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Integrating clinical medicine and population health: where to from here?
Andrew N Rouble1, Rim Zayed2, Bart J Harvey3,4
1Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Insights
Clinical population medicine (CPM) integrates population health into practice. While valuable for addressing social determinants of health, CPM must complement, not conflict with, public health efforts.
Area of Science:
- Healthcare Management
- Public Health Policy
- Clinical Practice Integration
Background:
- Healthcare cost containment drives interest in population-level outcomes.
- Clinical population medicine (CPM) is proposed as a novel integration of population health into clinical practice.
Purpose of the Study:
- To examine the function and utility of clinical population medicine (CPM).
- To analyze the scope and potential conflicts of CPM with public health practice.
Main Methods:
- Literature review to identify inconsistencies in CPM's mandate.
- Analysis of cited activities defining CPM in relation to established clinician roles.
Main Results:
- CPM's mandate is inconsistent, ranging from social determinants of health to community health planning.
- CPM activities often overlap with or conflict with public health practice.
- Many "CPM" activities represent established clinician research, evaluation, or advocacy.
Conclusions:
- CPM can encourage clinicians to consider community determinants in practice.
- CPM must be complementary to and distinct from public health practice to be effective.
Abstract:
Efforts to contain healthcare costs have led a renewed clinician interest in addressing population-level outcomes, with some proposing that the integration of population health into clinical practice represents a novel concept entitled "clinical population medicine" (CPM). This commentary offers an examination of the function and utility of CPM. In reviewing relevant literature, we note several inconsistencies in CPM's purported mandate, which ranges from simply incorporating the social determinants of health into clinical practice to broad involvement in community health planning. The latter of these seems to overlap, and potentially conflict, with the work of public health practitioners, and cited examples of activities used to define "CPM" seem to apply a label to established clinician activities around the determinants of health that would be captured more simply as research, evaluation, or advocacy undertaken by clinicians in other areas of practice. Our analysis suggests that CPM may have value in encouraging clinicians to incorporate community determinants and contextual considerations into their practices, but must take care to remain complementary and distinct from public health practice.
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