Revisiting the Social Contract: Physicians as Community Health Promoters

The Shaw family is a typical U.S. family whose members live in a suburb of a small midwestern city. Mr and Mrs Shaw have three school-aged children, work full time, and earn a combined income of $75,000. They commute to work and drive an additional seven hours per week for errands and social and school events. On average, they eat out twice each week, and on a third night Mrs Shaw picks up some prepared food from the supermarket for dinner. Both adults work out at the local health club on weekends. Mr and Mrs Shaw, who are in their early 40s, are both overweight but have no other overt medical problems. One of the children has moderate asthma that is kept under control with the support of the school nurse. They visit their physicians regularly and attempt to follow all health advice. Physicians for the Shaw family have provided its members with detailed information on maintaining optimum health and changing unhealthy behaviors.