Draft:Whole Health
healthcare philosophy
From Wikipedia, the free encyclopedia
Whole Health is a person-centered, integrative healthcare model developed in 2011 by physician Tracy W. Gaudet and colleagues in integrative medicine for the United States Department of Veterans Affairs (VA).[1]
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The Whole Health model looks to combine conventional medical care with self-care strategies and alternative therapies, with the primary goal of facilitating collaboration between caregivers and patients to personalize healthcare outside of their disease, while also making the latter active participants in their healthcare.[2]
Origins
The model emerged from the integrative medicine movement of the late 20th century, which looked to incorporate psychosocial, lifestyle, and behavioral factors into conventional biomedical care. The approach draws on the biopsychosocial model proposed by psychiatrist George L. Engel in 1977[3] and medical sociologist Aaron Antonovsky's salutogenesis theory (1979), emphasizing social wellness and psychological resilience rather than disease pathology alone.[4]
Adoption by the U.S. Department of Veterans Affairs
The Veterans Health Administration (VHA) established the Office of Patient Centered Care and Cultural Transformation. The office initiated a system-wide shift toward personalized healthcare delivery.[5]
Between 2011 and 2016, the VA conducted pilot programs at select medical centers to test Whole Health principles. The Comprehensive Addiction and Recovery Act of 2016 authorized expanded implementation to address chronic pain and opioid use. By 2018, eighteen VA facilities were designated as Whole Health flagship sites, adopting the complete three-component model across their systems.[6]
Core Components
Whole Health defines well-being in terms of physical, emotional, social, spiritual, and environmental factors. The “Circle of Health” framework places the individual at the center of healthcare decisions and identifies eight self-care domains supported by professional care and community resources. The model proposes that attention to each of these interconnected areas contributes to sustained health and overall well-being. [7]
The Pathway
A facilitated, non-clinical process in which individuals work with peer specialists or health coaches to clarify their personal Mission, Aspiration, and Purpose (MAP). Participants complete a Personal Health Inventory to identify life goals, values, and health priorities beyond medical diagnoses. This component, also known as "Empower," focuses on peer-led support rather than clinician-directed interventions.[8]
Well-Being Programs
Group-based educational and experiential offerings addressing lifestyle factors including nutrition, physical activity, sleep, stress management, and social connectedness.[8] The VA system includes complementary and integrative health (CIH) therapies such as acupuncture, yoga, tai chi, meditation, and massage therapy within this component, referred to as "Equip."[10]
Whole Health Clinical Care
Conventional medical treatment delivered by clinicians who integrate knowledge of the patient's MAP and Personal Health Plan into clinical decision-making. This "Treat" component emphasizes shared decision-making, care coordination, and alignment of medical interventions with patient-identified goals.[11] The Personal Health Plan (PHP) is developed collaboratively between the patient and their care team. It documents health goals, specific action steps, barriers, and follow-up strategies.
Criticism
The 2023 National Academies of Sciences, Engineering, and Medicine report Achieving Whole Health acknowledged that while early findings are promising, the field "lacks a standardized framework for measuring whole person outcomes or assessing cost-effectiveness."[12]
A recurrent area of debate surrounding Whole Health involves its incorporation of complementary and integrative health (CIH) practices such as acupuncture, tai chi, yoga, guided imagery, massage therapy, and meditation. Systematic reviews and meta-analyses of acupuncture, for example, frequently report low or very low certainty of evidence and wide variation in study quality.[13]