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To the Editor: In their model, Dr Gruen and colleagues¹ described the inner 2 domains (access to care, direct socioeconomic influences) as professional responsibilities, whereas the outer 2 domains (broad socioeconomic influences, global health influences) were said to be aspirations that "may not be sufficiently different from those of other citizens for them to be recognized as professional obligations." Thus, we are concerned that the authors were unduly narrow in their focus on physicians whose practices treat individual patients, and that they overlooked the contribution to advocacy and public involvement offered by preventive-medicine physicians who practice population-based, rather than individual patient–based, medicine. We contend that the authors should have mentioned both preventionists (ie, public health physicians who do not necessarily deliver individual care) and physicians involved in advocacy organizations as physician role models for public involvement.

Michael T. Compton, MD, MPH; Aneel Advani, MD, MPH; Joe McLaughlin, MD, MPH; Melissa Tobin-D'Angelo, MD; Elizabeth Tong, MD, MPH; Erica Frank, MD, MPH
Emory University School of Medicine
Atlanta, Ga

1. Gruen RL, Pearson SD, Brennan TA. Physician-citizens—public roles and professional obligations. JAMA. 2004;291:94-98. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:2076.

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