| As practitioners, we approach our patients and their problems within the framework of a conceptual model which organizes and defines the questions we ask, the information we seek, the diagnostic and therapeutic options, and ultimately the outcome of our interventions. Because we are so accustomed and conditioned to think and act within a specific framework, we rarely if ever consider the fundamental conceptual principles underlying our practice even though these principles can assume a powerful, although often unseen, authority over our professional lives.
The dominant medical model of western culture, the biomedical model is based on three underlying, yet untested, assumptions and principles: Objectivism, the idea that accurate knowledge can be exclusively achieved through an impersonal assessment of sensory based information; Determinism, the idea that causation is exclusively characterized by an upward and linear mechanistic linkage; and Positivism, the idea that knowledge exclusively accumulates through the accretion of data from the positive results of sensory based experimentation. This model has served us well, but with the progressive urbanization of life accompanied by the industrial and technologic revolutions humankind has seen the development of new and very different adversities which have resulted in the emergence of a uniquely new category of modern day ailments, particularly stress related diseases, acute and chronic, which are directly linked to personal attitudes and lifestyle. As a result, the limitations of a medical model which cannot effectively incorporate psychological, psychosocial, or spiritual factors, factors that are at the source of these ailments, has become increasingly evident.
The emerging public interest in health promotion, self-care, alternative healing practices, and mind/body medicine is a response to the limitations of the biomedical model and challenges future health practitioners to develop a more comprehensive understanding and approach to the care of individuals. 1 Ideally, such an approach would maintain the scientific rigor and discipline which has so successfully served the biomedical model while at the same time expand the vision and reach of modern medicine. New approaches to clinical care must be developed in a manner that can be easily integrated into clinical training and effectively assist the future practitioner in meaningfully expanding his/her capacity to respond to the changing needs and demands of a diverse population of clients.
The comprehensive model I am proposing incorporates and integrates the principles and practices of the biomedical model with the new and emerging initiatives noted above. It does so by presupposing that there are multiple maps and explanatory models for perceived reality. Each map is considered valid in itself, yet when considered together they provide a closer approximation to reality than is possible when each is taken alone. As complex beings living in a complex ecology, we can appropriately and simultaneously be considered as mechanical devices whose parts are amenable to repair, interactive units whose major component systems are the mind and body, and spiritual beings who emerge from and ultimately re-join the timeless flow of nature. The model I am proposing will consider each of these aspects of our being - mechanical, mind/body, and spiritual - their relationship to each other and the manner in which each can be integrated into a comprehensive approach to health.
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Elliott S. Dacher is a pioneer in the emerging medicine of the future. His knowledge and practical approaches to the field of health and healing have evolved from his extensive experience as a practicing internist 
