The 3 H and BMSEST Models for Spirituality in Multicultural Whole-Person Medicine

One of the seven core features of the patient-centered medical home is “Whole Person Orientation.” [1] The Institute of Medicine states that quality care requires “continuous healing relationships.”[2] The set of conceptual models proposed by Dr. Anandarajah in this provocative paper provides a framework for unifying these ideas, as well as providing a way to contextualize much of the burgeoning research on spirituality. She maintains that the model of spirituality described in this paper provides a way of thinking about spirituality that is applicable across all cultures and religions. Although this is an extraordinarily ambitious claim, I find that her arguments are well thought through and persuasive, at least to this member of western culture. The extensive bibliography on spirituality and healing is a valuable contribution in itself.

Research in primary care has been mostly empirical, with not enough attention paid to the development of conceptual models. Good conceptual models allow existing research to be understood within a larger framework, and also suggest directions for new research. Dr. Anandarajah’s models fulfill these functions admirably. Hopefully, they may also serve as the basis for developing a common language that begins to break down the Cartesian duality that has plagued our profession.

1. Robert Graham Center, The Patient Centered Medical Home: History, Seven Core Features, Evidence and Transformational Change. 2007, Robert Graham Center: Washington, DC.

2. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001, Institute of Medicine, Committee on Quality of Health Care in America.

Competing interests:   None declared