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John Q. Wong, MD, MSc 22 Jun 2010.  22 Jun, Tue  PH perspective  RCT  Cohort  23 Jun, Thu  Evidence-based public health (EBPH)  How to read an.

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Presentation on theme: "John Q. Wong, MD, MSc 22 Jun 2010.  22 Jun, Tue  PH perspective  RCT  Cohort  23 Jun, Thu  Evidence-based public health (EBPH)  How to read an."— Presentation transcript:

1 John Q. Wong, MD, MSc 22 Jun 2010

2  22 Jun, Tue  PH perspective  RCT  Cohort  23 Jun, Thu  Evidence-based public health (EBPH)  How to read an article about  Prognosis  Harm

3 John Q. Wong, MD, MSc 22 June 2010

4  Medical care provides quick relief for immediate concerns  Natural response  Great effort into putting out today’s fires  Little into preventing tomorrow’s conflagrations  PH programs  You bear the costs now but the benefits will be reaped on someone else’s watch  Examples  Improving road safety  Preventing measles  Limiting climate change

5  Medicine deals with identifiable people – patients  Directed at helping you  PH deals with statistical ‘lives’  Directed at improving the health of a group of people  Although it’s unclear whose lives were saved

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7  ABS-CBN  P95M cash donations  P109M in-kind donations  European Commission  P700M in tents, construction materials, water and sanitation facilties improvements, food, cash-for-work programs, basic agricultural inputs  Individual European countries  P600M  Why couldn’t the money have been spent on prevention?  Wider and more extensive sewer systems  De-clogging of sewer systems  Desiltation of rivers  Reforestation

8  St. Luke’s Global City  Cost P9.5B  620 patient rooms  500 doctors  1.2:1 patient to doctor ratio  DOH budget in 2007  P13B  90M Filipinos  63,000 government doctors  1,428 Filipinos to 1 government doctor

9 WWho’s Christiaan Barnard? HHeart transplant surgery 55,000 per year WWho’s Denton Cooley? CCoronary artery bypass graft 8800,000 per year  Who’s Maurice Hilleman?  Developed more than 40 vaccines  Including vaccines for measles, mumps, hepatitis A and B, meningitis, pneumonia, H. influenza, and rubella  Saves 8,000,000 lives per year

10  Physician providing curative care is more easily identified  People often don’t recognize that they have benefited from a PH measure  People take for granted when  They don’t get sick at work  Aren’t poisoned  Don’t get run over

11  Medical care is promoted by large special interests  Pharmaceutical companies  Private hospitals  Insurance companies  Medical societies  Some PH measures require societal change  Anti-Tobacco Law  Alcohol restrictions  Gun control  Seatbelts  Pollution control  Goes against powerful special interests

12  Medical practitioners  Can see their patients recover  Know their patients personally  Are recipients of the gratitude and respect of their patients  Are supported by powerful interest groups  Public health practitioners  Will not see the fruits of their labor  Don’t know who will benefit from their work  Receive no credit for their work  Need to go up against special interest groups

13  Public health  Produces benefits for many years even generations  Saves lives…millions at at time  Not everyone needs recognition  Produces fundamental societal change


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