Clinical hypothesis testing in family practice: a biopsychosocial perspective

Recent studies of the clinical problem-solving process have demonstrated the importance of hypothesis generation and testing in shaping the nature of information gathering, differential diagnosis, and therapeutic decision making. Family physicians and other primary care physicians are often faced with complex and undifferentiated illness problems that require them to go beyond the traditional biomedical model and entertain an expanded range of psychosocial hypotheses. In this paper the authors draw upon clinically relevant behavioral and social science research and propose several biopsychosocial hypotheses that have proven useful in the management of family practice patients. Seven illustrative case studies are presented, and some implications of this biopsychosocial paradigm for practice, research, and teaching are discussed.