Teaching Whole Person Care in Medical School

Abstract

In an ideal world, whole person care would involve the care for a whole person – physical, psychological, and spiritual needs – by another whole person. This would be a wonderful way to care for each other, but we would probably all come up short. Two limitations become immediately apparent. First, the patients’ needs may exceed the skill set of the physician in one or more domains. An individual patient may require, for example, a surgeon and a psychiatrist, as well as a spiritual advisor. Second, it is possible that the profile of needs of a particular patient may be better matched with the unique interests and experiences of one physician over another, even if both have had the same basic skills training. Another consideration is that whole person care is so personal and individual that a “one size fits all” approach to diagnosis and treatment cannot work. In patients with similar medical conditions, we need to consider the context for each individual and what the illness means to them, their families, and their communities at that particular point in time. However, while individual physicians cannot be expected to care for all domains of the patient’s well-being at all times, they must at least be aware that beyond the most apparent issue of the presenting concerns, there are domains that may either increase the patients’ suffering or open a path for the facilitation of healing. The physician must be sufficiently attuned to the patient to find an opening to the latter possibility. In his mentoring and teaching, a founder of palliative care medicine, Dr. Balfour Mount tells the story of a patient he had, a young woman in palliative care, where he spent time learning more about her and found that despite their obvious differences, they shared a love of the music of the Elvis Presley, which turned out to be his “way in” to facilitate her healing through their stronger connection.