Individualized population care: linking personal care to population care in general practice.
BACKGROUND
General practice is increasingly expected to deliver population care to individual patients. The feasibility and ethics of this policy shift have been challenged.


OBJECTIVE
Our aim is to suggest how to deliver population care while protecting personal care.


METHODS
We outline and discuss concepts of these types of care, their relation to the prevailing discourse regarding intervention benefits, and arguments for individualized population care.


RESULTS
Individualized population care can enable general practice to meet the health targets of individual patients in the light of population-based goals. It unifies the concepts of personal care and whole population care. Personal care focuses on the individual good in particular consultations. Whole population care focuses on the overall health good of a population without reference to the individuality of each population member. These types of care constitute elements of a continuum that varies in purpose and objects of focus. The limitations of a crude dichotomy of personal care and population care are made explicit in a series of five arguments that lend support to the concept of individualized population care.


CONCLUSIONS
We advocate a constructive but critical attitude towards the idea of population-based interventions in everyday general practice. Traditional personal care and whole population care can theoretically be integrated into individualized population care. However, this presupposes clinical-epidemiological expertise and moral awareness in practising clinicians.
Buetow
Stephen
S
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. s.buetow@auckland.ac.nz
Getz
Linn
L
Adams
Peter
P
D002983:Clinical Competence; D018672:Community Health Planning / Q000458:organization & administration*; D003220:Conflict, Psychological; D005194:Family Practice / Q000458:organization & administration*; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D055048:Integrative Medicine / Q000458:organization & administration; D017008:Negotiating; D009520:New Zealand; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010344:Patient Advocacy; D010347:Patient Care Planning / Q000458:organization & administration*; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration*; D010819:Physician's Role; D011320:Primary Health Care / Q000458:organization & administration; D011322:Primary Prevention / Q000458:organization & administration; D011634:Public Health