The epistemological and irrefutable change of the paradigm in Medicine and medical science and the new interactionist and teleonomic concept of health, changed the scenario of medical education, clinical practice and health governance. In our University formally from 1998, but not formally before, we introduced rigorous quality procedures for educating physicians and clinical teachers to Person Centered medicine which changes clinical method integrating the old one, which is, in a wrong way, problem centered on only biological variables: to date a great epistemological error. We launched also a PCM International Academy, and a program for spreading our procedures which resulted reliable and valid and for preparing PhD and clinical teachers.
At the same time researchers in medical education, are in trouble because they are linked to obsolete clinical assessment methods If they are not physicians make a great difficulty to understand new methodological languages. To date Medicine is risking developing its teaching and practice methods on obsolete physiological concepts, thanks to a spread epistemological ignorance of basic science teachers - eg they don't know the Allostasis revolution in physiology which is not known by almost all physicians and clinical teachers or the Relativity theory of biological reaction, fundament of PCM- confirming to date a wrong deterministic and mechanic approach to medical science and human nature that make far humans by their true nature, reinforcing a wrong and amoral dominant only bio-technological paradigm-well seen by the stock market- and the imperialist ingenuous empirical, superficial, pseudo epistemological approach called "evidence based medicine".
Like is happened in physics at beginning of the last century, with the birth of quantum physics, our experience depicts the necessity of a power operation, because physicians, who could receive from the adoption of Person centered clinical method, great benefits, as we showed, In difficult way accept innovations and the drug stock market has no interest to promote a change, which gives to persons more autonomy and less necessity of medicines. But the transition to Person centered Medicine is an obliged way if we want build medicine on the truth and not on pragmatic or amatorial trials of beginners in Person centered Medicine, or , its new plagiaristic superficial surrogates like " Personalized medicine", or " Skil person medicine" and on folk and ignorant people who want reduce Person Centered Medicine to a “non Conventional medicine”, like acupuncture, with approaches plagiarized from Internet !
We need people, for orienting to PCM Health Governance" and Medical Education, research and teaching PCM all over the world-,to date pioneers yet- humble for learning, brave for research, with a psycho-affective maturity and linked to the Hippocratic oath, for teaching basic sciences , clinics and research oriented to this epochal change of the human nature epistemology and to intoduce in their work and life the new concepts of Person Centered Medicine and Health not pseudo-health merchants and/or promoters of pseudo-truth adaptative conceptions of human nature , sold to the best power which has money and roles, surrogates of humanity.
Is it ignorance,"ignavia" or will of evil ?
Essential References
Brera G:R The Manifesto of Person Centered Medicine Medicine, Mind and Adolescence. 1999.XIV,1-2 :7-11 on line www.unambro.it
Brera G.R. Brera G.R. La medicina centrata sulla persona e la formazione dei medici nel terzo millennio. Con l’introduzione di Iosef Seifert : I sette scopi della medicina
"Person Centered Medicine and Medical Education in third Millennium with the introduction of Iosef Seifert . The seven aims of Medicine it.) Pisa:IEPI-Università Ambrosiana; 2001
Brera G.R. Epistemology and medical science: change of the paradigm. in G.R. Brera-Claudio Violato Ed . Proceedings from the Conference:”Return to Hippocrates: Quality and Quantity in Medical Education:Milano : Università Ambrosiana : 2005
Brera.G.R. Person Centered Medicine:theory, teaching research. International Journal of Person Centered. Medicine. ;1:69-79
History of Person Centered Medicine http://www.unambro.it/html/pdf/PCM_History.pdf
Brera GR Perspectives of Person Centered Medicine teaching in Italy -“Person Centered Medicine and Medical Education.” May 4 2011 (invited presentation in WHO)
I fully believe that medicine should be person centered. You have no idea the amount of patients whose conditions are out-of-the-guidelines. Most scientific institutions are american, so they based their guidelines on an american population and that really differs form, let's say, latin population. Person centered medicine allow physicians to give their patients a more effective care. I am not saying that evidence-based medicine is a bad thing, but we could always try to get the best for our patients and sometimes, the evidence-based treatments are not the best.
Answer to Dr. Mergen's letter
Limits of the Engesl's bio-psychosocial model
The Hengel's bio-psychosocial model is an interactionist model, based on an adaptative conception od health as " The organism ability to adapt or dominate a stress finalized to mantain a balance" (1) inspired to the system theory. It differs from Person Centered Medicine because it is deterministic . it is oriented to Cannon's overcame physiology paradigm :" Stability to constancy" ., but human beings are not adaptative "systems","organisms" but they are persons builders of a true or false reality about the inner and the outer world, giving to experience a meaning to which they are naturally called. It means that any knowledge, feeling or act have a meaning independently from the subject's awareness. Persons change their adaptation models. depending on the meaning interpretation quality and this is linked the biological variables behavior through neuromediators nad hormones whiche sends signals for the genes expressions, The right concept is the "Stability to change". (Peter Sterling, Allostasis paradigm that you show to don't know as many. teachers of basic science teachers or physicians. The quest for a meaning means that our life is trascendent and that there is a natural teleonomy, that Kairology assessed toward truth,love and beauty. The quality of the existential choices, also to be a physician, determine the being's quality and the person's existence and profession, acting as a risk or protective factor for physician and patient's health. Existence and science are related,
This fact allows to give a meaning to disease and suffering not only in reserching the true causes of a clinical picture, but as an existential event that can open to existence unforeseeable possibilities.
This interpretation allows to physicians and patients to become protagonists of an event, their meeting, that can not be reduced to a bio-psychosocial system but is more higher than their same existence., which calls for a sense and is meaningful. The interpretation quality of the event allows to both to become "Human beings", real persons or surrogates that adapt themseleves only to abstract theories, shared habits, or biotech protocols or suggestions.
Person Centered Medicine is interactionist and teleonomic, and put at first place spirituality, (the quest for a meaning) not as an option but as a necessity for a right interpretation of person's quality of life, determinant for health.
It means tge necessity to ask to ourselves: who is this person, how this person interprets his event ? It corresponds to the same question that a physician must pose to himself, in order to avoid to become only a bio-technician of life or death. To date a spread fashion.
Physicians must be trained to this interpretation work and to live their profession as an existential mission, an answer given to the fundamental question of existence. This intention works for their fulfillement and health,
Please read with more attention the Manifesto of Person Centered Medicine.
Prof. Giuseppe R.Brera
Published on Research Gate
Milan, 20 January 2014
International Program in PCM
http://www.unambro.it/html/smistamentoISPCM.html
(1) J.Romano in J.Am.Med Ass. ,143 1950 This definition has been adopted by Hengel
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