New York City's initiatives on diabetes and HIV/AIDS: implications for patient care, public health, and medical professionalism.
Two recent New York City Department of Health and Mental Hygiene initiatives expanded the mission and scope of public health, with implications for both New York and the nation. The programs target diabetes and HIV/AIDS for greater systemic and expanded reporting, surveillance, and intervention. These initiatives do not balance heightened surveillance and intervention with the provision of meaningful safeguards or resources for prevention and treatment. The programs intrude on the doctor-patient relationship and may alienate the very patients and health professionals they aim to serve. Better models are available to achieve their intended goals. These initiatives should be reconsidered so that such an expansion of public health authority in New York City does not become part of a national trend.
Goldman
Janlori
J
Center on Medicine as a Profession, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 11, New York, NY 10032, USA.
Kinnear
Sydney
S
Chung
Jeannie
J
Rothman
David J
DJ
D003219:Confidentiality; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006291:Health Policy; D006801:Humans; D007258:Informed Consent; D008297:Male; D019221:Mandatory Reporting; D009519:New York City / Q000453:epidemiology; D009749:Nutrition Surveys; D010817:Physician-Patient Relations; D015995:Prevalence; D011634:Public Health / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D012042:Registries