Updating Flexner

An Expanded Approach to Health and Healing
  • Elliott S. Dacher


Although there is general agreement that our current approach to health and healing is undergoing substantial change, there has been a lack of critical discussion regarding the extent, character, and direction of change. It is important for us to articulate the values that we would like expressed in a reconfigured approach to health and healing, and to ensure that our efforts to initiate change are aligned with these values. An over view of western history suggests that the post-modern world view is characterized by four essential values: multidimensional realism, intentionality, holism, and personal authenticity. A healing model, the Whole Healing model, and two clinical programs which express these values are presented.

In 1910 Abraham Flexner in his seminal report to The Carnegie Foundation For The Advancement of Teaching offered a series of recommendations that fundamentally altered the course of medical education in the United States. Based on the teaching model at the Johns Hopkins Medical School, he recommended that medical education be directly linked to university based clinical and laboratory sciences. This suggestion became the foundation of our current training programs. But in the same report Flexner also warned us that training in these sciences would in itself be insufficient. The practitioner, he stated, requires further skills, “. a different apperceptive and appreciative apparatus to deal with other more subtle elements One must rely for the requisite insight and sympathy on a varied and enlarging cultural experience.” Neither in science nor in the affairs of men and woman is our culture similar to that of 1910.

Confronted with the complexities of lifestyle and stress-related degenerative diseases, addictive disorders, anxiety, depression and their physical counterparts, dissatisfaction with the over use of pharmacological and interventionist therapies, a rising antipathy with professional arrogance and authority, the rise of self-care initiatives, feminism, holistic and ecological perspectives, along with a growing demand for high level health and wellness conventional medicine has finally reached its limitations. There is now a broad based consensus that change is necessary and desirable. Much like in Flexner’s times, our enlarging cultural experience is forcing us to reconsider our century old approach to the critical issues of health and healing.

In the United States individual states are increasingly providing licensure to new categories of health practitioners, medical schools are offering programs on holistic healing, the Office of Alternative Medicine is funding research on complementary therapies, insurance carriers are beginning to offer reimbursement for these therapies, the Internet is overflowing with information and informal dialogues, and the state of Washington has passed legislation mandating that “Every health plan after January 1, 1996 shall permit every category of provider (chiropractors, acupuncturists, naturopaths, etc.) to provide health services or care for conditions included in the basic health care services (offered by the health plan)...”

But the current pace of change has allowed both practitioners and the general public little opportunity for reflection and evaluation. As a result there has been a lack of significant discourse in regard to the extent and the direction of change. Motivated by very real concerns yet conditioned by old patterns of thought, fired up with enthusiasm and hope yet compelled by complex professional and financial interests, and carried along by a seemingly unstoppable momentum, we simply assume that our current initiatives are taking us in a beneficial and innovative direction. As a result, we have failed to ask the critical questions whose answers can either reassure us about our current efforts, or cause us to reconsider them. Consider these two simple but basic questions:
  • What perspectives do we wish to see expressed in a reconfigured approach to health and healing?

  • Do our current initiatives reflect and support the development of these perspectives?


World View Personal Autonomy Healing Model Spiritual Healing Intuitive Knowledge 
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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Elliott S. Dacher
    • 1
  1. 1.The Institute of Noetic SciencesGay HeadUSA

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