In 1977, Engel challenged the biomedical model and introduced the biopsychosocial model of health and illness to capture the oft-ignored social, psychological and behavioural dimensions of illness (Engel, 1977). The benefit of this holistic model of health is that it creates a wider paradigm for evidence-based medical interventions to be considered, beyond ‘plasters and pills’. If diseases can be accurately conceptualised by their underlying biopsychosocial context, then their remedies can take the form of non-pharmacological interventions, working at the root causes. It’s reimagining what effective and meaningful healthcare delivery can be. As Gavin Francis aptly wrote “drugs can be the least of healing, and the idea that therapies must be something that you swallow or inject – that they should be pills or syrups or infusions – is manifestly untrue” (Guardian, 2022).
Therefore, what’s currently missing in clinical education is the fundamental appreciation that though illness is a medical problem, it demands more than a medical solution. The former Chief Pharmaceutical Officer, Dr Keith Ridge, acknowledged this when he suggested solutions to tackling the overprescribing crisis, and recommended social prescribing as “a constructive alternative to drugs for many patients” (DHSC, 2021).
What Social Prescribing Taught me About Cures and Remedies
Social prescribing involves a patient referral to local, non-clinical services designed to support social, emotional and practical needs. Referrals involve a link worker, who takes the time to co-design a social intervention with the patient, addressing their specific concerns. Effects of social interventions have been positively evidenced on improving mental health outcomes (Kimberlee, 2013) and reducing primary care and emergency service use (Polley et al., 2019 ; Dayson & Bashir, 2014). Yet, a study in 2019 found that 93% of UK medical students had not heard of social prescribing before (Santoni et al., 2019). It is vital to fill this educational gap so that the future health workforce can move beyond overprescribing culture, and where necessary and most beneficial—seek alternative, evidence-based therapies with lower risks to patient health and the health system overall.