Healing Curing and the Goals of the Medical Home

Medicine in general and primary care in particular involve constant tension between diagnosis and elimination of the disease (cure) on one hand and alleviation of suffering in the context of disease and treatment (healing) on the other. In this context, healing means helping patients cope

©2011 Elsevier Ltd, Inc, BV

DOI: 10.1016/B978-1-4377-1160-8.10002-8

Table 2-1 Principles of a Patient-Centered Medical Home emotionally and practically with whatever condition they face, even when cure is not possible.

In The Nature of Suffering and the Goals of Medicine, Cas-sell (2004) elegantly describes this tension and the continual erosion of healing practices under the pressure to apply more specific, technologic cures. In A Time to Heal, Ludmerer (1999) documents how, despite decades of efforts in curriculum change, these core values of healing in medical education have failed to gain significant traction under the forces driving the payment for cure-seeking behaviors.

Thus, the physician seeking to create a medical home that balances cure and healing faces considerable challenges, especially in the delivery of healing. What are the essential components of such a health care home? How can they be delivered in the current medical context? What actions must the family physician take to create not only a practice that treats disease, but an optimal healing environment as well?

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