The unfolding reconceptualization of the core mission of medicine, recognizing the whole individual in context as its fundamental purpose and not as a mere carrier of diseases, draws on the wisdom of the great ancient civilizations and recent developments in clinical medicine and public health.

Early traces of person-centered care can be found in major Eastern civilizations, particularly Chinese and Ayurvedic, which are still alive and practiced today as traditional medicine. With sound philosophical, experiential and experimental bases, they focus on the patient’s total health rather than only on disease. Both of them articulate a comprehensive and harmonious framework of health and life and promote a highly personalized approach for the treatment of specific diseases and the enhancement of quality of life.¹

In the West, the earliest and most prominent is the Hellenistic culture. The need for holism in Medicine has been strongly advocated by ancient Greek philosophers, ethicists, and physicians. Socrates and Plato taught that “if the whole is not well it is impossible for the part to be well”.² This position was enriched by Aristotle, the philosopher and naturalist par excellence as well by Hippocrates, who brought theory, emotion, and individuality together into the practice of medicine and delineated its ethical and person-centered foundations.

Such broad and enlightened concept of health (full well-being and not only the absence of disease) has been incorporated into the well-known WHO’s definition of health. This notion has maintained its vitality throughout the vicissitudes of contemporary health care.

Modern medicine has brought a number of important advances in the scientific understanding of diseases and the development of valuable technologies for diagnosis and treatment. At the same time, it is has led to an impersonal and dehumanizing focus on disease, over-specialization of medical disciplines, fragmentation of health services, weakening of the doctor-patient relationship, and commoditization of medicine.³

In response, a new vision of person-centered medicine is emerging and covers a wide range of concepts, tasks, technologies and practices that aim to put the whole person in context as a center of clinical practice and public health.

Among hopeful developments are those of Tournier’s medicine de la personne in Switzerland, Rogers’ person-centered approach focused on open communication and empowerment in the United States, McWhinney’s family medicine movement in the UK and Canada, Brera’s early person-centered medicine program in Italy, and Alanen’s need-adaptive assessment and treatment approach in Finland.

The World Psychiatric Association, which was born from the articulation of science and humanism,⁴ established at its 2005 General Assembly an Institutional Program on Psychiatry for the Person.^5,6 A number of scholarly developments were based on this Institutional Program, in collaboration various WPA Scientific Sections.

This initiative expanded into general medicine through a series of Geneva Conferences since 2008 in collaboration with the World Medical Association, the World Health Organization, the International Council of Nurses the International Federation of Social Workers, the International Pharmaceutical Federation, the European Federation of Families of Persons with Mental Illness, and the International Alliance of Patients’ Organizations, among a growing number of other international health institutions. The process and impact of the Geneva conferences led to the emergence of the International Network (recently renamed College) of Person Centered Medicine (INPCM, ICPCM).⁷

Among the scholarly contributions of the ICPCM is the development of the Person-centered Integrative Diagnosis model,⁸ Another is a research project funded by WHO on systematic conceptualization and measurement of person- and people-centered care. A major achievement is the establishment of the International Journal of Person Centered Medicine in collaboration with the University of Buckingham Press. Further to be noted are the 2013 Geneva Declaration on Person Centered Care for Chronic Diseases and the 2013 Geneva Declaration on Person-centered Health Research.

The World Health Organization at the World Health Assembly in May 2009 adopted resolutions which for the first time included the promotion of people-centered care. In line with this, WHO started co-sponsoring formally the Geneva Conferences on Person-centered Medicine. The recent World Health Assembly adopted its Twelfth Global Program of Work 2014–2019 which emphasizes achieving universal health coverage conceived not as a minimum set of services, but as an active process of progressive embodiment in which countries progressively extend access to healing and prevention
focused on the person and where political, financial and human resources serve to increase access to integrated and people-centered health systems.⁹ In line with this, the main theme of the upcoming 7th Geneva Conference organized by the ICPCM in collaboration with WHO will be Person-centered Integrated Care for all.

Further indicator of international interest on person centered medicine is the work of a substantial academic group in Zagreb which has published a valuable volume on Person-oriented Medicine and Health Care and contributed to the organization of the First International Congress of Person-centered Medicine in November 2013. Also significant have been the works on person-centered medicine at the University of Gothenburg in Sweden, Francisco Vitoria University in Madrid, and Peruvian University Cayetano Heredia in Lima. In Francophone countries one can note the active personcentered projects of the French Psychiatric Association, the International Francophone Psychiatric Association and the Francophone Observatory of Person Centered Medicine.

Particularly distinguished in the field have been the Hippocratic and Aristotelian contributions of the Hellenic Psychiatric Association and the Cyprus Psychiatric Association first to the WPA Institutional Program on Psychiatry for the Person and more recently to the activities of the International College of Person Centered Medicine. The World Federation for Mental Health which has co-sponsored the Geneva Conferences on Person-centered Medicine since their inception has now adopted a person-centered Action Plan under the leadership of Professor George Christodoulou.

All the above promises well for a rewarding journey to Ithaca by all those committed to the construction of person centered medicine.

Juan E. Mezzich, MD, PhD
Professor of Psychiatry, Mount Sinai School of Medicine, New York University
President 2005–2008, World Psychiatric Association
Secretary General, International College of Person Centered Medicine
Editor-in-Chief, International Journal of Person Centered Medicine
Honorary President, Cyprus Psychiatric Association
Vice-President for Government Affairs, World Federation for Mental Health

References

1. Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: a comparative overview. Evidence-based Complem Alternat Med 2005, 2:465–473
2. Christodoulou GN (ed) Psychosomatic Medicine. New York, Plenum, 1987
3. Heath I. Promotion of disease and corrosion of medicine. Canad Family Physic 2005, 51:1320–1322
4. Garrabe J, Hoff P. Historical views on Psychiatry for the Person. Int J Person Center Med 2011, 1:125–127
5. Mezzich JE. Psychiatry for the Person: Articulating Medicine’s Science and Humanism. World Psychiatry 2007, 6:65–67
6. Christodoulou GN, Fulford KMW, Mezzich JE. Conceptual bases of Psychiatry for the Person. Int Psych 2008, 5:1–3
7. Mezzich JE, Snaedal J, van Weel C, Heath I. The International Network for Person-centered Medicine: Background and First Steps. World Med J 2009, 55:104–107
8. Mezz ich JE, Salloum IM, Cloninger CR, Salvador-Carulla L, Kirmayer L, Banzato CE et al. Person-centered Integrative Diagnosis: Conceptual Bases and Structural Model. Can J Psychiatry 2010, 55:701–708
9. World Health Organization. Twelfth Global Program of Work 2014–2,19. Geneva, Author, 2013

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