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Rethinking the Role of Medicine. Stephen R Leeder The Menzies Centre for Health Policy The University of Sydney. The Gadugil people of the Eora nation. The Medical Foundation – 50 years. …an early desire to do Medicine. Insulin. “Sorry, no By-Pass” – RNSH 1970. The Genome.
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Rethinking the Role of Medicine Stephen R Leeder The Menzies Centre for Health Policy The University of Sydney
Organ Regeneration Not this Possibly this
MEDICINE PUBLIC HEALTH DOCTORING
Doctoring • The foundational ethic: to relieve suffering and to save life (Faunce) • Lots of professionals can do bits of doctoring • The workforce crisis: it’s time to sort out who does what bits of doctoring (Gorman).
MEDICINE PUBLIC HEALTH DOCTORING
Medicine • Hi-tech enterprise, market-driven • Most advances depend on people other than medical doctors • Expensive.
MEDICINE PUBLIC HEALTH DOCTORING
Public Health and Prevention • Two courses of action – addressing individuals or addressing the population • The features of population-based approaches • “What is the cause of lung cancer in a population where everyone smokes?” • Individual versus population-based susceptibility • Both hi-risk individual and population-based approaches are needed to achieve health gain.
The Future • The rise and rise of hi-tech medicine • The question of equity • The gains, and losses of exponential growth in productivity.
The Challenge • Accepting the great advances in medicine • Defining who will do what doctoring • Developing an understanding of public health • Recruiting beyond government – from academia, business and civil society • Seeking a public health ethic • Identifying lots of heroes!