Training Physicians for Public Health Careers (2007) / Chapter Skim
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1 Fundamentals
1 Fundamentals
Pages 15-28
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From page 15... ...
, authorized the Health Resources and Services Administration to contract with the Institute of Medicine to determine what knowledge and skills that public health physicians need, the number of programs needed to maintain an adequate supply of physicians trained for public health careers, and to examine how these programs can be funded. Physicians are a vital part of the public health workforce and are the focus of this report.
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. Third, in the face of public health emergencies, the committee envisions a future with sufficient numbers of well-trained public health professionals, including physicians, to plan for and prevent these emergencies or to respond to them.
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concluded that America was not as healthy as it should be nor was it as well prepared as it should be to address future health challenges. The report's central message was that to protect and promote health and well-being, the nation needs a strong governmental public health infrastructure.
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The 2003 Institute of Medicine report explored several areas of action and change, including adopting a focus on population health that includes multiple determinants of health, strengthening the governmental public health infrastructure, building partnerships with other sectors, developing systems of accountability, emphasizing evidence, and improving communication within the public health system (e.g., among all levels of the governmental public health infrastructure and between public health professionals and community members)
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Changing societal norms and influences Changing the public health system • Increase emphasis on prevention • Strengthen the governmental public CHANGE NEEDED • Recognize the importance of a health infrastructure population approach to health • Forge and sustain diverse improvement partnerships • Acknowledge the contributions of • Improve accountability multiple determinants of health and • Develop and utilize evidence base policy on this evidence • Enhance communication Public policy that supports health Improved Population Health and the Elimination of Disparities: THE OUTCOME Healthy People in Healthy Communities FIguRE 1.1 Framework of the report The Future of the Public's Health in the 21st Century.
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In addition, clinical practitioners and researchers in basic health and social sciences work to design and implement public health interventions using the combined expertise of these diverse disciplines and professions to ensure that they have practical applicability and relevance. An effective public health system requires a well-trained workforce of sufficient numbers and diverse disciplines to address current and emerging public health needs.
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These broad public health programs and efforts combine the most current scientific discoveries with the expertise of individuals in other disciplines -- advertising and social marketing, indoor air quality assessment, legal enforcement, and public opinion -- that have become synonymous with public health practice. Nevertheless, as mentioned earlier, there is a growing shortage of public health workers (ASTHO, 2004)
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Public health professionals, on the other hand, focus on population health broadly by using interventions designed to improve public health through changes to the environments in which people live and work, by making concerted efforts to modify human behavior and lifestyles to improve their health, and by ensuring that all individuals in society receive uniform medical care. Public health professionals specialize in population-based areas, such as epidemiology, environmental health, disease control, maternal and child health, injury control, occupational health, and nutrition (Fineberg et al., 1994)
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Physicians who have supplemented their medical training with formal training in public health (in certificate or degree programs) or appropriate public health experience have the added benefit, from a public health perspective, of being able to draw upon their medical training while addressing issues using a more population-based approach.
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Physicians are therefore vital to the public health enterprise and bring unique knowledge, skills, and competencies that add value to addressing public health problems. Attracting Physicians to Public Health Ensuring that an appropriate number of physicians choose careers in public heath helps build a public health infrastructure that will provide benefits for all members of society.
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For example, data show that the average tenure of state health officers between 1990 and 2006 was 3.76 years.1 CONTExT Physicians are a crucial component of the workforce, and it is therefore imperative that adequate numbers of physicians with training in public health be available to support the broader public health community. All physicians engage in public health activities some of the time; and their training in public health is important to excellence in public health practice, teaching, and research.
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Events or significant changes in health care could dramatically alter the estimates of the numbers of physicians needed in the public health workforce. Factors that could alter future needs include • the emergence of new, as yet unknown environmental risks, such as emergent infectious disease agents or environmental toxins; • dramatic changes in the delivery of health care that reduce the risk of disease onset and the progression of diseases that demand a significant effort by public health physicians, such as the development of a vaccine or the implication of a therapy that derives from genomic medicine; • the discovery of behaviors that could significantly increase or reduce the risk of disease and disease progression that requires significant input from public health physicians to implement the behavior; • a dramatic change in or fragmentation of the existing health care system that places an increased burden upon public health physicians; and • a natural or human-made disaster (perhaps much more severe than recent disasters encountered in the United States)
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1998. Preparing currently employed public health professionals for changes in the health system.
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From page 28... ...
2003b. Who will keep the public healthy: Educating public health professionals for the 21st century.
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