The Public's Health Is Too Important To Be Left to Public Health Workers

Abstract

Practicing physicians are the key to effective health promotion and disease prevention in their communities, according to the Guide to Clinical Preventive Services released in May by the United States Preventive Services Task Force. The Guide focuses on the clinical practitioner and strongly advocates integrating preventive activities into clinical practice. It also shows how required interventions can be done by the physician normally responsible for ongoing care. Case-finding is emphasized as a viable and desirable strategy in early detection of disease. The report also acknowledges behavioral and lifestyle components of risk factors for disease and the physician's opportunities to promote change in patients' risky behavior. We discuss the implications of including patient education and counseling in the physician's clinical armamentarium, highlighting changes in educational and health care delivery systems that can make such interventions work in preventive programs. The soundness of a best-evidence synthesis method to formulate recommendations and the use of a priori scientific rules to determine the effectiveness of many current and proposed preventive activities are hallmarks of the task force's approach to integrating science and clinical practice.