The family doctor is the general practitioner who assumes the responsibility of attending to the patient in a comprehensive, biopsychosocial, contextualized manner, focusing on family and community, with continuous care, without selecting patients based on age, sex, disease, organs or body systems. Family medicine training can often feel like a massive, overwhelming banquet of information, and the concepts and theories that belong to family medicine are often difficult to explain and understand. Here, these concepts are explained through metaphors—a way of transforming a concept into something suggestive, interesting, and surprising—, irony—which implies that what is said is not what is meant—, and humor, which can be therapeutic. The series of short articles, "Cooking Up Family Medicine: A Metaphorical Kitchen Guide for Medical Training and Clinical Practice," is thus an ironic metaphor that breaks down the complexity, offering a refreshing, bite-sized approach to the foundational concepts every family doctor must master. It is a series of 10 short chapters / metaphorical and ironic cooking recipes." Inside these metaphorical cookbook articles, you won't find instructions for roasting chicken or baking bread. Instead, you will discover concise, ironic, and highly practical "recipes" designed to help you easily digest and internalize core clinical principles. Each article serves as a quick-to-read kitchen lesson, transforming abstract family medicine theories into actionable for your daily clinical practice. These series of articles provide the perfect ingredients to sharpen your clinical intuition—one delicious concept at a time. This article presents the recipe for “Three Delights Rice” (bio-psycho-social care). Bon Appétit, Doctor!

The academic discipline of family medicine is unique and coherent. It possesses knowledge, skills, and attitudes common to other clinical specialties, community medicine, behavioral sciences, and social sciences. However, it uses them in a particular way, thus constituting a recognizable, unified, specific, and differentiated set of skills [1]. But, concepts belonging to family medicine are often difficult to explain and understand. Metaphors enable us to understand something that is unknown in terms of its familiarity [2-5]. Irony is also a very useful educational tool [6], as it stimulates critical thinking and fosters self-reflection [7, 8]. And the respectful use of humor is important in medical practice [9-11]. Traditional medical textbooks treat knowledge like an assembly line: rigid, serious, and cold. This series of articles adopts a different approach. We treat family medicine like a kitchen. Why a kitchen? Because being a great family doctor is not so much about blindly following a strict protocol, but about knowing how to balance the ingredients. It takes a dash of clinical intuition, a generous dose of empathy, a solid foundation in evidence-based medicine, and, occasionally, a pinch of irony and humor to get through the day. Within these articles, you won't find instructions on how to bake a soufflé. Instead, you'll find a collection of concise, metaphorical "recipes" designed to help you "cook up" the core concepts of family medicine. So, wash your hands, put on your apron (or white coat), and let's get cooking! Bon appétit, doctor. In this scenario, here is the recipe for “Three Delights Rice” (biopsychosocial care).

Three Delights Rice (biopsychosocial care)

Three Delights Rice explains the biopsychosocial model: it's the perfect example of distinct elements that must coexist in the same dish (or consultation) for the recipe to make sense. If you remove one of the "delights," the dish changes its name and loses its balance.

The favorite dish in family medicine is Three Delights Rice. Family doctors are physicians with "three heads": the biological, the psychological, and the social. Providing biopsychosocial care is relatively easy, and its presentation, like that of Three Delights Rice, is effective because it offers a panoramic view of the patient, making medical intervention more appealing. Furthermore, regular consumption of biopsychosocial care, like regular consumption of rice, has a positive effect on the prevention and improvement of certain pathologies.

Ingredients

-300g of Patients

-200g of frozen Biological Aspects

-1 thick slice (about 50g) of Psychological Aspects deli meat

-2 Social Aspects

-2 tablespoons of Empathy Training

-Discussion Groups on the Emotional Aspects of Medical Practice to taste

Preparation

Place the Patients in a saucepan with plenty of boiling water and a small amount of Discussion Groups on the Emotional Aspects of Medical Practice, and cook for 10-15 minutes depending on the type of Patients used. Drain.

While the Patients are cooking, pour a tablespoon of Empathy Training into a non-stick frying pan and make a thin omelet (without folding) with the Social Aspects.

In the same pan, grill the previously thawed Biological Aspects (until white) and then the sliced ​​Psychological Aspects.

In a saucepan, add the other tablespoon of Empathy Training and all the ingredients. Stir to combine the flavors, adjust the amount of Discussion Groups on the Emotional Aspects of Medical Practice if necessary, and serve hot.

Variation

If you have a cooked Literature and Medicine Course, you can also add it to the rice.

Time

30 minutes... but it is preferable to rely on continuous care.

Cost

Medium

Precautions and Contraindications

All health problems are bio-psycho-social, but in acute and severe cases, it is necessary caution at the outset.

Biopsychosocial Concept

In 1977, Engel proposed a paradigm capable of scientifically incorporating the human domain into the experience of illness. The biopsychosocial model is an alternative to the reductionist biomedical model. Derived from general systems theory, the biopsychosocial model stems from biology and reflects the changes that contemporary science has made to its theoretical framework, such as the introduction of Heisenberg's uncertainty principle in quantum physics. The essential points of this new epistemology are: 1) There is no objective observer; 2) The presence of the observer and their instruments disturb the phenomenon in an indeterminable way; 3) There is no phenomenon in itself; the conjunction between the observer and the phenomenon produces a new condition in which phenomena appear that are products of both; 4) The causality of every phenomenon is multiple. Causal relationships are complex and nonlinear; 5) The concept of uncertainty is introduced; 6) It is not possible to fragment a phenomenon for study. Phenomena must always be considered as wholes; 7) The context must always be taken into account; and 8) The observer's subjectivity is part of the process [12-14].

The biopsychosocial model identifies biological, psychological, and social factors as ever-present elements with interrelated influences on health and illness. biopsychosocial model incorporates qualitative aspects—thoughts, beliefs, behaviors, the social context, and interactions with biological processes—to better understand and manage illness and disability. In this model, biological, psychological, and social processes are integrated and inseparable. For example, thoughts and feelings cannot be separated from the biological processes occurring in the brain [15].

For the family physician, biopsychosocial approach skills are crucial. The family physician with a biopsychosocial approach will focus on the highest possible levels of systemic organization (family, community), rather than on the lowest possible levels of systemic organization (cells, organs). It should be noted that the defining characteristic of family medicine is the understanding of the patient and their illness based not only on symptoms and signs, but also on psychological and social factors. The family physician should be able to simultaneously adopt a scientific, interactive, and integrated approach to each problem from biomedical, psychological, and social perspectives, and should be able to combine these perspectives into a comprehensive view to achieve a complete understanding. Family physicians know that the patient's personality elements and social relationships play a significant role in illness, and these elements are as evident and necessary as the biomedical aspects. Therefore, the defining characteristic of family medicine is the understanding of the patient and their illness based not only on symptoms and signs, but also on the psychological and social factors that connect the patient to their context [16-22].