palliative Care, 2(2), 3–23. https://doi.org/10.1300/J457v02n02_02.
Schneiderman, L. (2006). Effect of ethics consultations in the intensive care unit. Critical Care Medicine, 34(11 Suppl), S359–S363. https://doi.org/10.1097/01.CCM.0000237078.54456.33.
Sulmasy, D. P. (2002). A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist, 42(3), 24–33. https://doi.org/10.1093/geront/42.suppl_3.24.
Tarzian, A. J., ASBH Core Competencies Update Task Force 1. (2013). Health care ethics consultation: An update on core competencies and emerging standards from the American society for Bioethics and Humanities’ core competencies update task force. American Journal of Bioethics, 13(2), 3–13. https://doi.org/10.1080/15265161.2012.750388.
Wade, D. T., & Halligan, P. W. (2017). The biopsychosocial model of illness: A model whose time has come. Clinical Rehabilitation, 31(8), 995–1004. https://doi.org/10.1177/0269215517709890.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sotomayor, C.R., Gallagher, C.M. The Team Based Biopsychosocial Model: Having a Clinical Ethicist as a Facilitator and a Bridge Between Teams. HEC Forum 31, 75–83 (2019). https://doi.org/10.1007/s10730-018-9358-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10730-018-9358-3