What would an Ian McWhinney health care system look like?

We could not agree more that medicine is an art of translation, and with the importance of a complexity approach, as described by Martin et al in "What would an Ian McWhinney health care system look like" (1).

We have advocated for this for many years, suggesting complexity, the science for the 21st century according to Stephen Hawking, and chaos from which it arises, as a translation factor to the individual and to reality, and have proposed a complexity based medicine to reflect this (2-5).

We also agree that McWhinney's ideas for medicine reflect a complexity thinking, even though the vocabulary and concepts of complexity science were not available to him. It is intriguing to look at many other progressive ideas before the new age of complexity, to discover that they also reflect many elements of complexity thinking. One in particular is Rene Dubos' writing, whose entire 1966 essay "Hippocrates in Modern Dress" reflects a holistic complexity approach, as in this quote (6):

"The art of medicine demands of the physician a holistic attitude very different from the typical scientific approach. It involves the ability to select, intuitively as it were, those aspects of the total medical situation in all its complexity, which can be manipulated not only by scientific medical technologies but also by any other kind of influence which promises to be useful. Seen in this light, the art of medicine appears so complex and personal as to be outside the scope of the scientific method, just as is artistic creation."

It seems that, like McWhinney, Rene Dubos had a complexity thinking for medicine, way before complexity became known or popular. Now, we have ideas from complexity science that can help us to understand our reality better, and to shape it for the future, as an art and science (5).

We can now use readily available concepts and tools of complexity, the science for the 21st century, to address 21st century issues that impact medicine and health, as complexity based medicine and a complexity based approach to medicine and health.

1. Martin D, Pollack K, Woollard R. What would an Ian McWhinney health care system look like. Canadian Family Physician. 2014;60:17-19.

2. Rambihar VS. A New Chaos Based Medicine Beyond 2000: the response to evidence. 1999 Vashna Publications. Toronto.

3. Rambihar VS. Complexity Based Medicine: evidence based medicine at the edge of chaos http://www.bmj.com/content/348/bmj.g22/rr/682294 accessed 14 February 2014.

4. Rambihar VS, Rambihar S, Rambihar V. Tsunami Chaos Global Heart: using complexity science to rethink and make a better world. 2005 Vashna Publications Toronto. http://www.femmefractal.com/FinalwebTsunamiBK12207.pdf accessed 14 February 2014.

5. Rambihar VS, Rambihar Vanessa. Complexity: the science for medicine and the human story. Lancet 2010;375:9721.

6. Dubos Rene. Hippocrates in Modern Dress. Perspectives in Medicine and Biology. Winter 1966;274-288.

Conflict of Interest:

None declared