Making the Biopsychosocial Model More Scientific—Its General and Specific Models

Abstract The fundamental criticism that the biopsychosocial (BPS) model is not scientific is that it lacks a method to produce BPS information. Yet, those advising solutions have not addressed the method. In this Commentary, I articulate that the patient-centered interview is that method, the process needed to identify BPS content for the individual patient. What most understand to be the model is the general BPS model. It simply tells us that we must have interacting biological, psychological, and social data for all patients. In clinical medicine this is not particularly helpful, but for the field of medical science it is vital. It guides medicine away from the effete disease-only model of Descartes from the 17th century. What critics fail to understand is that the patient-centered interview is the lamented missing method. It produces a unique and specific BPS model for every patient at any given time. This is the part of the BPS model relevant to the clinician. Distinguishing the general from the specific BPS model is the first step in resolving the non-scientific criticism, but this simply displaces the need for scientific credibility from the general model to the specific model and, more precisely, to the patient-centered interviewing method needed to operationalize the latter. I review briefly how the field of medical communication has conducted much research over many years to eventually establish the patient-centered interview as evidence-based in randomized controlled trials. By definition, if the patient-centered interview is scientific, this makes the BPS model scientific. This enables us, for the first time, to identify a scientific BPS model for each and every patient.