PUBHLTH338: From Patients To Populations: Primary Care And Public Health In The United States
Undergraduate level
Residential
Winter term(s) for residential students;
2 credit hour(s) for residential students;
Instructor(s): Staff (Residential);
Prerequisites: None
Description: This course examines primary care as a healthcare delivery model and policy strategy. Using Starfield’s framework and case studies, students explore comprehensiveness, coordination, continuity, first contact, and patient-centeredness, while examining how financing, workforce, policy, and health system structures shape primary care’s ability to improve population health and patient outcomes.
Learning Objectives: By the end of this course, students will be able to:
1. Define primary care using Starfield's 4Cs and the emerging 5th C, patient-centeredness, and apply this framework to evaluate real-world case studies.
2. Explain how primary care in the United States is trained, credentialed, and financed, and how that financing structure shapes clinical incentives and workforce choices.
3. Compare the structure of U.S. primary care to comparator systems (UK) and evaluate what specific structural differences (in guideline-setting, screening logistics, or funding) actually produce in practice.
4. Analyze the tension between individual and population health as it plays out in primary care practice, recognizing that primary care sits at this fault line.
5. Evaluate primary care controversies and policies using evidence - including screening guidelines, the ACA's preventive visit mandate, and workforce models - by weighing competing perspectives from patients, clinicians, payers, and public health.
6. Identify a specific system-based constraint on primary care delivery, justify which of the 4Cs +patient centeredness it most directly undermines, and propose a realistic intervention along with its tradeoffs.
7. Reflect critically on whether primary care, as currently structured and financed in the United States, functions as an effective frontline of public health.
