Community medicine: future imperfect?

Abstract

The development of community medicine is seen in historical perspective and found to be a redirection of preceding trends rather than the development of new concepts. The current problems of the specialty are reviewed and found to be due to erroneous perceptions of its role by many doctors, to the specialty's present preoccupation with its academic purity, and to the failure to provide within the National Health Service the resources that were vital to the functions it was asked to perform. It is argued that the essential skill of community physicians is epidemiology, which must be applied within the management process of the National Health Service to enable it to adapt itself to the needs of changing disease patterns. It must also be applied to the prevention of disease and this will necessarily involve the community physician in much wider social problems than the provision of medical care services. This second responsibility may well prove to be the more crucial in the longer term.