Modern medicine is dominated by a scientific method that focuses on the biological mechanisms of disease, and on developing medical technology to control them. It has achieved great things, but at a cost that is becoming unaffordable. And at the expense of a deeper understanding of human nature and the complex personal dimension of illness and disease – their origins and their significance in the whole experience of our lives. At the expense, too, of a deeper understanding of how to promote health and healing, taking full account of this personal dimension and encouraging more effectively the self-regulation and self-healing that we know is possible. These concerns are widespread within the healthcare professions and amongst patients alike.
If we are to remodel medicine, as we must, it will require a minor revolution, or at least a metamorphosis. For most health professionals it should be the sort of revolution that consists of throwing off their chains. What is now a biomedical straight jacket will become a less restrictive and more comfortable garment; though still as useful, if not more so. Remodelling is necessary above all to restore what has been called ‘the soul of medicine’, its healing vocation. But it is essential, too, if medicine is to provide a health-care service that that is more effective and at less cost.
Remodelling Medicine celebrates the biomedical approach and the benefits that it has brought us, but accords it a more modest place in our understanding and management of human suffering, illness, disease and healing; in which biological events and imperatives are better understood in terms of their biographical significance and meaning, and our concern with the disordered parts is a consequence of our ‘worth-ship’ of the whole. Dr Swayne provides a persuasive argument that change is necessary, that there has been a long-standing belief amongst many engaged in or concerned with medicine that this is so, and that the momentum for change is growing; and offers pointers to the direction that change should take.