Modification of Health Behavior and Lifestyle Mediated by Physicians
Brian Oldenburg Queensland University of Technology
Peita Graham-Clarke University of Sydney
John Shaw Merck, Sharpe and Dohme
Sheila Walker National Heart Foundation of Australia (NSW Division)
The practice of clinical and preventive medicine is changing rapidly around the world. Although research leading to the development of new diagnostic techniques and drug treatments has always been part of the experience of physicians, changes within the health care system, and the impact of even broader political and economic changes on this system, will have even more profound effects on the practice of medicine over the next 25 years. The challenge to provide effective and affordable solutions to providing accessible and equitable health care has stimulated great interest in the contribution that can be made by public health and preventive medicine initiatives becoming more integral to the mainstream health care system.
The World Health Organization (WHO) strategy of "Health for All" by the Year 2000 ( 1) identifies four key goats for the health care systems of all countries: (a) the promotion and facilitation of healthy lifestyles; (b) a reduction in the burden of preventable ill health; (c) the reorientation of health care toward prevention, coupled with appropriate effective care of the sick and disabled; and (d) a health care system that is accessible, equitable, and economically sustainable. To achieve these goals, which have already been incorporated into the health policies of a number of developed countries, primary health care workers, and in particular primary care physicians, will be required to play a more prominent role in helping to prevent disease and promote better health among their patients and the public more generally.
The potential benefits of widespread physician involvement in preventive activities have been argued in the light of supportive evidence, and often assumed