Evidence, evidence, where is the evidence
Norman Vetter
----- Original Message -----
From: "Lyons Mary" <[log in to unmask]>
To: <[log in to unmask]>
Sent: 29 June 2001 14:47
Subject: Do we need Public health doctors?
> I suspect that the email from Padmanabhan Badrinath was written as a
> challenge to encourage debate. I hope so, as it certainly made me feel
that
> I had to respond anyway!
>
> In response to Badrinath's email;
>
> (Public health has always attracted more than its fair share of female
> doctors, so lets start by not using 'he' all the way through.)
>
> 'He could underestand the health needs of the population better with his
> medical background.'
>
> Why? A medical background does not necessarily enable someone to
determine
> health needs - we need a good variety of backgrounds in public health,
both
> medical and non medical, but the medical background is not superior, in
fact
> some might argue that the middle class background that spawns most doctors
> makes it difficult for them to understand the health needs of the poor.
> Because of training received, medical doctors may well be more likely to
> view health needs in terms of illness and medical services - a very narrow
> view of health needs. Health is determined more by things outside of
health
> services, such as social and community networks, education, employment,
> access to money and living and working conditions. Public health is about
> all of this, certainly not just the provision of health services. Health
is
> different from and is not primarily determined by health services (If the
> professionals are still confused - no wonder the general public is too)
>
> 'Colleagues (read hospital) are more inclined and feel comfortable
> >discussing issues with a medical person (and take him seriously!)'
>
> Does this matter? Public health is not determined by discussions with
> hospital doctors. I have never had any problems being taken seriously by
> medical colleagues on public health issues.
>
> 'He is assisted by a able multidisciplinary team from whom he seeks advice
> (director of health promotion etc)but he serves as the nodal point on
public
> health issues in the distrct.'
>
> if the main health problems in the area are determined by bad housing,
> poverty or unemployment, it would more sense to have someone better
> qualified in dealing with these issues as the lead person in the public
> health team.
>
> 'Here still public health is known as preventive medicine'
>
> Time for a change. That is no reason to keep things this way. 'Public
> health medicine' has always been a misnomer as public health has always
been
> more than public health medicine.
>
> One tricky issue is that the compensation package is different for
> >medical/non medical professionals in this field. Is this fare?
>
> Many people working in public health have trained in their own particular
> discipline for many years and many are comparatively more experienced and
> qualified than medical doctors, but the important point is that you are
paid
> for doing a job. I have already argued that in many cases a non - medical
> public health specialist might be better suited to taking the lead role,
and
> when they do, they should be appropriately rewarded.
>
> The only solution is for each of us to respect each others skills and
> understand that public health must be about partnership and working
> together. It's not about any particular discipline taking the lead.
>
> Mary
>
>
>
> Mary Lyons
> Senior Lecturer in Public Health
> Public Health Sector
> Liverpool John Moore's University
> 70 Great Crosshall Street
> Liverpool
> L3 2AB
>
> Phone; 0151 231 4337
> Fax; 0151 231 4320
> Email; [log in to unmask]
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