Simon’s views models as constructed representations of real-life phenomenon. In medicine however, we must understand the phenomenon within the specific context of the patient since “no two patients have instances of precisely the “same” disease.” (Ibid.) Simon also points out how models change over time and our current label of “cystic fibrosis” may become separated into different models representing the same phenomenon.
What is interesting here is the tension between models and their grounding in observable facts and their conceptual (or “modal”) development. In medicine, since the model does not intrinsically fit nicely onto any individual patient (even in Simon’s extremely simplistic picture), it seems the concept would evolve differently than models in physics. That is to say that our model of “cystic fibrosis” must be much more flexible than a model of “gravity” since it, at any given time, must be generally applicable to many cases which can substantially diverge from each other. This is different from gravity which makes much more general claims which are tested different. However, it is hard to see Simon making this argument consistent with his view that “the real world has a modal…structure, and for that model to be acceptable, its modal structure must reflect the real world’s modal structure” (357/8.) This seems to make medicine something that is ultimately reducible to the same thing as physics since each aims at explaining the real structures of the world (which would make them fundamentally the same as each other.)