Physician Assistants and Physicians learn from the medical model, or what is traditionally thought of as the “disease” model of learning medicine. This includes approaching disease from the perspective of basics of anatomy & physiology, pathophysiology, pathology, pharmacology, epidemiology, etiology, investigations, clinical presentation, and treatment.
To explain the medical model, we first have to look at a little bit of history to understand where this model comes from. The “old medical model” as described by psychiatrist Dr. George Engel in 1977, is a disease-oriented model which describes disease is a result of abnormal biological functioning (deviation from normal anatomy, physiology & molecular biology). Restoration to normal functioning relied on the physician to correct the abnormality.
Jonathan Fuller in a 2017 paper titled “The new medical model: a renewed challenge for biomedicine”, he describes a newer medical model that incorporates prevention of chronic disease, and use of evidence-based medicine. And evidence-based medicine is in reference to clinical research, epidemiological evidence. The goal of the new medical model is to “cure, prevent or manage the disease”.
In combination with the PA/MD’s assessment – patient history, physical examination, ancillary investigations, the physician/PA can diagnose the underlying problem and correct the dysfunction with a treatment plan (which may include different treatment modalities – patient education, counseling, therapeutic procedure, medication, encouraging lifestyle changes, topical or oral medications, injections, etc.)
Medical and PA programs today have moved towards patient centered, and interdisciplinary care, and away from physician paternalism.
 Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196:129–36
Nurse Practitioners learn in the nursing model and medical model. The nursing model is the foundation of holistic, whole person care. There is a biopsychosocial approach looking at patient needs across the whole spectrum – from cradle to grave regardless of diagnosis. And with training as nurses first, NPs focus on those patient needs, and not just the medial diagnosis.
When completing the Nurse Practitioner education program, students begin to focus on assessing, diagnosing and treatment disease, with some of the basic medical foundations but coming at it with a nursing focus.