some physicians include some public health elements. These physicians include infectious disease physicians investigating health care-associated disease outbreaks, pediatricians working in school health, and emergency medicine specialists serving as the medical directors of emergency medical services. Beyond their day-to-day duties, the stories that they can tell of prevention efforts that have not been practiced may be a critical factor in public policy making. It was the voice of a practicing pediatrician, for example, that launched the national effort to place every child in an appropriate restraint when the child was traveling in a moving vehicle.

Finally, some physicians have careers in public health; that is, they can be identified as specializing in public health, whether they practice this specialty for their entire career or enter it as a change in specialty at some point in their career. These public health physicians work in a variety of settings, including nongovernmental organizations, managed care organizations, occupational medicine, aerospace medicine, academia, public hospitals, and governmental agencies. Figure 2.1 illustrates these different levels of physician engagement with public health. Movement upward in the figure, as indicated by the arrow, indicates the need for higher levels of public health knowledge and practice.

A public health physician policy maker involved in the development of population health policies might work with legislators to ensure that

FIGURE 2.1 Physician involvement in public health.



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