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September 7, 1994

Preventive Medicine and Health System ReformImproving Physician Education, Training, and Practice

Author Affiliations

From the Department of Social Medicine, University of North Carolina at Chapel Hill (Dr Eggert), and Division of Associated, Dental, and Public Health Professions, Bureau of Health Professions, Health Resources and Services Administration, Rockville, Md (Dr Parkinson). Dr Eggert is now a preventive medicine consultant in the Epidemiologic Research Division, Brooks Air Force Base, Texas; Dr Parkinson is now chief of preventive medicine in the office of the USAF Surgeon General, Bolling Air Force Base, Washington, DC.

JAMA. 1994;272(9):688-693. doi:10.1001/jama.1994.03520090052018

PREVENTING disease, disability, and death has always made intuitive sense, long before the current debate on health system reform suddenly thrust disease prevention, health promotion, and public health onto the political center stage. Demands to control medical costs, improve the value, quality, and outcomes of health care, achieve universal access, promote generalism over specialization, and improve the responsiveness of academic health centers to their local communities1 have placed prevention and primary care in a new light. Increasingly, preventive medicine, public health, and primary care are recognized as fundamental components of a reformed health system. Concerns over environmental and occupational health hazards, the resurgence of infectious diseases, and the primacy of chronic diseases and injuries as the leading causes of mortality and morbidity focus attention on the need for researchers, educators, and practitioners trained in preventive medicine, public health, and other population-based fields. The inadequacy of undergraduate medical education and

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