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July 1998

Neurology and Public Health

Arch Neurol. 1998;55(7):1014-1015. doi:10.1001/archneur.55.7.1014

THE IDEA that public health concepts are part of the practice of medicine and neurology is very old. Prior to the 20th century, it was usually physicians who advocated and developed appropriate measures to improve the health of populations. It was less a question of physicians also being epidemiologists, and more a question of their capacity, through education, to think epidemiologically. Simply put, it was thought that part of the medical profession's mission was to be concerned not only with individual patients, but also with people in groups. As we approach the end of a millennium, it is evident that a schism now exists between practicing physicians and practicing professionals in the fields of public health. Although many factors have contributed to this schism, there is little doubt that a major one was the decision of the Rockefeller Foundation in 1916 to provide funding for the development of independent schools of public health separate from schools of medicine.1 As a result, medical education gradually became isolated from the research interests of public health faculty, and medical students acquired neither the inclination nor the analytic skills to contribute solutions to major public health concerns, such as poverty, population density, family size, and adequate housing.

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