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Merwyn R. Greenlick, PhD

JAMA. 1992;267(12):1645-1648.

Abstract
Debates about changing the current paradigm of medical education and medical practice have become fairly common in recent years. Based on my experience as a research director of a prepaid group practice program and as chair of a medical school department of public health and preventive medicine, I contend that the traditional one-to-one physician-patient role obligations should be expanded to include a set of "one-to-n" physician-population obligations. The latter include at least three components: (1) a resource allocation component, (2) a component focusing on the epidemiologic nature of clinical practice, and (3) a component focusing on members of the population who are not regularly attended to within the normal context of physician care. Discussing these in turn, I argue for a population-based clinical practice model of medical education that preserves the Hippocratic tradition while better preparing physicians for the complex practice and insurance realities of the 21st century.

(JAMA. 1992;267:1645-1648)

Author Affiliations
From the Kaiser Permanente Center for Health Research, and the Department of Public Health and Preventive Medicine, Oregon Health Sciences University, Portland.

Footnotes
Reprint requests to Kaiser Permanente Center for Health Research, 3800 N Kaiser Center Dr, Portland, OR 97227-1098 (Dr Greenlick).

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