Never forget that it is not a pneumonia, but a pneumonic man who is your patient. Sir William Gull (1816-90)
The management of the whole person, or the holistic approach, is an important approach to patient care in modern medicine. Whole person diagnosis is based on two components: 1
1. the disease-centred diagnosis
The disease-centred consultation is the traditional medical model based on the history, examination and special investigations, with the emphasis on making a diagnosis and treating the disease. The disease-centred diagnosis, which is typical of hospital-based medicine, is defined in terms of pathology and does not focus significantly on the feelings of the person suffering from the disease. The patient-centred consultation not only takes into account the diagnosed disease and its management but also adds another dimension—that of the psychosocial hallmarks of the patient ( Table 11.1 ) including details about: 1
• the patient as a person
• emotional reactions to the illness
• the effect on relationships
• work and leisure
• the environment
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