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OCR for page 291
Workshop E
Robert S. Lawrence
Among the participants in Workshop E there was general consensus that
a narrow view of COPC (a strict Karkian interpretation) was not appropriate
to the challenges of the United States. There are simply too many constraints
governing the definition of service areas, the availability of surveillance data
or the personnel to collect such data, the lack of coterminus boundaries
for different categorical service programs in many cities and counties, and
other features that vary from region to region. It was also agreed that
encouraging nascent efforts at COPC is important. Even the most modest
efforts to make a community diagnosis and intervention should be en-
couraged. There is a real value of the halo effect wherein a case-finding
and treatment program tend to organize a practice or a health department
in a direction that makes other COPC activities easier.
The group suggested that the curriculum of health professionals be ex-
panded to sensitize students about several of the important themes in COPC.
Among the more important ones are the distinction between community
wants and community needs, the cultural and ethnic diversity of patient
groups and the impact of this diversity on health behavior, the need to
organize records to include basic epidemiologic data via color coding of
charts or other techniques, and the teaching of policy analysis skills to help
the health professional determine the scope of responsibility.
There was strong feeling that there should be a follow-up to the con-
ference with the conferees forming a network of consultation and support,
distributing phone numbers and references on papers describing their own
COPC projects, etc. The suggestion was also made that descriptions of
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OCR for page 292
292
PART III: WORKSHOP DISCUSSION SUMMARIES
COPC projects, not previously published in refereed journals, might be
presented as brief case studies and published as working papers in COPC.
These case studies would essentially be the "materials and methods" portion
of a scientific paper.
There was general agreement among the participants that, for the full
development of COPC in the United States, the basic reimbursement mech-
anism for paying for health care had to be completely changed.
Finally, in response to the question how to do COPC, the response was
that there are really many ways and that the approach should be eclectic.
Private practice should be adapted to COPC, new practice systems should
be developed, nonpractice settings such as the industrial medicine services
of large corporations should be encouraged tO develop COPC, and the
remnants of HSA planning activities should be utilized especially at the
town, city, and county level to develop appropriate surveillance data for
COPC.
Representative terms from entire chapter:
planning activities
