[The integration of the behavioral sciences and biomedicine: the need for a metatheory]

Theoretical tensions and difficulties in the implementation of the biopsychosocial approach in health care uncover a problematic relationship between biomedicine and the behavioral sciences. The different professionals involved (e.g., psychologists and physicians) can interact through competition, collaboration, and integration and may be considered to represent health care subsystems, defined by profiles of their access to primary and secondary resources. Traditional institutionalization assigns the physician the hegemony in the system. Current challenges to this view underscore the need for a conceptual reformulation which should not only integrate--in a dialectical and complementary way--the contribution of physicians and other professionals, but also explicitly incorporate ethical and epistemological aspects derived from their relationship. Along with indications about the roles of metatheory, its relevance in the Latin American context is indicated.