Conference Participants

DAVID AXELROD, M.D., Commissioner, New York State Department of Health, Albany, NY, USA

HARVEY BARKUN, M.D., Executive Director, Association of Canadian Medical Colleges, Ottawa, Canada

SIR DOUGLAS BLACK, M.D., Past President, Royal College of Physi• cians, Reading, England*

MAXINE E. BLEICH, President, Ventures in Education, New York, NY, USA

SIR CHRISTOPHER BOOTH, M.D., Past President, The Royal Sociey of Medicine, London, England*

MARKLEY H. BOYER, M.D., Professor of Community Medicine, School of Medicine, Tufts University, Boston, MA, USA

JO IVEY BOUFFORD, M.D., Visiting Fellow, King's Fund College, Lon• don, Clinical Associate Professor of Pediatrics and of Epidemiology and Social Medicine, Albert Einstein College of Medicine (Former President, New York Health and Hospitals Corporation), New York, NY, USA

ROGER J. BULGER, M.D., President, Association of Academic Health Centers, Washington, D.C., USA

RUTH E. BULGER, Ph.D. Director, Division of Health Sciences Policy, Institute of Medicine, National Academy of Science, Washington, D.C., USA

RT. HON. LORD BUTTERFIELD, M.D., (Retired Vice-Chancellor and Regius Professor of Medicine, University of Cambridge), Cambridge, England

267 268 Conference Participants

ROBERT. D. COHEN, M.D., Professor of Medicine, London Hospital Medical College, London, England

JULIA E. CONNELLY, M.D., Associate Professor of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA *

DAVID S. GREER, M.D., Dean and Professor of Community Health, School of Medicine, Brown University, Providence, RI, USA*

JOHN D. HAMILTON, M.D., Dean and Professor of Medicine, Faculty of Medicine, University of Newcastle, Newcastle, Australia

THOMAS S. INDI, M.D., Professor and Head, General Internal Medicine and Professor of Health Services, School of Medicine, University of Washington, Seattle, WA, USA*

HARRY S. JONAS, M.D., Director, Division of Undergraduate Medical Education, American Medical Association, Chicago, IL, USA

ARTHUR KAUFMAN, M.D., Professor of Family, Community, and Emer• gency Medicine, School of Medicine, University of New Mexico, Al• buquerque, NM, USA

GEORGE I. LYTHCOTT, M.D., Retired Dean, City University of New York Medical School, New York, NY, USA

ARTHUR J. MAHON, ESQ., President, The Royal Society of Medicine Foundation Inc., and Vice Chairman, Board of Overseers, Cornell Med• ical College, New York, NY, USA

MICHAEL G. MARMOT, M.B., Ph.D., Professor of Community Medi• cine, University College and Middlesex School of Medicine, London, England

WILLIAM D. MATTERN, M.D. Associate Dean and Professor of Medi• cine, University of North Carolina, Chapel Hill, NC, USA

LIONEL E. McLEOD, M.D., Vice-President, Medical Services, University Hospital, University of British Columbia, Vancouver, Canada*

IAN R. McWHINNEY, M.D., Professor of Family Medicine, Faculty of Medicine, University of Western Ontario, London, Canada Conference Participants 269

THOMAS H. MEIKLE, Jr., M.D., President, Josiah Macy Jr. Foundation, New York, NY, USA *

DAVID H.H. METCALFE, M.B., B.S., Professor and Chairman, Depart• ment of General Practice, University of Manchester Medical School, Manchester, U.K. *

VICTOR R. NEUFELD, M.D., Director, Centre for International Health, and Professor of Medicine and Clinical Epidemiology, Faculty of Health Sciences, McMaster University, Hamilton, Canada*

WILLIAM G. O'REILLY, Executive Director, The Royal Society of Med• icine Foundation Inc., New York, NY, USA*

PETER RICHARDS, M.D., Ph.D., Dean and Professor of Medicine, St. Mary's Hospital Medical School; Pro Rector (Medicine), Imperial Col• lege of Science, Technology, and Medicine, London, England

MUTYA SAN AGUSTIN, M.D., Director, Department of Ambulatory Medicine, North Central Bronx Hospital/Montefiore Medical Center; As• sociate Professor, Pediatrics, Albert Einstein College of Medicine, Bronx, New York, NY, USA *

DAVID A. SHAW, M.D., Dean and Professor of Neurology, University of Newcastle Medical School, Newcastle-upon-Tyne, U.K.

ROBERT A. SPASOFF, M.D., Professor and Chairman, Department of Epidemiology and Community Medicine, Faculty of Medicine, Univer• sity of Ottawa, Ottawa, Canada*

PAULA L. STILLMAN, M.D., Curriculum Dean and Professor of Pedi• atrics, University of Massachusetts Medical School, Worcester, MA, USA

JOHN WADE, M.D., Director, The Manitoba Health Services Commission (Former Dean and Professor of Anaesthesiology, Faculty of Medicine, University of Manitoba), Winnipeg, Canada

MAMORU WATANABE, M.D., Dean and Professor of Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada

KERR L. WHITE, M.D., Retired Deputy Director for Health Sciences, The Rockefeller Foundation, New York, Charlottesville, VA, USA * 270 Conference Participants

SIR DAVID INNES WILLIAMS, M.D., President, The Royal Society of Medicine, London, England

ANTHONY B. ZWI, M.B., Lecturer, Department of Community Medicine, University College and Middlesex School of Medicine, London, England

* Members of the Planning Committee Name Index

Abbott, L., 132, 155 Black, D., 1, 15,81, 102, 104, 107, Acheson, E.D., 107, 108 108,267 Ackerman, B.A., 27, 50 Blane, D., 74, 81, 87,93, 104 Adams, P.F., 69, 103 Blaxter, 68, 69, 104 Adkins, R.J., 39, 50 Bleich, M.E., 267 Albutt, T.C., 3 Blendon, R.J., 1, 15 Alpert, J.J., 133, 155 Bloom, R., 136, 144, 156 American Board of Internal Medicine, Bloom, S.W., 47, 50 33,45,50 Bloomsbury Health Authority, 66, 104 Anderson, G.R., 39, 50 Booth, C., 55, 267 Antonovsky, A., 41, 50 Boufford, J.I., 249, 267 Ameill, B.P., 139, 155 Boyer, M.H., 267 Arraiz, G.A., 76, 103 Breslow, L., 74, 78, 99, 104 Ashby, E., 129 Brezenoff, S., 144, 155 Austin, C.A., 57, 58 Briefel, R.R., 66, 107 Axelrod, D., 52, 267 Bright, R., 3 Britton, M., 97, 104 Bailar, J.C., 100, 103 Brook, R.H., 97, 106 Brown, M.H., 58 Balaraj an , R., 101, 103 Bruner, J.S., 57, 58 Ball, J.R., 35, 52 Brunner, E., 78, 94, 95, 105 Barker, D.J.P., 97, 104 Bubolz, T.A., 110, 111 Barkun, H., 202, 267 Bulger, R.E., 267 Barnett, P.G., 133, 155 Bulger, R.J., 225, 267 Bartley, M., 74, 81, 87, 93, 104 Bunker J.P., 29, 50 Battista, R.N., 28, 50 Butterfield, Rt. Hon. Lord, 125, 267 Beaulieu, M., 121, 125 Becker, L., 83, 104 Canada Health Promotion Survey, 68 Belenky, M.F., 41, 50 Canada Health Survey, 68 Bentsen, B.G., 83, 104 Carline, J.D., 39, 51 Berenberg, W., 111 Cassell, E.J., 33, 50 Bergmann, B.B., 35, 50 Chalmers, T.C., 111 Beuregard, K., 81, 106 Chambers, L.W., 120, 125 Bevan, A., 19 Charney, E.. 133. 155 Bismarck, 6, 53 Chassin, M.R., 97, 106

271 272 Index

Chemiack, M.G., 29, 50 Eisenberg, C., 35, 51 Child, e.G., 111 Eisenberg, J.M., 29, 50 Chong, J.P., 120, 125 Eisenberg, L., 5, 15, 17 Chongtrakul, P., 120, 125 Elliot, D.L., 70, 105, 138, 155 Chronic Disease in Canada, 75 Elwood, J.M., 69, 104 Clark, R.M., 170, 172,201 Engel, C., 169 Clarke, R., 170 Engle, G.L., 28, 50, 226, 227 Clifford, P., 90, 105 Epidemiological Society of London, 3, Clinchy, B.M., 41,50 15 Cob1iner, W.G., 145, 155, 156 Evans, R.G., 61, 62, 104 Cohen, E., 146, 156 Cohen, R.D., 247, 248, 249-254, 267 Faculty of Medicine, 171, 173,201 Commission on Health Research for Farley, E.S., 83, 104 Development, 4, 15 Farrell, G., 144, 155 Connelly, J.E., 18,267 Fassig, J., 144, 156 Cooney, T.G., 138, 155 Feeney, A., 78, 94, 95, 105 Cullen, M.R., 29, 50 Feltovich, J., 137, 155 Cullen, T.J., 39, 50 Fink, A., 97, 106 Cu1p, W.J., 110, 111 Fishman, A.P., III Cumberland, W.G., 74, 78, 99, 104 Fleming, D., 81, 105 Flexner, A., 18, 19, 58 Daley, J., 139, 155 Foucault, M., 58 Daniels, N., 26, 50 Fraser, R.D., 109, 110 Dasco, C.C., 132, 155 Freeman, H.P., 95, 96, 105 Davey Smith, G., 74, 78, 81, 87, 94, Freeman, J.L., 111 95, 104, 105 Freeman, W.L., 83, 104 Davidson, N., 81, 92, 97, 106 Froom, J., 83, 104 Davis, A., 145, 155 Fulop, T., 101, 104, 106 Davis, D.L., 98, 104 Fund for the City of New York, 144 Dawson, D.A., 69, 104 DeBakey, L., 23, 51 Gamble, V.N., 40, 50 De1banco, T.L., 139, 155 Gastel, B., 4,15,32,51,52 Demeny, D., 145, 155 Gaste1, N., 137, 156 Department of Health, 75, 77, 82, 89, Geieger, J., 35, 51 104 George, D., 168, 205 Devin, J., 35, 51 Gertman, P.M., 139, 155 DeVries, M.J., 31, 50 Gillies, P.A., 69, 104 Dickinson, J., 174,201 Gilmore, G., 44,51 Dickman, R.L., 133, 155 Ginzberg, E., 32, 41, 50, 133, 134, Dickstein, L., 41, 50 137, 155 Doherty, R.L., 3, 15, 187,201 Girard, D.E., 138, 155 Donaldson, 96, 104 Gloyd, S., 35, 51 Dowler, J.M., 70, 104 Goldacre, M.J., 81, 82, 104 Duban, S., 42, 51 Goldberger, N.R., 41, 50 Goldfrank, L., 136, 144, 156 Ebert, R.H., 32, 41, 50, 132, 138, Gomby, D.S., 29, 50 155 Goodnow, J.J., 57, 58 Editorials, 94, 104 Gordon, D.R., 28, 51 Einstein, A., 14 Gordon, J.1., 178,201 Index 273

Green, L.A., 83, 104 Knox, E.G., 80, 81, 90, 105 Greenberg, B.G., 57, 59 Kolata, G., 31, 33, 51 Greenwood, 8 Komblatt, J.E., 138, 157 Greer, D.S., 16,43,51, 138, 155, Kosecoff, 1., 97, 106 267 Koska, M.T., 36, 51 Greer, T., 39, 51 Kroenke, K., 138, 155 Guilbert, J.-J., 101, 104 Kuczmarski, R., 66, 107 Kuhn, T.S., 226, 227 Haines, A., 29, 51 Halperin, A.K., 43,51 Lalonde, 114 Hamerman, D., 136, 144, 156 Lamberts, H., 83, 105 Hames, C., 83, 104 Lane, R., 109, 110 Hamilton, J.D., 18, 202, 206, 267 Last, J.M., 73, 105 Hansbarger, C., 42, 51 Lawrence, R.S., 28, 50 Hardin, F., 9, 15 Leeder, S., 170, 173, 188 Hardy, A.M., 69, 103 Levenson, D., 134, 156 Harlan, L.C., 88, 89, 104 Lightfoot, S.L., 40, 51 Harlan, W .R., 87, 104 Linz, D.H., 138, 155 Hastings, C., 3 Lloyd, D.M., 191, 194 Havelock, P., 33, 52 Lock, M., 28, 51 Haynes, R.B., 29, 52, 56, 59 Locke, J., 6 Head, 1., 78, 94, 95, 105 Louis, P.C.A., 3 Heller, R.F., 179, 191, 194 Ludmerer, K.M., 24, 51 Hovind, O.B., 90, 105 Lukomnik, J.E., 48,51 Lythcott, G.I., 203, 268 Iliffe, S., 29, 51 Innis, H.A., 56, 58 McCarthy, M., 81, 105 Inui, T.S., 31, 51, 52, 53, 55, 56, 58, McCluhan, M., 56 110, 267 McCord, c., 95, 96, 105 Irby, D., 44, 51 McCormick, A., 81, 105 MacDonald, P.J., 120, 125 Jacobson, B., 78, 81, 94, 106 McDowall, M.E., 93, 105 Jefferson, 6 McKeigue, 96, 105 Jonas, H.S., 127, 268 McKeown, T., 75, 105 Jordan-Simpson, D.A., 70, 104 McLachlan, G., 2, 15 Joseph, M., 145, 156 McLeod, L.E., 129, 268 Josiah H. Macy Jr. Foundation, 4, 15 Maclin, G., 145, 155 McPherson, K., 90, 105 Kahn, K.L., 97, 106 McWhinney, I.R., 56-59, 268 Kantrowitz, M., 101, 104 Maddison, D.M., 167, 168, 169, 170, Kark, S.L., 29, 51 171, 172, 190,201,205 Karmel, P., 165-167, 201 Madhaven, S., 144, 156 Kaufman, A., 42, 43, 51,101, 104, Mahon, A.J., 268 159, 268 Manning, P.R., 23, 51 Kehrer, B.H., 29, 50 Mao, Y., 109, 110 Kellerman, A.L., 29, 51 Marmot, M.G., 78, 93-95, 98, 105, Kellerman, G., 171 107, 109, 268 Kindig, D.A., 138, 157 Martin, J., 70, 105 Klein, R., 2, 15 Mattern, W.D., 268 274 Index

Matz, R., 136, 144, 156 Olsen, G., 184 Meikle, T.H., Jr., 268 Ontario Health Review Panel, 118, 125 Meltzer, H., 70, 105 Ontario Ministry of Health, 122, 125 Mennin, S., 42, 51, 101, 104, 105 O'Reilly, W.G., 268 Merrick, N.J., 97, 106 Organization for Economic Co- Metcalfe, D.H.H., 204, 225-229, 268 operation and Development, 1, 15 Midtling, J.E., 133, 155 Osmond, C., 97, 104 Miller, W.J., 91, 105 Milligan, S., 133, 155 Paccione, G.A., 146, 156 Minister's Advisory Group on Health Panel on Health Goals for Ontario, Promotion, 118, 125 118, 125 Monheit, A., 81, 106 Panel on the General Professional Morgan, P.P., 123, 125 Education of the Physician and Myers, W.W., 39, 50 College Preparation for Medicine, 32,52,255 Nadelson, C.C., 41, 50 Park, R.E., 97, 106 Nardone, D.A., 139, 156 Parker, D.L., 78-80, 106 National Center for Health Statistics, Parsons, P.E., 87, 88, 89, 104 66, 80, 83, 105 Pasteur, L., 11 Navarro, V., 133, 156 Patel, C., 78, 94, 95, 105 Network of Community-Oriented Pendleton, D., 33, 52 Educational Institutions for Health Perkoff, G.R., 133, 156 Sciences, 64, 101, 105 Perrin, E.B., 111 Neufeld, V.R., 45, 51, 63, 101, 106, Peters, L., 68, 106 120, 125-127, 129, 227, 268 Petersdorf, R.G., 133, 156 New York City Department of Health, Petty, W., 12 135, 156 Pickering, R.J., 120, 125 New York City Health & Hospitals Pickles, W.N., 29, 52 Corporation, 134, 156 Pitter, D., 136, 144, 156 New York State Commission on Pless, B., 140, 157 Graduate Medical Education, 154, Pole, J.D., 81, 102, 104 156 Powis, D.A., 172,201 New York State Council on Graduate Premier's Council on Health Strategy, Medical Education, 3, 15, 155, 118, 125 156 Prime, M., 109, 110 NHS Management Executive, 106 Niebauer, L.J., 83, 104 Nightingale, F., 19 Quijano, E.C., 145, 155, 156 North, F., 78, 94, 95, 105 Quiroga, J., 35, 51 North Central Bronx Hospital, 135, 156 Radical Statistics Health Group, 81, Nuelsen, P.H., 139, 155 106 Nutting, P.A., 29, 51, 139, 156 Ramsey, R., 44, 51 Reagan, M.D., 137, 156 Oates, M.J., 120, 125 Recommendations on Basic Medical Odegaard, C.E., 31, 49, 51 Education, 241, 248 Odell, 96, 104 Recommendations on Training of Office of Population Censuses and Specialists, 245, 248 Surveys, 70-71, 73, 74, 82, 84- Redman, S., 202 86,96, 106 Reid, S., 179 Index 275

Report of the Ontario Health Review Shultz, J.M., 78-80, 106 Panel, 100, 106 Singer, A.M., 133, 157 Rice, D.P., 78-80, 106 Skeff, K.M., 138, 157 Richards, P., 229, 268 Smith, A., 78, 81, 94, 106 Richards, R., 101, 106 Smith, C.T., 133, 157 Rodgers, B., 70, 107 Smith, T., 181 Roemer, M.I., 132, 156 Soler, N.G., 137, 155 Rogers, C., 42, 52 Solomon, D.H., 97, 106 Rogers, D.E., 4, 15,32,51, 137, Spasoff, R.A., 109, 110, 125-127, 139, 156 129, 268 Rootman, I., 68, 106 Stansfeld, S., 78, 94, 95, 105 Rose, G., 97, 103, 106 Starfield, B., 138, 140, 157 Rosenbaum, M., 81, 105 Starr, P., 26, 52 Rosenblatt, R.A., 137, 156 Stephen, T., 68, 106 Rosenstock, L., 29, 50 Stewart, M., 33, 52 Rosser, W.W., 83, 104, 121, 125 Stillman, P.L., 251, 268 Roter, D., 33, 52 Stoddart, G.L., 61, 62, 104 Rousseau, J., 6 Suberman, c., 136, 144, 156 Royal Commission on Medical Submissions to the Karmel Education, 55, 56 Commission, 166, 202 Royal Society of Medicine, 4, 15 Swanson, A.G., 132, 157 Rutstein, D. D., 111 Tarlov, A.R., 133, 157 Sackett, D.L., 29, 52, 56, 59 Tarule, J.M., 41, 50 San Agustin, M., 136, 137, 144, 145, Task Force on the Staffing and 155, 156, 268 Funding of Clinical Academic Saskatchewan Commission on Units, 2, 15 Directions in Health Care, 2, 15 Tate, P., 33, 52 Saunders, N., 184 Taylor, C.M., 138, 157 Saunders, N.A.S., 178, 202 Terrill, A.M., 137, 155 Schlenker, T., 35, 51 Thomas, J.W., 87, 104 Schofield, T., 33, 52 Tosteson, D.C., 41, 42,52,243,248 Schorr, L.B., 35, 52 Townsend, P., 81, 92, 97, 106 Schroeder, S.A., 25, 32,43,47,52, Tugwell, P., 29, 52, 56, 59, 120, 125 132, 138, 156, 157 Schuster, B.L., 32, 52 United Hospital Fund of New York, Schwartz, C.E., 146, 156 135, 157 Schwartz, J., 98, 104 United States Department of Health Schwarz, M.R., 39, 50 and Human Services, 72-73, 80, Schwenk, T.L., 132, 157 94, 107 Scrimshaw, N., 35, 51 University Hospitals Association of Seidel, H.M., 133, 157 England and Wales, 63, 106 Seifert, M., 83, 104 Seldin, D.W., 31, 52 Vessey, M.P., 81, 82, 104 Semenciw, 76, 106 Vinson, T., 169 Shaw, D.A., 20, 268 Virchow, R., 14, 17,53 Shelton, R.M., 111 Short, P., 81, 106 Wade, J., 254, 268 Showstack, J.A., 25, 52, 132, 157 Wadsworth, M.E.J., 70, 107 276 Index

Walton, 1.1.,32,52 Williams, T.F., 57, 59 Warner, K.E., 78, 98, 107 Winkenwerder, W., 35, 52 Warren, R., 68, 106 Wong, T., 76, 103, 110 Watanabe, M., 161, 269 Wood, M., 83, 105 Watennan, R., 42, 51 Wooliscroft, J .0., 132, 157 Webb, D.W., 139, 156 W orId Conference on Medical Wennberg, J.E., 90, 105,107,111 Education, 32, 52 White, I., 78, 94, 95, 105 W orId Federation for Medical Education, 4, 15 White, K.L., 3, 9, 15, 18,31,52,57, World Health Organization, 100, 101, 59, 60, 63, 107, 114, 121, 123- 107 125, 179, 202, 269 Woteki, C.A., 66, 107 Whitehead, A.N., 57, 59, 81, 107 Whitehead, M., 106, 107 Zones, J.S., 25, 43, 47, 52, 132, Wigle, D.T., 91, 105, 109, 110 157 Williams, D.I., 157,269 Zwi, A.B., 107, 109,269 Subject Index

Accidents, death from, 87-88 Chronic disease, levels of effect, 213 Advocates, physicians as, 30-31 Cigarette smoking, death from, 76, 78 AffIrmative action programs, 40 Clinical pharmacology, University of Age Newcastle, 181 age specific impact of disease/health Cohort, importance of data, 98 in Information and Analysis Unit, Committee on Medical Aspects of 72-75 Food Policy, 69 in research data, 92 Communication, impact of, 10-11, 17 years of potential life lost measure, Community Health Research Unit, 73-75 117-118 AIDS, death from, 80 Community health workers, 218 Alcohol use, death from, 78-79 Community medicine, University of Ambulatory Sentinel Practice Network, Newcastle, 179-180 83 Competition American Society for Clinical as barrier to change, 47-48 Investigation, 4 effects of, 53 Annual Health Report, 66 Conservatism as barrier to change, 47 Audit procedures, 247, 253 Consumer Controlled Health Care Australia System, 2 call for reform, 3 Costs of health services, 88-90 national developments in health/ Course requirements, population-based medical education, 186-189 medicine, 240-242 See also University of Newcastle Curriculum learner-centered approach, 42 Behavioral science and medicine, opportunities for change, 41-44 University of Newcastle, 180-181 population-based medicine, 238-239 Biomedical science, in medical school primary care model, 146-148 education, 32 sites for teaching/learning, 43-44 Black Report, 92 teachers, 43 University of Newcastle, 174-178 Canada goals of investigative commissions, Data on health, 63-67 2 age specific impact of disease, 72- sources of health information, 67 75 Case manager, physician as, 28 cost of services survey, 88-90

277 278 Index

disability surveys, 70 Health, Law, and Ethics, University of forms of information effects of, 66 Newcastle, 182-183 Health Intelligence and Analysis Health and Activity Limitation Survey, Units, 63 70 information about preventable Health and Lifestyles Survey, 68-69 deaths, 75-80 Health Care Analysis and Intelligence life-style information, 69-70 Center, costs of operation, 123 limitations of data, 90 Health Divide, 92-93 and perceptions of community, 68- Health for All by the Year 2000, 101 69 Health Intelligence and Analysis Unit, population based data collection, 64, 101, 103 66 Health Intelligence Unit, 60 risk of death information, 71-72 Educating Future Physicians for use and planning of services, 80-88 Ontario example, 118-119 use in influencing medical experiences to date, 119-124 education, 100-102 functions of, 115 Death future view for, 124-125 information about preventable McMaster University example, 116- deaths, 75-80 117 mortality and Newcastle Health nature of, 115-116 Area, 194-196 rationale for, 113-115 risk of death information, 71-72 University of Ottawa example, 117- Descriptive epidemiology, population• 118 based medicine, 236, 252 Health Priorities Analysis Unit, 115- Diagnosis-related groups, 137 116, 120 Disability surveys, Health Information Health services and Analysis Unit, 70 cost of services survey, 88-90 Disease management, 100-10 1 costs, 88-90 use and planning of services survey, Educating Future Physicians for 80-88 Ontario, Health Intelligence Unit Health statistics example, 118-119 impact of, 9-10 Environment, awareness of, 12 nature of, 8 Environmental and occupational health, Health watcher, physician as, 29 University of Newcastle, 180 Hospital stay, data on, 84-87 Ethnicity in research data, 94-96 Evaluation of health care, population• Information technology, impact of, 9, based medicine, 238 17 Infowatch, 117 Gatekeeper, physician as, 29 Internal medicine, University of Gender in research data, 91-92 Newcastle, 182 General Household Survey, 68 International Classification of Primary General Practice Morbidity Survey, 83 Care, 83 Geographic distribution of disease, Interpersonal skills in medical school importance of data, 97-98 education, 33

Harvard, New Pathway, 42 Learning, learner-centered approach, Hawthorne effect, 10, 207 42 Index 279

Liaison Committee on Medical issues related to areas of study, 32- Education, 127-129 35 Life expectancy, data on health, 71-72 mission of, 23-27, 221 Life-style population-based medicine, 145- affecting factors, 69 148, 150-151 information for data on health, 69- power sources in, 45-47 70 proposed spheres of learning for, Lisbon Initiative, 100 18-19, 22, 61-62 and public trust, 8-9 McMaster University, 63 questions as stimulus for change, 37 Health Intelligence Unit example, recruiting methods, 38-41 116-117 resistances to change, 45-48 Management by increment strategies, time factor in course of study, 35 35-36 Methode numerique, 3 Managerial era and health services, Minority groups and medical school, 12-13 40-41 Medical developments Mission of medical schools, 23-27 awareness about environment, 12 effects of research efforts, 222-223 national mission, 36 better communication, 10-11 and research, 37-38 information technology, 9 Molecular biology, impact of, 11-12, managerial climate, 12-13 17 molecular biology, 11-12 use of health statistics, 9-10 National Ambulatory Medical Care Medical genetics, University of Survey, 83 Newcastle, 183 National Cancer Institute, goals of, Medical informatics, University of 99-100 Newcastle, 183 National Health and Nutrition Medical profession, limitations of Examination Survey, 69 traditional approaches, 7-9 National Health Interview Survey, 68, Medical Research Council Survey of 69 Health and Development, 70 National Health Service, 2, 20, 125- Medical schools 126, 211 challenges / opportunities to, 6-7, New York City, public health care, 36-38 133-137 curricular opportunities for change, New York State, Commission of 41-44 Graduate Medical Education, 154- data on health, 63-67 155 dimensions of medical education, North Central Bronx Hospital 208 financing of, 149-150 and distribution of health in society, institutional competencies for, 137- 63 140 educational evaluation and change, medical education, 145-148 44-45 primary care model, 140-143 enumeration of proposed graduate quality assurance, 143-144 competencies, 265-266 research, 144-145 focus on determinants of health, 62 funding sources, 25 Occupational Medicine Program, 38 historical view. 132-133 280 Index

Pediatrics, University of Newcastle, Primary care model, 140-143 181 curriculum for, 146-148 Physicians medical subspecialties, 142 clinical roles of, 28-30 patient flow, 141 competencies required of, 219-220 primary care teams, 140-141 disease-centered versus person- special programs, 142-143 centered care, 218-220 Priority Health Problems Model, 101 future and number of, 133 Professional organizations and roles as advocate, 30-31 physicians, 30 Placebo effect, 10 Provider, physician as, 28 Population-based medicine Psychiatry, University of Newcastle, course requirements, 240-242 182 curriculum, 238-239 Psychoneuroimmunology, 11 descriptive epidemiology, 236, 252 evaluation of health care, 238 Quality assurance, population-based incorporation into curriculum, 242- medicine, 143-144 244 meaning of population-based, 234- Race, in research data, 94, 96 235 Reforms mechanisms for change, 246 call for reform, 2-4 medical audit procedures, 247, 253 cellular model, 213-217 overview of availability of health hospital box model, 209-212 and health services, 237, 252-253 role map model, 217-220 postgraduate education, 244-247, Reproductive medicine, University of 254,255 Newcastle, 181 preventive medicine, 237-238, 253 rational for teaching, 235 Research role of medical school, 150-151 effects on mission of school, 23-27 statistical analysis, 236-237, 252 and medical schools, 37-38 teaching approaches, 239-240 population-based medicine, 144-145 undergraduate education, 148-149, See also Data on health 238-244 Resistances to change, medical See also North Central Bronx schools, 45-48 Hospital; University of Newcastle Risk of death information, data on Population Health Program, 130 health,71-72 Population perspective and social contract, 260-261 Science disciplines, University of Postgraduate education, population• Newcastle, 183-184 based medicine, 244-247, 254, Sites for teaching/learning, 43-44 255 Social class, in research data, 92-94 Prevention Social contract emphasis on, 20-21 and medical school, 25-27, 53-54, and physician, 28 258-259 and population-based medicine, 237- point of view in, 260 238,253 population perspective in, 260 Primary care Societal heterogeneity, 91-99 nature of, 211 age, 91-92 sociomedical interface, 211, 212 ethnicity, 94, 96 technomedical interface, 211, 212 gender, 91 Index 281

geographic distribution of disease, curriculum, 174-178 97-98 dean, 167 period or cohort, 98 educational objectives, 172 race, 94, 96 environmental and occupational social class, 92-94 health, 180 Society for Medical Observation, 3 foundation faculty, 169-170 Sociomedical interface, primary care, Health, Law, and Ethics, 182-183 211, 212 internal medicine, 182 Statistical analysis, population-based Kannel Committee, 165-167 medicine, 236-237, 252 links to Health Service, 184-185 Surgical sciences, University of medical genetics, 183 Newcastle, 182 medical infonnatics, 183 objectives of educational program, Teachers, medical schools, 43 196-201 teacher effectiveness measure, 44- origin of, 165 45 pediatrics, 181 Teaching Health Unit, 120 postgraduate education, 185-186 Technomedical interface, primary care, profile of Newcastle health area, 211, 212 191-196 Tertiary specialist, 218 psychiatry, 182 Turnberry conference reproductive medicine, 181 implementation of recommendations, science disciplines, 183-184 264 strategies to sustain community issues addressed, 260-262 orientation, 189-191 levels for improvement of health, student selection, 171-172 262-263 surgical sciences, 182 proposed competencies, 265-266 troubled times for, 170-171 recommendations of, 263-264 vice-chancellor, 168-169 Working Papers, 171 University of Ottawa, Health Undergraduate education, population• Intelligence Unit example, 117- based medicine, 238-244 118 United Kingdom, call for refonn, 2 University of Washington School of sources of health infonnation, 67 Medicine, Community Medicine United States, call for refonn, 2-3 Program, 38 sources of health infonnation, 67 educational evaluation, 44-45 University of Newcastle and physician commitment to Pacific behavioral science and medicine, Northwest area, 39-40, 55 180-181 state support, 25-26 clinical phannacology, 181 community medicine, 179-180 Years of potential life lost measure, community studies, 172-174 73-75