|The Integrated Health Pyramid|
Copyright Sinclair Health Limited 2011
Back in Medical School in 1998 I had a strange dream one night and woke up with this image of a blue equilateral pyramid in my mind. I wrote it down and discussed it with my friend now a GP Dr Michael Bazlinton.
I nicknamed this diagram the Integrated Health Pyramid and it underpins my practise. Back then I often talked to colleagues about what used to be called holistic medicine - treating the person and the physical problem, not just seeking disease but aiming to balance all areas of life to create positive wellbeing which in turn underpins good health. I had a vision of a multidisciplinary clinic with all the services required for integrated health under one roof revolving around a primary care base.
My dream clinic would comprise of General Practise, visiting medical specialties, Osteopathy and Acupuncture for physical conditions, with internal referrals to Mental Health in the form of Psychological assessments and therapies alongside robust self help resources, linked to spiritual support from local faith based organisations. These might supply counselling and guidance. Social problems would be referred to community groups such as gyms and local activity, interest groups and befriending agencies - these would complete the loop and reduce the risk of loneliness.
Over the years I refined my integrated way of looking at health through using the Integrated Health Pyramid; it helps clinicians and patients to look at the whole picture and search for common health imbalances in these 4 areas which need to be maintained in equilibrium for overall wellbeing. If one area becomes burdened the other areas are affected as each is linked to the other three. Solutions can be sought in these areas in a holistic fashion also so the pyramid acts as an aid memoir for planning the best health outcomes.
The patient journey is such an important concept as I find increasingly that many patients in my NHS practise are distressed by the uncertainty of waiting for tests and a diagnosis, however a supportive approach from a clinical team caring for the whole family in context can make this process more bearable; excellent communication skills and clear information giving underpin the relationship of patient to clinician and thus with good patient liaison staff we could minimise the unknown. This all requires time, a commodity which is increasingly squeezed in the NHS and is giving rise to the worried well - a growing group of well educated patients with simple niggles requiring explanation and reassurance, who are not satisfied by a quick "I'm sure its fine" answer, instead requiring explanations at the appropriate educational level. Easy access to a knowledgeable clinician with time and supportive frontline staff would all help to minimise the worry and smooth the patient journey, limiting time with specialists and maintaining a positive doctor-patient relationship.
My Integrated Health Pyramid paradigm builds on the bio-psycho-social model of medicine by adding in the spiritual dimension and completing a multidimensional integrated view of health.