Some Ideas on How Decision-Making Process on Multiple Causal Interrelations can be understood in General Medicine: "The Auction of Fish"

Authors: Turabian JL*

DOI: 10.23880/eij-16000125

Volume 3, Issue 2

Abstract

General practitioner (GP) knows the presence of multicausal epidemiological agents at several levels, from the micro level (subatomic particles, atoms, molecules, cells, tissues, organs / organ systems, the nervous system, and the person -experience and behavior) to the macro level (agents that belong to the social structure, structural factors and social and political activities, the social environment, the agents related to work, the toxic agents of the environment, social groups, etc.) and that interventions at the highest possible level will be the most effective (family, community, social structures). Thus, the GP, in each consultation, with each patient, in each health problem that is presented to him, during the interview with the patient, must decide at what level he performs his biopsychosocial intervention. There is a complex mental process or doctor-patient dialogue of understanding and decision-making about the agents of the multi causal that interrelate between the micro and the macro levels. In this article, some ideas are presented on how this process can be understood, and certain constructions are proposed for its practical application. The example or metaphor of the auction convention of the fish market is used to guide the theoretical and pragmatic considerations of the process of interaction of the different heterogeneous causal agents at different levels (macromicro): goods are exchanged under the peculiar protocol of auction of descending offer. The "auction" stops in the price (level and causal agent) that the GP has decided that in that case, in that problem, in that situation, it will be possibly accessible to therapeutic intervention. It can be think a "computerized fish auction protocol" that helps to make and implement decisions in a network of multi-causal agents at macro-micro levels.

Keywords: General practitioner; Family medicine; Theoretical models; Multifactorial causality; Complex biological system; Community networks; Ecosystem; Social problems; Public health practice

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