They would seem to be at least so it appears to be in the presentation of the "population medicine approach" of by Dr. Harold Sox,former editor of the Annals of Internal Medicine, former president of the American College of Physicians (ACP) and former chair of the U.S. Preventive Services Task Force, offered in the November 13 ,2014 issue of the Journal of the American Medical Association (JAMA).
Here is my thumbnail summary of what Dr. Sox wrote in describing how the population medicine approach would work.The major important diseases would be identified as would methods for their prevention. With that knowledge in hand , then funds could be transferred across patients and disease processes so that the maximal overall health benefit could be achieved.In this process it might well be that sometimes funds would be diverted away from the testing and treatment of some so that the preventive measures could be funded and then " in a few generations" the benefit would be fully realized.He is explicit regarding the fact that in the short run some people would be harmed although he does not seem to explain why it would be only the short run as would not new preventative measures always be formulated and have funds diverted to their execution.The population medicine advocates claim the approaching of each patient strictly as a individual is "obsolete" and are promoting a statistical medicine that claims to be capable of provided the greatest health benefit to the greatest number.Practicing physicians know how difficult it can be to recommend what might be best for the individual patient,the "populationists" glibly claim to know what is best for everyone.
In chess, pawns or for that matter any piece, might be sacrificed in executing a strategy of placing the opponent 's king in checkmate. Is it the case that individuals might be sacrificed in executing a strategy of maximizing the health of the specified population as measured by some metric such as quality adjusted life years (QALY) per dollar spent ? After careful study and multiple re-reads of Dr. Sox's article my answer to the question posed in this commentary's title is yes.The patients are the pawns on the chess board of population medicine.