October 6, 1978

A Commentary on a Commentary on Improving the Public Health

Author Affiliations

Cleveland Clinic Cleveland

JAMA. 1978;240(15):1587-1588. doi:10.1001/jama.1978.03290150033013

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To the Editor.—  Charles D. Aring, MD, is a highly intelligent physician who uses his intelligence. His COMMENTARY, however, needs a commentary, because it clearly blames physicians for not preventing enough disease (239:2557, 1978). Ivan Illich, René Dubos, Thomas McKeown, and Michael Wilson are all cited as authorities for what is made to seem a new idea that people should take more responsibility for their own health, and that since they do not, physicians are at fault. It is made to appear that if doctors could do less doctoring and more educating, all would be well. Congress and Senator Kennedy vociferously concur. Free enterprise is obviously a failure.Charitably overlooking the end-to-end clichés, the message is clear that we physicians had better do something about it or else the government, committees, and an assortment of humanitarians will.No physician I have ever known denies that preventive medicine is preferable to