Biomedical models and healthcare systems: Tangible pathology has great validity

doi:10.1136/bmj.330.7488.419-b

BMJ 2005;330:419-420 (19 February), doi:10.1136/bmj.330.7488.419-b

Letter

Biomedical models and healthcare systems

Tangible pathology has great validity

The first 150 words of the full text of this article appear below.

EDITOR—Like Wade and Halligan,¹ I think that current medicalthinking about illness has serious limitations, which leadsto problems for doctors and patients and helps administratorswith diagnosis and certification.^2
3 The traditional medicalmodel is based on a direct link between lesion and symptom.Medical teaching rightly emphasises the processes linking symptomswith lesions.

Four groups of patients are discernible on the basis of suchideas.

The first comprises those whose symptoms are due to disease.This is home territory for doctors and reasonably well dealtwith by current medical knowledge.

The second includes patients who have disease but no symptoms.This is the territory covered by screening, and, although ofdebatable worth, medicine has developed strategies for makingprogress in this area such as the Wilson-Junger screening criteria.

The third group consists of people who have no symptoms andno disease. These people are healthy as far . . . [Full text of this article]

Peter Davies, general practitioner

Shelf Surgery, Halifax HX3 7PQ npgdavies@blueyonder.co.uk

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