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Whole-Person Approach to Management

The patient-centred consultation not only takes into account the diagnosed disease and its management but adds another dimension—the psychosocial hallmarks of the patient (Table W2).

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Table W2 Whole-person diagnosis and management

Disease-centred diagnosis

Patient-centred diagnosis

Aetiology of disease

  • Significance of illness to patient

  • Effect on family and relationships

  • Effect on work and income

  • Psychological effects

    • stress and anxiety

    • abnormal illness/behaviour

    • sleep

    • depression

  • Effect on sexuality

  • Effect on attitudes and spirituality

Disease-centred management

Patient-centred management

  • Rest

  • Drugs

  • Intervention

  • Surgery

  • Other invasive techniques

  • Psychological support

  • Appropriate reassurance

  • Patient education

  • Empowering self-responsibility

  • Anticipatory guidance/special hazards

  • Prevention

  • Health promotion

  • Lifestyle recommendations/modifications

    • diet/nutrition

    • exercise

    • alcohol

    • smoking

    • stress management

  • Family and social supports

  • Self-help groups

  • Alternative options

  • Consultation and referral

  • Follow-up

  • Consideration of meditation

Whole-person diagnosis is based on two components:

  1. the disease-centred diagnosis

  2. the patient-centred diagnosis

The management of the whole person, or the holistic approach, is fundamental to good general practice. The general practitioner has an obligation to his or her patients to use natural healing methods wherever possible and be very discerning and conservative with investigatory medicine and drug prescribing.

Patients appreciate natural remedies and taking responsibility for their own management wherever possible and appropriate. Examples include relative rest, exercise, swimming, stress management, meditation, spiritual awareness, antioxidant therapy (e.g. vitamin C, vitamin E, selenium), weight control, optimal healthy nutrition, avoidance of toxins (e.g. illicit drugs, nicotine, caffeine and alcohol) and sexual fulfilment.

Underlying a successful outcome is motivation, and the healing factor of the physician in being the motivator, teacher and facilitator should never be underestimated.

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