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Rationale

The increasing number of physicians practicing under managed care and in community-oriented primary care practices necessitates expanding medical education to prepare graduates for population-based clinical practice. Population-based clinical practice includes (in a managed care setting) the health of an enrolled population and/or (in a community-based setting) the health of a population, in addition to that of the individual patient, through concern with resource allocation, epidemiology, and the care of patients whose needs are not currently met by the health care system.

Prerequisites

A basic understanding of epidemiology as it relates to the medical literature.
A basic understanding of health care financing issues.

Specific Learning Objectives

  1. Knowledge: Each student should be able to describe:
    1. how disease epidemiology in a community differs from that experienced in office or hospital practice.
    2. how health care financing and organization affect individual patients, physicians, and the community.
    3. how community and individual responses to health problems may be affected by both individual and community social characteristics.
    4. local government, social service, or community organizations that provide links between the underserved members of the community and the medical care systems.
    5. the barriers faced by his/her patients in the community setting.
  2. Skills: Each student should be able to:
    1. identify patients whose illnesses may put the community at risk.
    2. identify the unique characteristics of a community that affect an individual’s health as well as that of the community.
    3. consider how a patient’s community and cultural context may affect his or her approach to health care.
  3. Attitudes: Each student should:
    1. incorporate a population-based perspective in analyzing clinical problems.
    2. use, in daily patient care, an understanding of the social characteristics of a particular community that affect patient attitudes toward health.