What is Person Centered Medicine: Conceptual Review with Focus on George Engel’s Perspectives

Abstract

Background: “Person centered medicine” has recently emerged as a new alternative to “patient centered medicine” with the aim of representing a different focus for clinical practice. However, it is still necessary to clarify its conceptual bases and its identifying features. Objectives : To review the conceptual bases of Person Centered Medicine and highlight its main features. Methods: A non systematic review of the literature on the person and patient centered medicine field and particularly the works that George Engel published in 1977 and 1980 in which this author proposed the biopsychosocial (BPS) model as an alternative to the biomedical one. Results: The a nalysis led to identify one element, a “life dimension” that differs from the biopsychosociocultural determinants that are typical of the BPS and that until now has not been well understood.  The “life dimension” takes shape in the interpretation that the person makes of a series of concrete experiences and their consequences, “problems of living”, that are liable to be considered “medical problems”. This is what leads the person to adopt the condition of being a patient (patienthood). Consequently, any medical problem is above all a problem of living or, in other words, a manifestation of a “life or existential dimension” that is inherent to the person (personhood). This perspective requires the physician to consider this dimension along with the model's other components in any clinical interaction, and it is the basis for the use of a hermeneutic or interpretative methodology that has communication and dialogue as its main tools. Conclusions: The term “person centered medicine” reflects the clinical focus that takes into account the “life dimension” of the person. Further research is needed to elucidate the meaning of this dimension as a basis to clarify both the concept of this clinical approach and its main practical elements.