A HOLISTIC approach implies providing all-round support and care to a patient. That support is not just for their specific physical injuries or specific system-related diseases but also, for example, their mental health needs.
This patient support should consider their whole physical, emotional, social and spiritual wellbeing. Full family counselling and family involvement should be part of any holistic care.
Given an array of subspecialties, doctors are now becoming more specific in handling organ or system-specific disorders or injuries.
One must therefore ask whether doctors are offering holistic care and full-family counselling. And whether a patient really benefits when they are treated for specific conditions without examining the patient as a whole.
A personal experience involving my family member made me reflect on the way the medical profession handles patients.
This family member of mine was admitted to the hospital after a road accident. With multiple fractures and intra-abdominal injuries, he was promptly referred to the relevant specialists who addressed only their specialty-specific injuries. Pain management, a critical issue in this case, was not well addressed.
There was even confusion about which primary department was responsible for the patient.
It is important to interpret the situation from a patient's perspective. On the matter of patient wellbeing, one cannot assume anything. Enquiring, listening and confirming the diagnosis are key skills. Teamwork by different specialists involved in the care of the patient is vital for holistic care.
Most of us are too involved in our own specialty without considering much the other aspects of patient care. This is more unintentional. With respect to present medical education and behavioural intention, clinical teachers and students are affected by their own subjective norms and perceived behavioural control.
The teaching of holistic healthcare should be introduced early in medical education. Many studies done in this field recommend that when designing the curriculum for medical education during undergraduate years, a holistic approach and teamwork should be included in the curriculum.
During teaching sessions, medical schools should include holistic care, highlighting the importance of team approach and communication skills.
Medical schools can simulate an integrated acute trauma-ward scenario where multiple specialty teams work together to treat the patient holistically. Another example of integrated and holistic treatment of chronic disease would be a one-stop centre for diabetes with secondary organ complications.
The medical profession should also consider making policies and promoting the platform of holistic healthcare and teamwork in medical education. This will ultimately improve patient healthcare.
The holistic approach can also be included in allied-health fields like nursing and public health where both medical practitioners and community nurses can get involved. Such involvement can move beyond individual patient care, especially when referred, to a focus on the whole community. This forms a basis for collaboration and will result in a healthy community and better health for the whole nation.
Examples of approaches to holistic care when treating patients, which the medical profession should set an example and educate our medical students early, include the following:
1. Be sympathetic and stress the importance of the social smile.
2. Ask how the patients feel and understand their needs.
3. Reassure and treat them with respect and dignity.
4. Involve the patients and their family members in decision-making.
5. Make them feel free to get a second opinion and encourage teamwork among doctors.
6. Treat patients wholly and not just not specific symptoms or organs.
A curriculum that inculcates holistic treatment and teamwork in administering healthcare will produce well-rounded medical graduates and tomorrow's leaders in the medical profession.
The writer is consultant anaesthesiologist at the Faculty of Medicine, AIMST University
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times
