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Cited by 1,546Medicine, History, and PhilosophyEmpathy and Medical EducationPatient-Provider Communication in Healthcare

The DOI matches its Crossref record; 64 of the 65 references it cites were found in a registry or an index.

The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry

Open access
Borrell-Carrio, F.·2004·The Annals of Family Medicine
DOI 10.1370/afm.245PMC PMC1466742
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Abstract

The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. At the practical level, it is a way of understanding the patient's subjective experience as an essential contributor to accurate diagnosis, health outcomes, and humane care. In this article, we defend the biopsychosocial model as a necessary contribution to the scientific clinical method, while suggesting 3 clarifications: (1) the relationship between mental and physical aspects of health is complex--subjective experience depends on but is not reducible to laws of physiology; (2) models of circular causality must be tempered by linear approximations when considering treatment options; and (3) promoting a more participatory clinician-patient relationship is in keeping with current Western cultural tendencies, but may not be universally accepted. We propose a biopsychosocial-oriented clinical practice whose pillars include (1) self-awareness; (2) active cultivation of trust; (3) an emotional style characterized by empathic curiosity; (4) self-calibration as a way to reduce bias; (5) educating the emotions to assist with diagnosis and forming therapeutic relationships; (6) using informed intuition; and (7) communicating clinical evidence to foster dialogue, not just the mechanical application of protocol. In conclusion, the value of the biopsychosocial model has not been in the discovery of new scientific laws, as the term "new paradigm" would suggest, but rather in guiding parsimonious application of medical knowledge to the needs of each patient.

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1 of the 65 references couldn’t be matched to a known paper.

Research works printed but not linked: 8

  1. Simon FB, Stierlin H, Wynne LC. Circularity/recursiveness/circular causality. The language of family therapy. In: A Systemic Vocabulary and Sourcebook. New York, NY: Family Process Press; 1985:37-39.
  2. Stewart M. Towards a global defi nition of patient centered care. BMJ. 2001; 322:444-445.
  3. Frank AW. The Wounded Storyteller. Chicago, Ill: The University of Chicago Press; 1995.
  4. Torío J, García MC. The clinical interview and the patient-physician relationship: opinions and preferences of consumers. Aten Primaria. 1997;19:44-60.
  5. Torío J, García MC. The clinical interview and the patient-physician relationship: opinions and preferences of consumers. Aten Primaria. 1997;19:63-74.
  6. Torio J, García MC. Evaluation of patient-orientation in primary care practice. Aten Primaria. 1997;20:45-55.
  7. Broggi MA. The relationship of solidarity in the clinic. A Mediterranean alternative. Homage to Lain Entralgo. JANO. 2000;1329:103-104.
  8. Haynes RB. BMC Health Services Research 2002. Available at http:// www.biomedcentral.com/1472-6963/2/3.

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Metadata

Authors
Borrell-Carrio, F.
Venue
The Annals of Family Medicine
Publisher
Annals of Family Medicine
Published
2004-11-01
Volume
2
Issue
6
Pages
576-582
ISSN
  • 1544-1709 (ISSN-L)
  • 1544-1717
DOI
10.1370/afm.245
PMC
PMC1466742
OpenAlex
W2138876001
Cited by
1,546
References
65
Citations by year
2026: 108 · 2025: 105 · 2024: 98 · 2023: 100 · 2022: 116 · 2021: 126 · 2020: 146 · 2019: 113 · 2018: 80 · 2017: 66 · 2016: 62 · 2015: 67 · 2014: 63 · 2013: 46 · 2012: 50
FWCI
10.44
Type
journal article
Language
en
Open access
Locations
  • The Annals of Family Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • Revista Chilena de Medicina Familiar (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
biopsychosocial model, mind-body problem, circular causality, clinician-patient relationship, empathy, self-awareness, clinician bias, intuition, patient education, therapeutic relationship, clinical decision-making, new paradigm
MeSH terms
Delivery of Health Care, Humans, Models, Psychological, Hospital-Patient Relations, Observer Variation, Evidence-Based Medicine

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