Medical personnel sometimes wonder what is the difference between medicine and public health? Or, as I like to phrase the question, what is the difference between the medical model of care and the public health model?
Physicians are trained according to the medical model, which basically involves looking at an ill patient and deciding how best to treat their illness, no matter how many resources are required.
The public health model looks at populations of ill people, trying to figure out what could have prevented the illness in the first place and improve the health not only of that individual, but of the whole population of which he or she is a part. Another important aspect of the public health model has to do with using limited resources in a way that will help the most numbers of people (this involves cost effectiveness and efficiency) and be equitable to all.
In our work in Haiti, we are operating with both models. We place priority on the public health model, as we care for individual ill patients. We try to prevent similar illnesses in the future, make sure that all people have access to basic medical treatment, and use our resources in the most effective and efficient manner. Our goal is to improve health in entire communities, establishing a model of care that can be replicated elsewhere. Meeting this goal begins with improving access to primary care of illnesses, so that minor illnesses can be treated promptly, thus preventing more serious complications from developing. There are many things that prevent people from getting the medical help they need in Haiti. These include distance (usually people have to travel on foot and the country is very mountainous), expense, fear of doctors and hospitals, and personal beliefs about health and disease. Many times, even when a patient is able to get to a local clinic or dispensary, they don’t find the medications they need, or the staff is not trained adequately totreat their illness. That’s why we place special emphasis on having an adequate supply of essential medications and in providing the highest quality care possible. In future newsletters we will discuss further plans we have for meeting the health care needs of the communities we serve.