Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul 12:5:1672.
doi: 10.12688/f1000research.9042.2. eCollection 2016.

Applying a complex adaptive system's understanding of health to primary care

Affiliations

Applying a complex adaptive system's understanding of health to primary care

Johannes Bircher et al. F1000Res. .

Abstract

This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS) and is based on five components (a-e). Humans like all biological creatures must satisfactorily respond to (a) the demands of life. For this purpose they need (b) a biologically given potential (BGP) and (c) a personally acquired potential (PAP). These properties of individuals are embedded within (d) social and (e) environmental determinants of health. Between these five components of health there are 10 complex interactions that justify viewing health as a CAS. In each patient, the current state of health as a CAS evolved from the past, will move forward to a new future, and has to be analyzed and treated as an autonomous whole. A diagnostic procedure is suggested as follows: together with the patient, the five components and 10 complex interactions are assessed. This may help patients to better understand their situations and to recognize possible next steps that may be useful in order to evolve toward better health by themselves. In this process mutual trust in the patient-physician interaction is critical. The described approach offers new possibilities for helping patients improve their health prospects.

Keywords: Meikirch model; complex adaptive system; diagnosis; family medicine; health; internal medicine; primary care; therapy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: No competing interests were disclosed.

Figures

Figure 1.
Figure 1.
The Meikirch model consists of five components (a–e) and ten complex interactions (1–10).
Figure 2.
Figure 2.. General model of a complex adaptive system (CAS).

References

    1. Virchow R: Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre. Berlin: Hirschwald,1858. Reference Source - PubMed
    1. Lorenz E: The Essence of Chaos. Edward Lorenz: Seattle,1993; Appendix 1:S181–184. Reference Source
    1. Sturmberg JP, Martin CM, Katerndahl DA: Systems and complexity thinking in the general practice literature: An integrative, historical narrative review. Ann Fam Med. 2014;12(1): 66–74. 10.1370/afm.1593 - DOI - PMC - PubMed
    1. Bircher J, Kuruvilla S: Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy. 2014;35(3):363–86. 10.1057/jphp.2014.19 - DOI - PMC - PubMed
    1. Bircher J, Hahn EG: Understanding the nature of health: New perspectives for medicine and public health. Improved wellbeing at lower costs [version 1; referees: 2 approved]. F1000Res. 2016;5:167. 10.12688/f1000research.7849.1 - DOI - PMC - PubMed