Community-Oriented Primary Care : Preparing Physicians for the Future in the United States

Abstract

As the health care system continues to evolve, there will be a shift in the care that physicians are asked to provide: from high-tech to patient-centered, from treatment-focused to prevention-focused. To improve the health of communities, health

providers need to apply skills beyond those contained in the traditional biomedical model and must strive to encompass the community-based public health model. Physicians must function effectively within a multidisciplinary team in order to

provide optimal health care in a setting of complex needs which far exceed the capacity of any one health discipline to address adequately. Students need first hand experience working with population issues in all learning settings-the hospital, the clinic and the community-to stimulate their interest in a population perspective. The medical education community needs to search for innovative, creative approaches to help the students develop the knowledge skills, and attitudes to practice. Community-oriented primary care (COPC) addresses the need to train practitioners in primary care practice that is community-responsive and that includes a public health perspective. It helps bridge the gap between academic medicine and the community it is designed to serve while fostering linkages among providers and community groups. It provides the structure for the various members of a public health team, often isolated from one another within their own institutions, to share ideas that focus on the need for integrity and simplicity in a community-responsive health care system. But perhaps most importantly, it restores the social contract between medicine and society.