“Based on a multi-faceted image of man, the focus is on the patients’ self-healing forces.”
About the origins of health
Instead of focussing on the causes of illness, the pathogenesis, as it is done in conventional medicine, in salutogenesis the central question is the one about the origin of health.
‘Is the human being really nothing but the coincidental outcome of the combination of his or her physical constitution, character disposition and social environment?’ The Austrian neurologist and psychologist Viktor Frankl and the Israeli sociologist Aaron Antonovsky worked intensively with this question. Both of them noted that situations that are physically and/or mentally extremely hard would not necessarily cause people to get ill. Antonovsky was driven by the question which forces in the human being make this possible. This change of perspective is known as ‘salutogenesis’.
Strengthening vital forces
Anthroposophical medicine has been a salutogenetic approach from the beginning, directed at the self-healing forces and the patient's self-competence. Based on a multi-faceted image of man, the focus is less on the problems within the complex system of cause and effect that is the human organism, and more on the self-healing forces and spiritual resources of the patient. The treatments with medicines, artistic therapies, rhythmic massage and curative eurythmy, are all aimed at supporting what is still strong and healthy in the patient’s organism. The Swiss health authorities assume that there is a potential amount of 1,5 billion Francs that could be saved by promoting this kind of patient self-competence.
Creating self-healing forces within oneself
The significance of this salutogenesis-based approach to medicine for the healthcare system as a whole and the financial possibilities related to it are not yet sufficiently documented. Our highly specialised, technology oriented medical system is based on analysis: patients have their diagnosis listed like a report of all their defects, complete with a therapy plan and appropriate medicines. New financing models are based on reimbursing doctors and hospitals according to the number and gravity of these diagnosed cases (Diagnosis Related Groups, DRGs). The political decision to have the health care system this heavily centred on the ill patient will certainly make health care more expensive. There are other possibilities of diagnosis and financing. Seven years ago the WHO introduced a system of classification aimed at an ‘integral diagnosis and a positive influence on the patients’ wellbeing and their ability to be active.’
Supporting self-healing and self-competence
The Swiss PEK study (Program for the Evaluation of Complementary Medicine, see article by Dr P. Heusser, page 4) showed that the average consultation time with an Anthroposophical doctor is longer than with a conventional doctor. However, since the costs for laboratory tests, x-ray examinations and medicines are lower, the complete treatment is less expensive. Results of the German AMOS study (Anthroposophical Medicine Outcome Study) confirm these findings, concluding that Anthroposophical Medicine is less cost-intensive, even counting the costs of curative eurythmy, rhythmic massage, and artistic therapies. On average patients had to be hospitalised for one day less per year. Anthroposophical medicine as an ‘art of healing’ with a salutogenetic approach is always focussed on the patients’ self-healing forces and their self-competence. Those forces that are still strong and healthy even in the case of illness.
Dr. med. Hansueli Albonico, Head of the Department for Complementary Medicine, regional hospital Emmental AG, Langnau, Switzerland