Challenges of complexity in Family Medicine

Abstract

The authors identify some aspects of family medicine (FM) that may benefit from theoretical and methodological contributions from complex adaptive systems theory. They highlight chronic co-morbidity, the challenges of behavioural changes to prevent disease and to promote health, factors associated with patient compliance to treatment, the placebo effect, the biological, psychological, familial, social, occupational, economic and cultural factors that determine the way people suffer and get health care, the role of the community and personal autonomy and empowerment, the hurdles of dealing with technology and the health care system labyrinth. Theoretical trends are briefly addressed from von Bertalanffy (1968) up to the present. The levels of systemic organization relevant to FM are also discussed: individual, familial, organizational and community. Complexity theory (science) is presented with emphasis on the study of complex adaptive systems (CAS). The «edge of chaos» concept is discussed as a zone of greater possibilities for change and adaptive transformation of complex adaptive systems. Some principles of complexity and tools that might be useful in the daily work of FM are presented here. The authors stress the need for creating and adopting cognitive strategies and integrative ways of seeing and reading the human being and the world. That means constantly acknowledging and accepting of the principles of incompleteness and of knowledge-related uncertainty.