Community Medicine

Community medicine is concerned with the prevention of disease, the determinants and natural history of disease in populations, and the influence of the environment and of society on health and disease. There has long been a dichotomy of opinion as to whether the prevention of disease can be realized best within the confines of clinical medicine or totally divorced from the treatment of individuals. A strong case can be made that prevention of disease is best achieved by separating community medicine a reasonable distance from clinical practice. The objectives of the 2 practices are basically different. The clinician offers his/her best service when dealing with an individual who has a complaint. The community medicine practitioner is devoted to preventing the occurrence of complaints in the population. The role of the clinician in the prevention of disease is important but limited. Education for medical practice should begin by defining the problem to be faced. The future practitioner should be educated about these problems and then direct his/her practice to their solution. If this approach is successful the problems should be changed and improved or solved. This in turn should be perceived by education which should modify its training for practice accordingly. This procedure is followed to a reasonable degree in both clinical and community medicine practice and education. It is particularly important in community medicine where the problems must be sorted out of a complex social matrix. Some developing countries have tried to solve their problems by the production of doctors. In this venture they have often been very successful, but the result has been a drain on the financial resources of the country and little improvement in the health of the majority of the population. Developed countries have placed their faith in the treatment of disease to the exclusion of prevention and have been confronted by the rising costs of service and a stable or even increasing bur