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Erica Ilene Lubetkin, MD, MPH, Shoshanna Sofaer, DrPH, Marthe R. Gold, MD, MPH, Marc L. Berger, MD, James F. Murray, PhD and Steven M. Teutsch, MD, MPH

Erica I. Lubetkin and Marthe R. Gold are with the Department of Community Health and Social Medicine, City University of New York Medical School, New York, NY. Shoshanna Sofaer is with the School of Public Affairs, Baruch College, City University of New York, NY. Marc L. Berger and Steven M. Teutsch are with Outcomes Research and Management, Merck & Co Inc, West Point, Pa. James F. Murray is with Health Benefits Management, Human Resources Decision Support, Merck & Co Inc, Whitehouse Station, NJ.

Correspondence: Requests for reprints should be sent to Erica Ilene Lubetkin, MD, MPH, Department of Community Health and Social Medicine, CUNY Medical School, 138th St and Convent Ave, New York, NY 10031 (e-mail: lubetkin{at}med.cuny.edu).

Both the medical care and public health systems have invested considerable resources to define, measure, and improve quality and health outcomes. A movement toward accountability has generated performance indicators from the medical arena and "leading health indicators" from the public health arena.

The focus on specific conditions by the medical care system has been at odds with public health’s emphasis on improving population health and has perpetuated a bifurcated system.

Aligning the goals of medical care with those of public health will require reformulation of performance measurement and accountability into a common language that is valued by both systems. Such a creation would amount to a whole that is stronger than the sum of the component parts.

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