2018 © Stylized Osteopathic Seminars| Edward G. Stiles, DO, FAAODist. | estilesdo@omtsos.com
3 Clinical Options

There are three possible scenarios or expressions of the Host + Disease = Illness paradigm

 

HOST + DISEASE = ILLNESS 

In this scenario, the disease process is the key component and responds very well to traditional allopathic/medical strategies. Unfortunately, the practitioner may incorrectly conclude that host - oriented approaches are unnecessary for all patients with that diagnosis. 

 

HOST + DISEASE = ILLNESS

In this scenario, the host component is the key component but the patient has the same “illness expression”. These patients frequently respond poorly to traditional allopathic/medical strategies, and may therefore require large doses of medications and prolonged courses of medical care in order to attain a beneficial clinical outcome. When manipulative care is added to the medical/disease orientated care, in order to remove the hindering role of somatic dysfunction on the clinical schematic, the patient’s condition frequently starts to improve and is easier to manage medically. This clinical outcome will be realized only if the somatic dysfunction is playing a significant patho - physiological role and is properly and effectively treated with OMT (osteopathic manipulative therapy). Unfortunately, the clinical outcome may be misunderstood and the clinician conclude that all patient’s with that medical diagnosis never require medical care but only OMT or other host-orientated care.

HOST + DISEASE = ILLNESS

In this scenario, the host and disease components are about equal. In these cases, either traditional allopathic/medical care or OMT will realize only about a 50 - 60% beneficial response. Both groups may be perplexed with the poor clinical outcome of their management strategy. The full clinical potential is not realized unless quality host orientated care and traditional/allopathic approaches are simultaneously utilized.

Notice

  • All three of these scenarios have the same clinical expression as the illness. A superficial evaluation may not realize and appreciate the uniqueness of each clinical case. 

  • These scenarios also illustrate and suggest how important it is consider both the disease paradigm and the host paradigms when considering a patient’s clinical illness, both from the diagnosis and management perspectives. Quality care, I believe, must consider the patient’s illness from both the host and disease perspectives of the illness paradigm...then the patient has the greatest chance of realizing their health potential.

  • Notice, this illness paradigm reality challenges Kuhn’s belief that a new paradigm will always replace an older paradigm. This clinical paradigm suggests two paradigms, host and disease models, can be combined and be synergistic in the clinical environment.

Somatic/mechanical dysfunction can additionally and adversely impact another aspect of the body’s physiology...the tensegrity phenomena or its clinical expression. This can be either a beneficial or detrimental influence.