By Frederic S. Goldstein

As providers move rapidly into what they call population health, it is becoming clear that there are many definitions  of population health and many people who state they provide population health management. David Kindig, MD has pointed out, it’s time to provide more specificity to delineate what population health is, and what providers and others are doing within population health.

Dr. Kindig proposes that we use the term “Total Population Health” to define programs that seek to improve the health of all individuals while we re-name the services offered by providers which tend to be clinical in nature and focus more on the care of individuals as “Population Medicine.”  I think this delineation is a good way to define the difference.  In fact I have used a slide for years to illustrate this point,  When looking at the social determinants of health: community, transportation, safety, environment, access to foods, etc and considering the obesity epidemic and its precursor to Type 2 diabetes, heart disease and other chronic illnesses.  Here it is,

Is this the classic lazy American?

Can the Healthcare System Fix This?

Or is this a lack of sidewalks, an unsafe neighborhood? And what role should/can providers play in this?

I believe the providers should focus on Population Medicine, better caring for chronic diseases and providing acute medical care and leave the social determinants, which are well outside the walls of the care system, to others with more expertise. An area of low hanging fruit is the inefficiencies, abuse and fraud in the healthcare system identified by IOM (see slide 3).  Now there’s a good place to start as one moves to Value Based Payments and capitation.

The thinking of Dr. Kindig is also similar to the Accountable Health Organization approach that David Nash and I wrote about last year.

What do you think?


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