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Community Oriented Primary Care
An Overview
Fitzhugh Mullan, M.D.
COPC is...
• A basic method for the practice of community medicine
• A blending of public health practice and clinical medicine
• A training discipline for community based academicians
COPC is...
A systematic approach to the practice of medicine in the community built on principles of epidemiology and communityorganizing
COPC blends...
•Public health and personal health care
•Epidemiology and primary care
•The forest and the trees
•The forester and the tree surgeon
COPC process...
• Community definition
• Community characterization
• Problem prioritization
• Detailed assessment
• Intervention
• Evaluation
Community Definition
• Geographic community
• Health care coverage “community”
• Special Population Community
Community Characterization
• Quantitative Information– Demographic– Health data
• Qualitative Information– Focus groups– Key informants
Problem Prioritization
• Issue triage
• Frequency, severity, and feasibility principles
• Prioritization groups– Community– Staff
Detailed Assessment
•Develop Community-Specific Information
•Examine Literature and Experience
•Select an Intervention
•Invent No Wheels
Intervention
To consider...
• Time
• Personnel
• Tracking
• Impact
• “Winning”
Evaluation
• Process
• Impact
• Outcome
• Community utility
The Power of COPC
• COPC as a Movement
• COPC as an Ethos
• COPC as an Organizing Principle
COPC -- A Much Used Term
• “Lower Case” COPC
• “Upper Case” COPC
Origins of COPC
• Sidney and Emily Kark
• Phoela, Kwazulu Natal, RSA
• Department of Family and Community Health, University of Natal in Durban
COPC Migration
• Hadassah - Hebrew University, Jerusalem
• Kiryat HaYovel Community Health Center
• International MPH program
COPC in the United States
• IOM Conference, 1982
• IOM/NAS Publications, 1982-84
• Parkland Hospital, Dallas
• Montifiore Social Medicine Residency Program
• APHA Book
DC and COPC
• COPC track at GWSPHHS, 1997
• CNMC General Academic Pediatric Fellowship Program, 1997
• GW-Hebrew University International Certificate Program, 1998
• Medical University of Southern Africa partnership, 1999