Title: Being a Preventive Medicine Physician
Dr. Hitesh Deka, Assistant Professor
E-mail: drhiteshmd@gmail.com
Introduction: Preventive and Social Medicine or
better known as Community Medicine, is a branch
of medicine dealing with providing health services
in areas of prevention, promotion and treatment of
rehabilitative diseases. Studies in preventive and
social medicine are helpful in providing guided care,
offering scholarly services, policy formulation,
consulting and research in health care. During the
medical under-graduate training course, the one
subject that expands almost the whole of the
curriculum is the subject of Preventive Medicine.
One cannot deny the factual significance of health
management at clinical level also with the basic
foundation of disease distribution which is
otherwise known as clinical epidemiology. However,
many students in the course of under-graduate

training lose focus on the subject of preventive
medicine as an option for specialization or career
opportunity for reasons known but never
addressed. This article is intended to give a basic
and conceptual idea about the subject of Preventive
Medicine in terms of the applicability and also to
provide some food for thought to the budding
professionals to explore the broad areas of public
health administration.
Historical perspective of Preventive Medicine: The
industrial revolution of the 18th century while
bringing affluence also brought new problems-
slums, accumulation of refuse and excreta,
overcrowding and variety of social problems. Filth
and garbage was considered as man’s greatest
enemies and it lead to great sanitary awakening
bringing Public Health Act of 1848 in England
followed by similar adaptation in various countries,
in acceptance of the principle that the state is
responsible for the health of the people.

While preventive medicine is mostly academic
oriented but the later evolved concept of public
health is defined as the process of mobilizing local,
state, national and international resources to solve
the major health problems affecting communities
and to achieve Health for All by 2000.
By definition, preventive medicine is applied to
“healthy people”, customarily by actions affecting
large numbers of populations. It got a firm
foundation only after the discovery of causative
agents of diseases and the establishment of the
germ theory of disease.
Community Medicine has been defined as that
specialty which deals with populations and
comprises those doctors who try to measure the
needs of the population, both sick and well, who
plan to administer services to meet those needs and
those who are engaged in research and teaching in
the field.

Decade old concept of health care approach has
experienced a dramatic change with the advent of
advances in preventive medicine. Today health is
not merely an absence of disease; it is related to
quality of life instead. Health development is
essential to socio-economic development as a
whole. Since health is an integral part of
development, all sectors of society have an effect
on health. Study of health and disease in population
is replacing study of disease in man. Contemporary
medicine is no longer solely an art and science for
the diagnosis and treatment of diseases. It is also
the science for the prevention of disease and
promotion of health. Today technical sophistication
of modern medicine is not an answer to everyday
common ailments of the vast poor in the country
but adoption of appropriate technology and
cheaper interventions are increasingly being applied
as life saving measures and for disease prevention
in community health care. A physician’s role is no
longer confined to diagnosing and treating those

who come to the clinic but he is also responsible for
those who need his services but cannot come to the
clinic. In the spate of new ideas and concepts,
increasing importance is given to justice and equity.
Newer recognition of the crucial role of community
participation called for the new approaches to make
medicine in the service of humanity more effective.
The public Health Administration in India actually
started in 1869 with the appointment of a Sanitary
Commission. The first Municipal Act was passed in
1884 in Bengal. But, the recommendations of the
Bhore Committee in 1946 laid the foundation of
modern public health care in India.
In the follow up of the recommendations of Medical
Education Conference in 1955, departments of
Preventive and Social Medicine were established in
Medical Colleges. The Government of India
launched the Re-orientation of the Medical
Education system in the year 1977 and aims at
involving medical colleges directly in the health care

delivery system by accepting total responsibility for
promotive, preventive and curative health care of at
least 3 Community Development blocks in the first
instance, ultimately extending to the whole district.
The framework of Preventive Medicine: One need
to understand the basic difference of providing and
protecting health at individual and community level
while to understand the holistic approach of health
services.
The core principals of preventive medicine are-
1.To provide specialized services for people’s
health in defined population.
2.To help prevent diseases through protection
and maintenance of health.
3.To assist in preventing disability and premature
death.
4.To manage and assess health related to
environmental and occupational factors

Why a Preventive Medicine Physician: A preventive
medicine physician is a doctor who has experience
in public health as well as clinical care. This allows
one to provide insight and expertise in the
prevention of disease, injury and death,
Preventive medicine practice can be found in
primary care clinics, government agencies,
corporations, public health departments, healthcare
facilities and health insurance companies. If one
have ever done a screening for high blood pressure
or diabetes and treated it before the condition
develops, then he has practiced the preventive
medicine.
While physicians and other specialists focus on
helping people after they are sick, preventive
medicine physicians try to help before a condition
or illness develops. Their goal is to prevent health
issues before there is need to treat them.
What a Preventive Medicine Physician do: There
are many different genres of interest in preventive

medicine, so the doctor can practice in a number of
areas, including public health, health policy, clinical
medicine and research. They may conduct research
to find new ways to prevent disease and death or
they may do a combination of both. Many primary
care physicians also practice preventive medicine.
One may find Preventive Medicine Physicians in
many settings including:
1.Occupational Medicine which deals with health
and safety of workers eg-CGHS, ESI etc.
2.General preventive medicine and public health
eg-Medical Colleges, International
Organizations/NGOs, Govt Agencies etc.
3.Clinical informatics. Eg-Medical Technologies, AI
etc.
4.Addiction medicine that handles health of
people addicted to various things.
5.Concerning health of people working under
specific conditions or environment eg. Disaster

situation, relief camps, marginalized population
etc.
6.Newer areas like Geriatric care, Adolescent
care, Palliative care etc.
The specific tasks performed in each specialty and
sub-specialty differs but the underlying purpose
remains the same and that is to preserve human life
by preventing disease or infirmity.
Required education and training: To be a
Preventive medicine physician, one has to complete
the compulsory 4 ½ years UG training under NMC.
Their formal medical training typically includes:
1.Completion of four and half years of medical
school and obtaining a medical degree.
2.Completion of minimum 15 hours each of
graduate level course in various fields to ensure
a solid foundation in public health such as-
a. Epidemiology
b.Health service administration.
c.Bio-statistics

d.Environmental health sciences.
e.Social and behavioral sciences.
3.Completion of a residency or fellowship in a
program such as public health, occupational
health, preventive medicine or environmental
health.
A medical license or university recognition is also
required in which ever state they deem to practice.
What a Preventive Medicine Physician Treat: All
doctors practice preventive medicine to some
degree but only some chooses to specialize in it.
Preventive medicine physicians can be clinical or
non-clinical. Clinical physicians see patents while
the non-clinical physicians do not.
In a clinical setting, a preventive medicine physician
see patients or may provide counseling as needed
to correct an un-healthy lifestyle or habit that may
not be conducive to good health. There are no
specific preventive medicine conditions but rather
health conditions to be prevented.

This might mean helping one to make changes to
one’s diet or to counsel for cessation of smoking or
may help in to lose weight in order to prevent
conditions like diabetes, obesity and diseases
related to smoking. They may give one shots or
provide preventive health screenings facilities.
In a non-clinical setting, a preventive medicine
physician may practice epidemiology or
biostatistics. They may also manage health services
and administration which could include assessing or
developing health policies by directing, developing
and evaluating diseases and health management
programs. This area of practice is extremely broad.
Reasons to see a Preventive Medicine Physician:
One may be directed or referred to a preventive
medicine physician if one is at risk of developing
health conditions like diabetes, high blood pressure,
obesity and heart diseases-due to either genetic or
one’s lifestyle. In preventive health clinic one may
be advised on how to make the necessary

adjustments to avoid developing chronic conditions.
The primary care physician may also act as a
preventive medicine physician and handle many of
these tasks, including providing immunizations and
medications to prevent health conditions.
The Way ahead: The very concept of Preventive
health is as old as the civilization itself. The idea of
being healthy, to adapt to shelter, hygienic life
adaptation are all may be discoveries out of
necessity but also reflects the preventive concept of
health. In this field of preventive medicine and
public health, tremendous changes have taken
place, but greater changes can be anticipated in the
coming decades. Ideas and policies cannot be static
and planning must have enough flexibility to cope
with fast changing world of science and technology
or industrialization and urbanization. According to
Charles Darwin, “it is not the strongest of the
species that survive or the most intelligent, but
rather the one that is most responsive to change”.

Preventive medicine has demonstrated its survival
instinct so far and will definitely acclimatize itself to
changes in the society.
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