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medical model

medical model An imprecise and widely used term. The characteristics of the medical model are rarely specified. The term sometimes refers to the framework of assumptions underpinning the relationship between doctor and patient. Erving Goffman, in Asylums (1961), viewed the medical model as a particular version of a more general ‘tinkering services’ model that assumes a technically expert server and an individual client with an object in need of repair. In medicine the object is the body, and Goffman explored the special characteristics of this ‘medical servicing’ relationship.

More commonly, the term medical model refers to medicine's ideas and assumptions about the nature of illness, notably its natural scientific framework and its focus on physical causes and physical treatments. As such the term is frequently invoked in the context of ideological and political debates and inter-professional rivalries in which the relevance of this particular set of ideas is called into question. One problem with the term is that it suggests a uniformity of medical ideas about causation and treatment that does not fit the empirical diversity very well, since doctors do not focus exclusively on physical factors, even in relation to physical illness. For this reason some prefer the term ‘bio-medical model’, since it clearly indicates the focus on the biological, and allows that there are other medical models. An alternative model of health and illness, employed by some doctors but especially favoured in nursing circles for its greater breadth, is a ‘bio-psycho-social model’ encompassing the biological, psychological, and social aspects. However, attempts to integrate these three terrains present considerable problems, and the term is arguably more rhetoric than reality.

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