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Promoting synergies between clinical medicine and public health

In the health profession hierarchy, public health is a poor cousin of clinical medicine, regarded at best as worthy but dull and at worst as lacking in intellectual merit – ‘it is not brain surgery’. The divide runs deep (Table 1), to the detriment of not only both disciplines, but also, more crucially, of people’s health. Specialisation in clinical medicine risks leading to providing ever more complex care to an ever smaller numerator (patients), while public health evolves towards promoting interventions potentially benefiting an ever larger denominator (populations), but perhaps beyond the scope of the health sector [1]. A combined ‘clinical public health medicine’ perspective can help to bridge the divide, building on experience in academia [2] and in healthcare provision, notably the United Kingdom general practitioner (GP) system, which integrates primary care with preventive medicine and public health in delivering health services: (i) primary clinical care (patient-initiated consultations); (ii) preventive medicine (e.g. cervical cancer screening); and (iii) public health (e.g. childhood immunisations). Drawing on our diverse clinical and public health experience, we give examples of the mutual benefits of good clinical medicine and public health and identify areas with scope to promote synergies between the two.