J Health Behav Med Hist 2026-3.
Behaviour as an organ – the next concentration in healthcare.
Robert C. van de Graaf, MD
Director, MEDTCC Institute for Health, Behaviour, Medicine and its History, The Netherlands
In healthcare, we know exactly where things become complex.
For a bypass, a tumour, or brain surgery, we build teams, pool expertise, and concentrate experience. We call this highly complex care – and rightly so.
But while hospitals fight to retain surgical procedures and insurers define volumes, another development is unfolding almost unnoticed. A new form of highly complex care is emerging.
For an organ we have never recognised as autonomous:
the behavioural organ.
The forgotten organ
The organ that enables us to move, chew, swallow, choose, delay, and persist. That governs what we do – and what we refrain from doing. An organ that, when dysregulated, can pull the entire body down with it.
Smoking, drinking, eating, sitting, swallowing, gambling, gaming, absenteeism – behaviours that reinforce or trigger one another,
like the sides of a Rubik’s cube. Try to align one face, and the others immediately shift.
This is precisely the area of care we are least prepared for, while it causes the greatest burden of disease. And is often the disease itself.
Unhealthy lifestyle behaviour: originating, maintaining, amplifying.
Fragmented care
The patient with an accumulation of lifestyle problems, multiple diagnoses, and a life full of counteracting circumstances finds no integrated treatment anywhere.
We cut the behavioural organ into pieces: nutrition coach, exercise coach, psychologist, addiction physician, breathing coach, sleep coach, lifestyle coach, screen-use coach, smoking cessation coach, burnout coach, medical coach, medication withdrawal clinic – each addressing a fragment of the same organ.
Everyone does their best. But no one oversees the whole. And certainly not the interaction between behaviour and the rest of the body. Not even the patient.
The patient becomes subject to a system that divides them into symptoms, disciplines, and minutes. A form of care that ragments,
while behaviour is precisely what connects.
What works
Yet we know what works. Intensive, when necessary multidisciplinary treatment, under behavioural medicine leadership and with shared goals.
The behavioural organ is not a side issue. It is an organ – living, learnable, vulnerable. A delicate organ that, like the heart or the brain, can become dysregulated, recover, and relearn how to function – but only if treated with precision.
In mild cases, primary care guidance may suffice. But in severe dysregulation, highly complex behavioural medical care is required: concentrated, multidisciplinary, clinical when needed.
With physicians, psychologists, physiotherapists, dietitians, and others – provided they are specialised in behavioural medicine.
Working together on one treatment plan, around one person
and their behavioural organ.
The next concentration
We have centres for the heart, brain, and lungs. Perhaps it is time for centres of expertise for the behavioural organ. Where we no longer operate on the consequences, but treat the behavioural organ itself, with the same surgical precision it deserves.
If the behavioural organ is the most decisive organ of our time,
then this is the next logical concentration.
Translation from: Gedrag als orgaan – de volgende concentratie in de zorg (Arts & Auto).