HOW TO PRACTISE POPULATION MEDICINE by Muir Gray
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‘Clinicians have a responsibility to the population they serve, as well as to the individual patients who happen to have been referred to them’ J. A. MUIR GRAY
What is population medicine?
Imagine you are a rheumatologist in Barchester Royal Infirmary. Last year you saw 346 patients with rheumatoid arthritis and worked hard to improve the effectiveness and safety of the service offered, struggling to reduce its cost while at the same time ensuring that each of the 346 patients had a good experience. This is evidence-based, patient-centred, and high quality medicine, all necessary and meritorious, but, applying the principles of population medicine, you estimate that about 1000 people in Barsetshire’s population of 647,000 have rheumatoid arthritis. Not all of them have been diagnosed, and some may have been wrongly diagnosed. A small survey allows you to estimate that 200 of those not referred would derive great value from your service. Rather than seeking extra resources, you build a network of general practitioners, pharmacists, physiotherapists, and patients, and define clear pathways using the internet to run the network and offer patients unbiased information. You and your team feel responsible for all the resources, both financial and carbon, used by the population-based service and you write an Annual Report to be accountable to the population served and to let you compare your service with other similar services.
How To Practise Population Medicine explains these new responsibilities, and provides the
new skills for the 21st century clinician. It focuses on the clinician’s responsibilities for
productivity, efficiency, better value, sustainability, equity, and the whole population. In
addition, it sets out the wide range of skills needed – to create systems, build networks, map pathways, engage both patients and the public, manage knowledge, build and use a budget, and create the right culture. This is the future, and it is needed now.
What is population medicine?
Imagine you are a rheumatologist in Barchester Royal Infirmary. Last year you saw 346 patients with rheumatoid arthritis and worked hard to improve the effectiveness and safety of the service offered, struggling to reduce its cost while at the same time ensuring that each of the 346 patients had a good experience. This is evidence-based, patient-centred, and high quality medicine, all necessary and meritorious, but, applying the principles of population medicine, you estimate that about 1000 people in Barsetshire’s population of 647,000 have rheumatoid arthritis. Not all of them have been diagnosed, and some may have been wrongly diagnosed. A small survey allows you to estimate that 200 of those not referred would derive great value from your service. Rather than seeking extra resources, you build a network of general practitioners, pharmacists, physiotherapists, and patients, and define clear pathways using the internet to run the network and offer patients unbiased information. You and your team feel responsible for all the resources, both financial and carbon, used by the population-based service and you write an Annual Report to be accountable to the population served and to let you compare your service with other similar services.
How To Practise Population Medicine explains these new responsibilities, and provides the
new skills for the 21st century clinician. It focuses on the clinician’s responsibilities for
productivity, efficiency, better value, sustainability, equity, and the whole population. In
addition, it sets out the wide range of skills needed – to create systems, build networks, map pathways, engage both patients and the public, manage knowledge, build and use a budget, and create the right culture. This is the future, and it is needed now.