A population-centered model for public health medicine

Abstract

ObjectivesPublic health physicians (PHPs) are trained in both medicine and public health, yet practice models in each of these fields incompletely describe their work. A model of practice for public health physicians would better enable training and professional development in the specialty. The objective of this study was to develop an empirically grounded method of the practice of public health medicine by public health physicians. Study designThis was designed as a constructivist grounded theory (CGT) study. Semistructured interviews with 18 public health physicians in Canada were conducted over the course of 1 year. MethodsTranscribed interviews were coded in three stages (line-by-line, focused, and theoretical). Constant comparison, theoretical sampling, reflective and analytic memos, and team discussion on reflexivity were used to ensure rigor and the proper application of CGT methods. ResultsThe key finding of this study is the population-centered medical method (POP-CMM), an empirically grounded method of PHP practice. In this model, PHPs bring values, knowledge, and stances to their practice of medicine with populations as patients. They work to diagnose and intervene on public health issues, with a focus on prevention and systems. Essential to this work is knowledge sharing and relationship building between physicians and populations. ConclusionsPOP-CMM represents a method of practice for PHPs. Further exploration of this method in other countries and systems would bring insight into PHP practice globally. The model has important connections to the practice of medicine and presents the possibility of developing a general model of physician practice for a range of patients, from individuals to populations.