community oriented primary care an overview fitzhugh mullan, m.d

Community Oriented Primary Care

An Overview

Fitzhugh Mullan, M.D.

COPC is...

• A basic method for the practice of community medicine

• A blending of public health practice and clinical medicine

• A training discipline for community based academicians

COPC is...

A systematic approach to the practice of medicine in the community built on principles of epidemiology and communityorganizing

COPC blends...

•Public health and personal health care

•Epidemiology and primary care

•The forest and the trees

•The forester and the tree surgeon

COPC process...

• Community definition

• Community characterization

• Problem prioritization

• Detailed assessment

• Intervention

• Evaluation

Community Definition

• Geographic community

• Health care coverage “community”

• Special Population Community

Community Characterization

• Quantitative Information– Demographic– Health data

• Qualitative Information– Focus groups– Key informants

Problem Prioritization

• Issue triage

• Frequency, severity, and feasibility principles

• Prioritization groups– Community– Staff

Detailed Assessment

•Develop Community-Specific Information

•Examine Literature and Experience

•Select an Intervention

•Invent No Wheels

Intervention

To consider...

• Time

• Personnel

• Tracking

• Impact

• “Winning”

Evaluation

• Process

• Impact

• Outcome

• Community utility

The Power of COPC

• COPC as a Movement

• COPC as an Ethos

• COPC as an Organizing Principle

COPC -- A Much Used Term

• “Lower Case” COPC

• “Upper Case” COPC

Origins of COPC

• Sidney and Emily Kark

• Phoela, Kwazulu Natal, RSA

• Department of Family and Community Health, University of Natal in Durban

COPC Migration

• Hadassah - Hebrew University, Jerusalem

• Kiryat HaYovel Community Health Center

• International MPH program

COPC in the United States

• IOM Conference, 1982

• IOM/NAS Publications, 1982-84

• Parkland Hospital, Dallas

• Montifiore Social Medicine Residency Program

• APHA Book

DC and COPC

• COPC track at GWSPHHS, 1997

• CNMC General Academic Pediatric Fellowship Program, 1997

• GW-Hebrew University International Certificate Program, 1998

• Medical University of Southern Africa partnership, 1999