INTRODUCTION TO COMMUNITY
MEDICINE
Dr Ayesha Akram
Community ?
 A group of people living in the same place or having a
particular characteristic in common.
(http://oxforddictionaries.com/definition/american_english/community)
Dr. Ayesha Akram
Community ?
 A group of people living in the same place or having a
particular characteristic in common.
(http://oxforddictionaries.com/definition/american_english/community)
Dr. Ayesha Akram
Medicine ?
 The science of diagnosing, treating, or preventing disease and
other damage to the body or mind
(http://www.thefreedictionary.com/medicine)
Dr. Ayesha Akram
Medicine ?
Dr. Ayesha Akram
Medicine ?
Dr. Ayesha Akram
Community Medicine
 Community Medicine is defined as “the art and science of
application of technical knowledge and skills to the delivery
of health care to a given community, designed in
collaboration with related professions as well as human and
social sciences on the one hand, and community on the other.
(WHO, Geneva)
Dr. Ayesha Akram
Preventive Medicine
 “The science and art of preventing disease, prolonging life
and promoting physical and mental health and efficiency”
Dr. Ayesha Akram
Public Health
 “The science and art of preventing disease, prolonging life and
promoting physical and mental health and efficiency through
organized community efforts for ,
The sanitation of the environment
2. The organization of medical and nursing services for the early
diagnosis, prompt treatment and prevention of disease
3. The development of the social machinery which will ensure to
every individual in the community a standard of living adequate
for the maintenance of health
1.
(Winslow, 1920)
Dr. Ayesha Akram
Comparison

Aim
Objective
Clinical Medicine
Community Medicine
To shorten morbidity and
prevent mortality in ill or
diseased
person
explore
methods which would reverse
or eliminate disease states
To reduce unnecessary morbidity
and premature mortality in the
whole
population.
Explore
greatest potential for health
improvement
Cure patient of disease
Improve health status of a
community
Dr. Ayesha Akram
Clinical Medicine
Information
Required
Diagnosis
Community Medicine
Clinical
history, Population data, Health
physical examination problems, disease pattern,
and laboratory tests availability of health services.
Felt needs of the community
Differential diagnosis Community diagnosis
and
probable
diagnosis
Dr. Ayesha Akram
Clinical Medicine Community Medicine
Action Plan
Evaluation
Treatment
rehabilitation
and Community health program
Follow
up
assessment
and Evaluation of change in health
status
Clinical & Community Medicine

Focus: Clinical medicine focuses primarily on the
individual, while public health focuses on the community.

Time frame: Relevant time frames in Clinical Medicine
are usually single lifetimes, while public health thinks in
terms of generations.
Dr. Ayesha Akram



Ethics: From an ethics perspective, clinicians advocate for
individual people. Public health practitioners advocate for the
community, for a group of people.
Rights: In clinical medicine we focus on individual rights of a
patient. In public health, we think about human rights, social
justice, and environmental justice.
Education: From an education perspective, in clinical
medicine we focus on the biomedical model with more emphasis
on cure than prevention (although this is shifting now). In
public health, we learn more about sociology, epidemiology,
economics and more.
Dr. Ayesha Akram
WHO
Dr. Ayesha Akram
http://www.who.int/hrh/en/HRDJ_1_1_02.pdf
Five Star Doctor
 The concept of the “five-star doctor” is an ideal profile of a
doctor possessing a mix of aptitudes(abilities) to carry out
the range of services that health settings must deliver
Dr. Ayesha Akram
Care Provider
Communicator
Manager
Five Star
Decision Maker
Dr. Ayesha Akram
Leader
Care Provider
 Knowledge, Skills
 Competent
 Must Know the physical, mental and social needs of the
patient
 Must ensure the full range of treatment (Preventive,
Curative, Rehabilitative)
 Equipped with latest techniques
 Life long learner
Dr. Ayesha Akram
Care Provider
Dr. Ayesha Akram
Decision Maker
 Analytical Skills
 Decisions in terms of efficacy and cost effectiveness.
 Most appropriate decision in a given situation
 Legal Issues
 Dealing with the Human Beings
Dr. Ayesha Akram
Decision Maker
Dr. Ayesha Akram
Communicator
 Communication Skills
 Taking history
 Respect of the patient
 Listening
 must be excellent communicator in order to persuade
individuals, families and the communities to adopt healthy
lifestyles and become partners in the health effort.
 How to break bad news
Dr. Ayesha Akram
Communicator
Dr. Ayesha Akram
Leader
 five-star doctors” will not simply be treating individuals who
seek help but will also take a positive interest in community
health activities which will benefit large numbers of people.
 Leadership role in the community
Dr. Ayesha Akram
Leader
Dr. Ayesha Akram
Manager
 Must acquire managerial skills.
 Multidisciplinary team
Dr. Ayesha Akram
Manager
Dr. Ayesha Akram