How can a holistic perspective benefit practitioners, patients, and the planet?

Sayed Adam Bukhari, King’s College London, 4th year medical student

In today’s mechanistic and increasingly complex world, the imperative for a holistic approach to healthcare has become increasingly evident. The concept of holistic medicine has emerged as a promising solution to address the diverse and interrelated aspects of human health and well-being. A holistic perspective extends beyond the traditional medical model, emphasising the interconnectedness of individuals, their environment, and the planet as a whole.1 At the heart of this essay lies the conviction that a holistic perspective encompasses deep thinking and reflection on both the theoretical and practical aspects of care. Firstly, this essay will delve into the significance of practitioners reflecting on the philosophy of the care they provide. Secondly, it will explore how a holistic mindset enables practitioners to consider often overlooked factors that profoundly influence patient well-being. Finally, this essay will illustrate how a holistic mindset can promote environmentally sustainable practices within the context of healthcare.

A new paradigm

A holistic perspective encourages practitioners to reflect and reconsider the philosophy of the care they provide for others. The development of modern medicine has been largely dominated by an empirical, reductionist approach, often reflected in the delivery of care by practitioners today.2 A holistic perspective enables practitioners to develop an awareness of the fundamental views and approaches that influence their practice through self reflection. This can also give rise to intellectual humility, which can be defined as a mindset that ‘involves recognizing and owning our intellectual limitations in the service of pursuing deeper knowledge, truth, and understanding.’3 This can involve not limiting oneself to a singular philosophical outlook, and considering other ontological and epistemological perspectives when delivering care to others.4

This thought process also compels us to re-think what we consider ‘evidence’ to be.4 Although in many ways effective, a strictly empirical approach to delivering care is neither infallible nor exclusively dependable if we hope to deliver truly holistic care.2 It can be argued that modern medical practice is too dismissive of other sources of evidence for treatments, such as records of historical use and the personal experiences of patients.5 Intellectual humility enables us to recognise the limitations of the approaches we employ, and subsequently empowers us to consider other approaches that may also deserve a place in the delivery of care. For example, honey has been used in many societies as a natural remedy for thousands of years.6 Furthermore, many patients have testified to the benefits of using honey.7 By adopting a holistic perspective, a practitioner may consider this information alongside other types of evidence, such as original research data, when formulating treatment plans. This may help practitioners bridge the gap between traditional, alternative and scientific approaches to healthcare.

Furthermore, a holistic perspective encourages practitioners to consider the implications of their theoretical approaches. By approaching care through an empirical, reductionist perspective, are we suggesting that honey has no benefit simply because it has not been evaluated under a singular framework? Are we also affirming that past civilisations had no claim to wisdom? Undoubtedly, such an approach fails to appreciate that beneficial knowledge can be accessed through a variety of means.8 It is also worth noting that human beings are incredibly complex, and much remains unknown about the interplay between physical, mental, social and spiritual factors in the manifestation of illness.9,10 A holistic perspective therefore encourages practitioners to be mindful of reducing complex presentations down to simple issues, and to maintain a health dose of intellectual humility in knowing that not all is known.

The self awareness and intuition that arises from a holistic perspective may also contribute to a practitioner’s own sense of identity and fulfilment. Recognising their role as a ‘healer’, practitioners may develop a greater sense of responsibility for promoting their patient’s overall wellbeing, rather than solely physical health. Furthermore, having a deeper insight into one’s own internal states and thoughts can aid practitioners in preventing burnout.11 Such thinking also encourages one to be more mindful of their underlying intentions and motivations for delivering care, which can make for more meaningful work.12 In a time where practitioners are facing unprecedented levels of burnout and low motivation, fostering purpose through a holistic perspective is becoming ever more important.13

Truly holistic care

A holistic perspective gives practitioners the insight to explore commonly overlooked yet deep-rooted factors that influence the well-being of a patient. It is no secret that patients are incredibly diverse, and vary widely in their cultural norms, life perspectives, and religious and spiritual beliefs. These factors can have a profound effect on a patient’s well-being and preferred approach to receiving care.14 Interestingly, discussions exploring these aspects are often absent from consultations in Western societies.15 This is in light of increasing numbers of people, particularly young adults, who live without structured belief systems or frameworks for navigating life.16 Whilst down to individual choice, the absence of these frameworks have been shown to negatively impact the well-being of such individuals.17 Many patients also have an aversion towards facing death.18 Holism, which forms the theoretical foundations of a holistic perspective, is to consider the patient as a ‘whole’, which includes all aspects of their body, mind, spirituality and emotional state in relation to their surroundings.19 In light of contemporary challenges regarding mental and spiritual health, such as many reporting a lack of direction, a holistic perspective demands courage on behalf of both practitioner and patient in discussing these matters.15 For some individuals, speaking to their local practitioner about their spiritual struggles can be a source of improved well-being.20 However, the fact that such conversations are considered outside of the norms of modern practice can act as a barrier to facilitating them.15 A holistic practitioner must therefore create an open and inclusive atmosphere if they are to achieve a more comprehensive understanding of the factors influencing the well-being of their patients.

Whilst a holistic perspective encourages practitioners to explore their patients’ beliefs and life perspectives, this is not so that they may impose their own views, but rather that they may support and empower patients to navigate through their individual life journeys. To be a true ‘healer’, practitioners must employ a variety of approaches and tools inspired by a holistic perspective. For example, if a patient holds the belief that a faith-based therapy, such as prayer, may improve their condition, this should be acknowledged by the practitioner and considered alongside conventional treatment options. By integrating patients’ perspectives into their therapy, practitioners demonstrate genuine care, inclusivity and respect for patient views, all of which align with the aims of holistic medicine.1,21 After all, if we are to champion the well-being of our patients, how can we hope to do so whilst neglecting the aspects that may well be most important to them?

Consistency in principle

A holistic perspective also helps to expose the inconsistencies within our own value-based approaches. Upon reflection, it is clear that the ultimate patient is our planet. If we claim to uphold the principle of promoting the well-being of others, how can we simultaneously neglect the health of our planet? To illustrate, current infection control measures in many hospitals involve one-use disposable equipment designed for minimising risk to patients, yet these same measures contribute to huge amounts of non-biodegradable waste.22 The fate of such waste is that it often ends up in landfills or incinerated, releasing toxic gases into the atmosphere.23 Upholding consistency between our principles and actions allows us to move away from modern, tunnel-visioned approaches to healthcare that promote patient health but at the detriment of the wider ecosystem. A holistic perspective encourages environmental stewardship and equal consideration for the environment in which we live. By utilising their roles to promote sustainable health practices, practitioners can advocate for environmentally-friendly health policies, educate patients on environmentally sustainable behaviours, and implement holistic practice models within health systems.24,25 It can also be considered a responsibility of practitioners to promote the wellbeing and safety of our planet for future generations who have an equal right to live and thrive.26

Overall, a holistic perspective provides the necessary thinking that enables practitioners to deliver on the fundamental aims of holistic healthcare. By reflecting on the philosophy of the care they deliver, practitioners can recognise the limitations of their approaches and consider different perspectives in order to provide better care to their patients as well as themselves. Attentiveness and perception to the underlying views and beliefs of patients can allow for a more complete picture of their wellbeing, guiding individual patient therapy more effectively. Embracing environmental stewardship and consistency in thought and action can help to promote a healthier planet for current and future generations. In adopting a holistic perspective, a more thoughtful, considerate and optimistic future can be shaped for the world and all of its inhabitants.

References

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