Responsibilities beyond the patient

Does a general practitioner in a mining area who encounters a cluster of emphysema cases have a duty to speak up about local working conditions? Does a doctor working in an area of high smoking prevalence have a duty to target the community with smoking cessation or other initiatives?

Speakers—including a GP and a public health pioneer—at a discussion hosted by the BMJ and King’s Fund in London last week were united in agreement that all clinicians do have a responsibility to the population as well as to the individual patient.

Iona Heath, president of the Royal College of General Practitioners, said: “In any collectively funded health system, GPs must find a way to balance the needs of the individual with the needs of the population. On the other hand, if you are an entirely private …