PUBLIC HEALTH AND CLINICAL STANDARDS




While practicing, researching and teaching clinical medicine and public health, I aimed at

 

  • making explicit the underlying values (such as equity and social justice in medical practice, management and policy)
  • grounding theory in practice – hence an extensive reliance on professional action-learning and action-research
  • basing health policy research and recommendations in managerial knowledge, and managerial knowledge in professional practice


The articles in this section are mostly early papers exposing our standards in action-research and services evaluation together with criteria for non-commercial health care delivery, management and policy.

 

HEALTH POLICIES

 

Health policies should secure the Human Right to Care and as such, the access of everybody to the full scope of health services - from GPs and first line teams to University Teaching Hospitals. Besides, policies should make sure that professionals abide by a code of ethics:

 

Unger, JP., Morales, I., De Paepe, P. et al. Neo-Hippocratic healthcare policies: professional or industrial healthcare delivery? A choice for doctors, patients, and their organisations. BMC Health Serv Res 20, 1067 (2020). https://doi.org/10.1186/s12913-020-05890-3


https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05890-3 

 

Importantly, health policies should integrate clinical care and disease control programmes whenever these public health programmes strengthen the former:

 

Unger J.-P., De Paepe P., Ghilbert P., Soors W., Green A. 1. Disintegrated care: the Achilles heel of international health policies. In low and middle income countries. International Journal of Integrated Care2006; 6. ISSN 1568 – 4156


https://www.ijic.org/articles/10.5334/ijic.156/

 

Unger J.-P., De Paepe J.-P., Ghilbert P., Soors W., Green A. 2. Integrated care:a fresh perspective for international health policies inlow and middle-income countries. International Journal of Integrated Care2006; 6. ISSN 1568 - 4156

 

https://www.ijic.org/articles/10.5334/ijic.157/


HEALTH PLANNING

 

Because access to professionally delivered health care is a Human Right, health services organization and planning should pursue the population coverage with a national, universal health system spanning from the GP health team to the university teaching hospital, and from psychosocial services to specialized clinics.

 

Unger J.-P., Criel B. Principles of health infrastructure planning in less developed countries. Int J Health Plan Manag1995; 10: 113-128


https://www.academia.edu/15624296/Principles_of_health_infrastructure_planning_in_less_developed_countries

 

HEALTH SERVIC'ES ORGANIZATION AND MANAGEMENT

 

Health management should be democratic, favor teamwork, professional autonomy and bottom up flows of knowledge and decisions in health services.

 

Unger J.-P., Macq J., Bredo F., Boelaert M.Through Mintzberg's glasses: a fresh look at the organization of ministries of health. Bull WHO2000; 78(8): 1005-1014.


https://apps.who.int/iris/bitstream/handle/10665/268199/PMC2560822.pdf?sequence=1&isAllowed=y

 

Disease control organization Health systems should control diseases but in general, public health programmes shouldn’t be permitted to strain care quality of and access to clinical care in those health services where they are integrated.

 

Unger J.-P., De Paepe P., Green A. A code of best practice for disease control programmes to avoid damaging health care services in developing countriesInt J Health Planning and Management2003; 18: S27-S39.


https://onlinelibrary.wiley.com/doi/pdf/10.1002/hpm.723

 

PUBLIC HEALTH CARE SERVICES

 

To deserve public financing, health care services should meet defined health care and organisation quality criteria.

 

Unger J.-P., Marchal B., Green A. Quality standards for health care delivery and management in publicly-oriented health services. Int J Health Planning and Management 2003; 18: S79-S88.


http://dspace.itg.be/bitstream/handle/10390/1442/2003ijhp0S27.pdf?sequence=1


https://pubmed.ncbi.nlm.nih.gov/14661939/

 

MEDICAL ETHICS

 

The physician ethical commitment should encompass combined clinical and public health principles.

 

Unger, JP., Morales, I., De Paepe, P. et al. In defence of a single body of clinical and public health, medical ethics. BMC Health Serv Res 20, 1070 (2020). https://doi.org/10.1186/s12913-020-05887-y;


https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05887-y

 

Unger, JP., Morales, I., De Paepe, P. et al. A plea to merge clinical and public health practices: reasons and consequences. BMC Health Serv Res 20, 1068 (2020). https://doi.org/10.1186/s12913-020-05885-0


https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05885-0

 

CONCEPTUAL ANTINOMIES PRESENT IN MY RESEARCH

 

the doctor’s professional autonomy and primacy of professional ethics

VS.

the health technician’s managerial subjugation


ethical medical practice

vs.

commercial practice of medicine


the Hippocratic Oath

vs.

the methodological individualism of neoclassical economics


medical professionalism (encompassing, amongst other, a scientific approach to health problems)

vs.

biomedical sciences


policies aimed at realizing the universal right to health care

vs.

policies subject to the political economy of care


the science of health management with a social and professional mission

vs.

the science of health management for commercial and thus industrial purposes