Bridging the Healing Gap: A Call for Integrative Measures in Modern Medicine

By Namitha Alluri

In an increasingly fragmented world, the essence of medicine as a healing art is often overshadowed by technological advancements and systemic inefficiencies. The dissonance between the ideals of medical practice and its execution is poignantly captured by Byron Good’s notion of “Medicine as a moral enterprise.” Good emphasizes that medicine is not merely a technical endeavor but a profoundly ethical one, where the commitment to healing and caring for patients forms its moral backbone (15). However, this moral commitment is frequently compromised by the realities of medical practice, which are shaped by systemic constraints and a biomedical model that prioritizes technical proficiency over holistic care. This literature review explores the deep-rooted need for human doctors and the inherent healing aspects of medicine that transcend mere clinical interventions. It delves into the social, cultural, and psychological dimensions of healing, critiquing the biomedical model’s limitations and highlighting the gap between the ideals of medical practice and its execution. By examining cross-cultural perspectives, the influence of misinformation, and the importance of personalized care, this review underscores the irreplaceable value of human interaction in medicine. Incorporating Sienna Craig’s “mosaic model,” this review argues that bridging the gap between idealized healthcare goals and the practical realities of patient care can be achieved through interdisciplinary and multi-professional care teams (8). 

Understanding Healing: 

In the contemporary healthcare setting, patients often seek a quick cure for their ailments. However, underlying this desire for a cure is a deeper, often unspoken need for healing. This distinction is critical yet frequently overlooked in modern medical practice, not only by doctors, but even patients themselves. Healing extends beyond the mere treatment of symptoms; it is a process of restoring “wholeness” by addressing the totality of a person’s experience (11). This involves not only alleviating physical symptoms but also attending to emotional, social, and spiritual suffering. True healing, whether done in a recognized medical setting or not, enables patients to find meaning in their suffering, helping them to integrate their illness into their broader life narrative (27). Providing effective medical care in this manner requires the understanding of cultural context, including understanding the symbolic and metaphorical elements of healing that resonate with patients’ beliefs and experiences. Traditionally, medicine was not just about treating diseases but also about restoring balance and harmony in a person’s life (21). We especially see this desire manifest through how patients construct meaning around their illness experiences. Theorized in Arthur Kleinman’s Meaning-Centered framework, patients interpret and make sense of their symptoms and recovery process through the lens of their beliefs, hopes, and expectations of their life (18). Alongside medical concerns, patients often express emotional and psychosocial concerns, wanting consultations that encompass aspects of being listened to, having their concerns acknowledged, and feeling respected (25). Even more, patients value a holistic perspective even in recovery healing, valuing doctors that show empathy, emotional support, and create a conducive healing environment (24). 

As Byron Good, emphasizes, individuals pursuing the medical field hope to listen and care for their patients as holistically and empathetically as possible. However, their “why medicines” are set up for failure as they train through the biomedical system: they are specifically taught to inhabit a world in which the body is looked at scientifically and efficiently (15). Kleinman digs deeper into this critique, arguing that biomedicine’s emphasis on disease pathology and evidence-based interventions can overlook the holistic needs of patients, including their cultural beliefs, social contexts, and emotional well-being. He details several characteristics of biomedicine, from the “separation of the mind and body” to the orientation toward “silver bullet solutions,” emphasizing that modern medicine replaces subjective experiences with objective data. This reductionist approach can lead to a fragmented understanding of illness experiences, contributing to the gap between doctors’ intentions of providing compassionate, patient-centered care and the constraints imposed by the biomedical system (19). Even more, as new doctors enter the workforce, the pressure to adhere to protocols, prioritize technical proficiency and respect hierarchical roles shapes their professional identities and influences their priorities. Amid the burden of exceeding expectations and the relentless pursuit of exceptional competence in healthcare, the emphasis on humanistic aspects of care becomes overshadowed (16). 

Furthermore, studies that dive into factors influencing young doctors’ choice of medical specialities sheds light on this overwhelming push-and-pull feeling. Factors such as work environment, career prospects, and societal expectations significantly influence doctors’ career decisions, compared to the genuine interest and social connection desires evident in the past. This highlights how external pressures and institutional structures can take a toll on and shape doctors’ altruistic interests, further widening the gap between their intentions to provide comprehensive care and the realities of healthcare practice (26). Even so, most doctors try to pursue deep efforts to align care with patients’ preferences. A key challenge, rooted from system issues, is that of a time constraint, hindering the space to engage in meaningful discussions between patients and doctors. Thus, their “failure” lies in developing the trust and mutual understanding to create an agreeable conclusion (28). Empathetic communication is integral to the desired holistic patient-centered care in healthcare delivery and without ample time and conversation with medical professionals, patients resort to other sources of information.

Widening the Gap

Misinformation

The proliferation of misinformation, especially through digital platforms like social media and the internet, has significantly impacted the doctor-patient relationship, exacerbating the existing gap between healthcare intentions and realities (1). As the internet is quite literally a touch away, people are more often than ever utilizing it to answer their medical questions– whether that be in supplement to a physician’s advice or even without. The accessibility and rapid dissemination of information on social-media platforms like Facebook, Twitter, and YouTube contribute to the propagation of misinformation (32). Unsurprisingly, patients often encounter conflicting or inaccurate information about medical conditions, treatments, and healthcare practices, leading to confusion and uncertainty. This influx of misinformation complicates the doctor-patient dynamic, as patients may arrive at appointments with preconceived notions or unrealistic expectations based on unreliable sources (13). The prevalence of misinformation can also contribute to the spread of myths and misconceptions about healthcare, creating tension between patients’ perceptions and medical realities. This newfound skepticism and reluctance adds an element to discuss in the already limited time and condensed conversation that patients and doctors have, creating frustration in providers that are having to deflect online theories while also having to convince patients of their treatment plans. This widens not only the gap between the provider and patient, but also shifts the priorities of doctors. 

Diversity of Perspectives

As Kirmayer highlighted earlier, cultural beliefs and practices play a crucial role in shaping individuals’ healthcare-seeking behavior, reflecting a diverse array of perspectives and beliefs shaped by evolving American culture and immigration trends (21). These beliefs even include prioritizing home remedies or traditional healing methods over professional medical assistance. In these cases healthcare providers are taught to be culturally sensitive in their healthcare delivery, informative on western practices, and respectful towards these diverse cultural perspectives (33). Even if beliefs aren’t based on different medical systems, they can take root in knowledge, attitudes, and health-seeking behaviors of family caregivers of patients. Family dynamics is shown to play a significant role in influencing individuals’ decisions regarding when and where to seek healthcare and how they engage with medical professionals (7). This adds another factor in the patient-provider interaction, with doctors having to not only address cultural barriers, but also promote open dialogue to destigmatize illness and educate their patients (14). Modern medicine is in constant tension between efficiency and diverse patient needs; the intricate relationship between culture, illness, and care plays a vital role in healing yet is often broken by systemic constraints. However, as we continue to critique and emphasize the limitations in the biomedical foundations of medicine, we overlook and hinder any positive progress in our current systems; in doing so, a small, yet arguably the most important factor, the patient-provider relationship, takes the greatest hit (20). Hence, it’s not an exaggeration to assert that the essence of healing lies fundamentally in the profound social interaction—an enduring yearning intrinsic to human nature.

Healing is a Social Interaction

Healing is inherently a social process, involving interactions between patients, healthcare providers, families, and communities. This multifaceted process requires a collaborative effort to address not only the physical aspects of illness but also the emotional, social, and psychological dimensions. Effective healing is deeply rooted in the quality of the interaction between clinicians and patients (31). Empathy, trust, and open communication foster a therapeutic alliance that enhances the patient’s sense of safety and support. This relationship is not merely a backdrop but a fundamental component of the healing process, demonstrating that social interaction is a core element of effective healthcare. Moreover, the mechanisms of psychological healing are rooted in the social interactions of shared understanding, communal engagement and consistent emotional support. Based on this premise, ancient healing traditions often involve social rituals and communal activities, reinforcing the idea that social bonds and collective experiences are integral to the healing process. Thus, this finding has been encouraging medical professionals not only to meet these cultural expectations in some patients, but also to uphold this value throughout their care of all patients (4). However, technological advancements in medicine, despite their precision and efficiency, often prevent and/or replace the nuanced social interactions that are crucial for healing, leading to the recent rise in patient dissatisfaction with their care. Buta’s analysis reveals that healing is not just facilitated through accurate diagnoses and effective treatments but also supplemented with adequate relational and emotional connections between healthcare providers and patients– arguing that the latter contributes to the “magic” of medicine. These connections facilitate trust, adherence to treatment, and overall patient satisfaction, further emphasizing that the social aspect of healing is indispensable (5). These strong relationships in medicine are necessary to understand the broader social context of the patient-clinician relationship and illness at hand. Patients navigate their health within the context of their lives, understanding their illness within their biological environment, social relationships, and cultural beliefs (18). Providers must understand this complexity, addressing the interconnected factors that contribute to health and illness, going beyond the traditional biomedical model and incorporating social and cultural dimensions into their practice. These holistic findings align with the idea that healing is not merely a biomedical process but a social one that requires profound engagement between individuals (3). 

Tangible Solutions: Multi-Professional Team Approaches to Care

Recognizing the social nature of healing and the structural constraints on individual doctors underscores the need for a team-based approach to medicine. By incorporating elements from various medical professions, healthcare can better address diverse perspectives and foster larger social engagement. This integrative model ensures that different facets of patient care are addressed comprehensively and holistically. In her book, Healing Elements, author Sienne Craig makes a similar call: she advocates for an integrative model of healthcare that combines multiple medical systems, including traditional, folk, and biomedical practices. Emphasizing the importance of aligning medical care with patients’ worldviews and cultural contexts, she highlights the value of incorporating diverse medical traditions and practices into a cohesive treatment plan. For example, by intertwining traditional Tibetan medicine with biomedicine, care encompasses features of balance and harmony and diagnosis and treatment respectfully. By integrating multiple perspectives, healthcare providers can offer treatments that address both the various needs of patients, thereby promoting a more holistic form of healing (8). 

Interdisciplinary teams, though rare, are not new in medicine. Interdisciplinary teams in medicine, also referred to as multi-professional and multi-disciplinary, represent a collaborative approach involving professionals from various disciplines working together to address complex healthcare issues comprehensively. This includes, but is not limited to three or more medical specialties, psychology, social work, and therapy (30). Multi-disciplinary teams were first seen in oncology. For example, in managing unresectable hepatocellular carcinoma (HCC), the benefits of interdisciplinary teams in managing complex medical conditions are countless. Consisting of oncologists, surgeons, radiologists, palliative care specialists, mental health professionals, and life coaches, the multimodal team work together to develop comprehensive treatment plans for patients with HCC. This integrated approach ensures that patients receive optimal care across various modalities, leading to statistically better outcomes and improved quality of life (22). Another notable example is the Moms Do Care program in Massachusetts, with a similar program at Dartmouth Health, known as Moms in Recovery program. These programs focus on serving pregnant, postpartum, and parenting individuals with substance use disorders. The interdisciplinary approach here involves healthcare providers, social workers, addiction specialists, and mental health professionals working collaboratively to support these vulnerable populations. By integrating medical care, addiction treatment, mental health support, and social services, the program aims to improve not only maternal health outcomes, but also the life prospects and health of the children of the mothers (29). Furthermore, Fiore and Papuga’s case report on multimodal care for a patient with functional movement disorders following a motor vehicle accident showcases how interdisciplinary teams can address complex neurological conditions. By involving chiropractors, physical therapists, neurologists, and psychologists, the team develops a holistic treatment plan that incorporates physical rehabilitation, cognitive-behavioral therapy, and pain management strategies. Rather than making the patient venture out to find the team members, the respective professionals would arrive at the same facility, minimizing motor stress and mental stress on the patient This comprehensive approach not only improves the patient’s functional outcomes but also enhances their overall well-being (12). Finally, the field of Intellectual and Developmental Disorders are the latest in adopting an interdisciplinary evaluation. Focusing on Autism Spectrum Disorder (ASD) specifically, the assigned multidisciplinary team involves a psychiatrist, neurologist, neuropsychologist, physical therapist, occupational therapist, social worker, and an education specialist. By combining expertise in diagnosis, therapy, and educational interventions, interdisciplinary teams were shown to develop tailored treatment plans that addressed the needs of each patient. This was patient-centered and specific, aligning treatment to their goals and intentions for their unique lives (6). 

The benefits of multi-professional team approaches are exemplary. Multidisciplinary teams significantly improve patient outcomes by ensuring that care plans are comprehensive and tailored to individual patient needs. The integration of diverse expertise allows for more accurate diagnoses, better treatment plans, and enhanced patient satisfaction. Furthermore, patients benefit from the continuity of care, as team members collaborate to provide seamless support across different stages of treatment (30). Even more, patient-centered teamwork inevitably allows for more social connection by each provider and for constant contact with the patient. As each provider brings their own diagnostic protocol and works with their colleagues to create a comprehensive treatment for the patient, they inevitably engage a holistic lens that respects the patient’s cultural and personal context from nuanced perspectives. In Sweden, where person-centered teamwork is common, patient-provider relationships are reportedly more meaningful; patients also feel more empowered to actively participate in their healthcare decisions because of  “effective and compassionate care” (9). Furthermore, considering the structural constraints on the amount of time and effort a single doctor can give to a patient, interdisciplinary work allows healthcare providers to work effectively in teams to not only enhance the quality of care for patients, but reduce the burnout and turnover of providers, allowing a culture of respect and diversity (23). Plus, establishing these teams will establish clear communication, mutual respect and defined roles not only for clinicians themselves, but also within patient-clinician interactions, leading to more coordinated and agreeable care delivery and receival (10). In addition, incorporation of multiprofessional teams push for systemic changes in training healthcare providers solely in generative biomedical gazes to working on teamwork and collaboration; by creating structures that facilitate integrated care, such as shared decision-making processes and robust communication channels, we can start dismantling the zoomed-in focus that governs the foundation of modern medicine (2). Moreover, multidisciplinary teams don’t only include medical doctors; rather, they call for incorporating all areas of health professions, from anthropologists, social workers, sociologists. Specifically in the mental health field, these non- doctoral roles can provide insight on culturally sensitive interventions, dissipate stigma within the patients’ networks, and promote positive and quality care outcomes. Together, these professionals can address the full spectrum of patients’ needs, expand treatment plans, offer a wide range of perspectives, broaden their colleagues’ perspectives, while also alleviating their individual workloads. (17). 

Conclusion: 

Modern medicine stands at a crossroads, where the immense potential to heal and the stark realities of systemic limitations often clash. Doctors, driven by altruism and a profound commitment to alleviating suffering, find themselves constrained by a biomedical model that prioritizes technical proficiency over the human elements of care. With an eroding patient-provider relationship, both parties fail to understand each other and recognize what is “most at stake” during illness and suffering (18). Bridging this gap demands a radical reimagining of healthcare—one that prioritizes integrative measures and multi-professional collaboration. The multi-professional team approach offers a beacon of hope, bringing together diverse healthcare professionals to address the full spectrum of patient needs. This model fosters a culture of respect and collaboration, ensuring that medical care is not only comprehensive but also culturally sensitive and deeply personal. The findings from interdisciplinary research underscore the transformative potential of such teams, highlighting improved patient outcomes, enhanced satisfaction, and a holistic understanding of health– the true essence of healing. As healthcare providers, patients, and communities, we must champion a system that is devoted to the intrinsic social nature of humans with each other and the world around them. By integrating diverse medical perspectives and fostering collaborative care, we can bridge the gap between the ideals and realities of modern medicine. This is not just a structural shift; it is a moral imperative that ensures that medicine remains true to its most profound calling: to heal, to alleviate suffering, and to honor the intricate tapestry of human life. 

References

1. Adams, Z., Osman, M., Bechlivanidis, C., & Meder, B. (2023). (Why) Is Misinformation a Problem? Perspectives on Psychological Science, 18(6), 1436-1463. https://doi.org/10.1177/17456916221141344
2. Adler S. R. (2002). Integrative medicine and culture: toward an anthropology of CAM. Medical anthropology quarterly, 16(4), 412–414. https://doi.org/10.1525/maq.2002.16.4.412
3. Anja Krumeich, Wies Weijts, Priscilla Reddy, Anne Meijer-Weitz, The benefits of anthropological approaches for health promotion research and practice, Health Education Research, Volume 16, Issue 2, April 2001, Pages 121–130, https://doi.org/10.1093/her/16.2.121
4. Brandon A. Kohrt, Katherine Ottman, Catherine Panter-Brick. et al. Why we heal: The evolution of psychological healing and implications for global mental health. Clinical Psychology Review. 82 (2020), 101920, 0272-7358, https://doi.org/10.1016/j.cpr.2020.101920.
5. Buta M. G. (2023). Can computers replace medical thinking?. Medicine and pharmacy reports, 96(1), 111–116. https://doi.org/10.15386/mpr-2523
6. Campbell, J. M., Ogletree, B., Rose, A., & Price, J. (2020). Interdisciplinary evaluation of Autism Spectrum Disorder. In M. B. McClain, J. D. Shahidullah, & K. R. Mezher (Eds.), Interprofessional care coordination for pediatric Autism Spectrum Disorder: Translating research into practice (pp. 47–63). Springer Nature Switzerland AG.
7. Chrisman, N.J. The health seeking process: An approach to the natural history of illness. Cult Med Psych 1, 351–377 (1977). https://doi.org/10.1007/BF00116243
8. Craig, S. (2012). Healing elements: Efficacy and the Social Ecologies of Tibetan medicine (pp. 112-144). University of California Press.
9. Dellenborg, L. (2020). A Living Intervention : Anthropology and the Search for Person-centred Teamwork in a Hospital Ward in Sweden. <i>Kritisk Etnografi</i>, <i>3</i>(2), 105–122. https://doi.org/10.33063/diva-432453
10. Dinh, J. V., Traylor, A. M., Kilcullen, M. P., Perez, J. A., Schweissing, E. J., Venkatesh, A., & Salas, E. (2020). Cross-Disciplinary Care: A Systematic Review on Teamwork Processes in Health Care. Small Group Research, 51(1), 125-166. https://doi.org/10.1177/1046496419872002
11. Egnew T. R. (2005). The meaning of healing: transcending suffering. Annals of family medicine, 3(3), 255–262. https://doi.org/10.1370/afm.313
12. Fiore A, Papuga O, Multimodal Care of a Patient With Functional Movement Disorders Following a Motor Vehicle Accident: A Case Report. Journal of Chiropractic Medicine. 22, 3(2023), 239-245, 1556-3707, https://doi.org/10.1016/j.jcm.2023.03.010.
13. Fridman, I., Johnson, S., & Elston Lafata, J. (2023). Health Information and Misinformation: A Framework to Guide Research and Practice. JMIR medical education, 9, e38687. https://doi.org/10.2196/3868
14. Gabra, R.H., Ebrahim, O.S., Osman, D.M.M. et al. Knowledge, attitude and health-seeking behavior among family caregivers of mentally ill patients at Assiut University Hospitals: a cross-sectional study. Middle East Curr Psychiatry 27, 10 (2020). https://doi.org/10.1186/s43045-020-0015-6
15. Good, B. J. (1994). Medicine, rationality, and experience: An anthropological perspective (pp. 65-87). Cambridge University Press.
16. Haruta, J., Ozone, S., & Hamano, J. (2020). Doctors’ professional identity and socialisation from medical students to staff doctors in Japan: narrative analysis in qualitative research from a family physician perspective. BMJ open, 10(7), e035300. https://doi.org/10.1136/bmjopen-2019-035300
17. Kaiser, B. N., & Kohrt, B. A. (2019). Why Psychiatry Needs the Anthropologist: A Reflection on 80 Years of Culture in Mental Health. Psychiatry, 82(3), 205–215. https://doi.org/10.1080/00332747.2019.1653142
18. Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. (3-30). University of California Press.
19. Kleinman, A. (1995). Writing at the margin: Discourse between anthropology and medicine. (pp. 21-40). University of California Press.
20. Kleinman, A., Eisenberg , L., & Good, B. (1978b). Culture, illness, and care: Clinical lessons from Anthropologic and cross-cultural research. 2 (1978) https://pubmed.ncbi.nlm.nih.gov/626456/ 
21. Kirmayer L. J. (2013). The cultural diversity of healing: meaning, metaphor,and mechanism. Heart views : the official journal of the Gulf Heart Association, 14(1), 39–40. https://doi.org/10.4103/1995-705x.107123
22. Lang D, Agarwal R, Brown S, Borgmann A, Lockney N, Goff L, Heumann, T. Multidisciplinary Care and Multimodal Treatment Approaches for Unresectable Hepatocellular Carcinoma. Advances in Oncology. 4 1(2024), 247-262, 2666-853X, https://doi.org/10.1016/j.yao.2024.02.002.
23. Lennox-Chhugani N. (2023). Inter-Disciplinary Work in the Context of Integrated Care – a Theoretical and Methodological Framework. International journal of integrated care, 23(2), 29. https://doi.org/10.5334/ijic.7544
24. MacAllister, L., Bellanti, D., & Sakallaris, B. R. (2016). Exploring Inpatients’ Experiences of Healing and Healing Spaces: A Mixed Methods Study. Journal of patient experience, 3(4), 119–130. https://doi.org/10.1177/2374373516676182
25. McKinley, R. K., & Middleton, J. F. (1999). What do patients want from doctors? Content analysis of written patient agendas for the consultation. The British journal of general practice : the journal of the Royal College of General Practitioners, 49(447), 796–800.
26. Michalik, B., Kulbat, M., & Domagała, A. (2024). Factors affecting young doctors’ choice of medical specialty-A qualitative study. PloS one, 19(2), e0297927. https://doi.org/10.1371/journal.pone.0297927
27. Saint Arnault D. (2009). Cultural determinants of help seeking: a model for research and practice. Research and theory for nursing practice, 23(4), 259–278. https://doi.org/10.1891/1541-6577.23.4.259
28. Spinnewijn, L., Aarts, J., Verschuur, S., Braat, D., Gerrits, T., & Scheele, F. (2020). Knowing what the patient wants: a hospital ethnography studying physician culture in shared decision making in the Netherlands. BMJ open, 10(3), e032921. https://doi.org/10.1136/bmjopen-2019-032921
29. Sternberger L, Sorensen-Alawad A, Prescott T, Sakai H, Brown K, Finkelstein N, Salomon A, Schiff DM. Lessons Learned Serving Pregnant, Postpartum, and Parenting People with Substance Use Disorders in Massachusetts: The Moms Do Care Program. Matern Child Health J. 2023 Dec;27(Suppl 1):67-74. doi: 10.1007/s10995-023-03775-5. Epub 2023 Oct 4. PMID: 37792152; PMCID: PMC10692242.
30. Taberna, M., Gil Moncayo, F., Jané-Salas, E., Antonio, M., Arribas, L., Vilajosana, E., Peralvez Torres, E., & Mesía, R. (2020). The Multidisciplinary Team (MDT) Approach and Quality of Care. Frontiers in oncology, 10, 85. https://doi.org/10.3389/fonc.2020.00085
31. Wampold B. E. (2021). Healing in a Social Context: The Importance of Clinician and Patient Relationship. Frontiers in pain research (Lausanne, Switzerland), 2, 684768. https://doi.org/10.3389/fpain.2021.684768
32. Yeung, A. W. K., Tosevska, A., Klager, E., Eibensteiner, F., Tsagkaris, C., Parvanov, E. D., Nawaz, F. A., Völkl-Kernstock, S., Schaden, E., Kletecka-Pulker, M., Willschke, H., & Atanasov, A. G. (2022). Medical and Health-Related Misinformation on Social Media: Bibliometric Study of the Scientific Literature. Journal of medical Internet research, 24(1), e28152. https://doi.org/10.2196/28152
33. Zhang, Q., Feng, S., Wong, I.O.L. et al. A population-based study on healthcare-seeking behaviour of persons with symptoms of respiratory and gastrointestinal-related infections in Hong Kong. BMC Public Health 20, 402 (2020). https://doi.org/10.1186/s12889-020-08555-2

Image Credit: https://www.researchgate.net/figure/Interprofessional-Collaborative-Practice-Model-The-Four-Seasons-Interprofessional_fig1_342789808