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Tuesday Apr 12, 2016

Family Medicine's Role in Strengthening Public Health

“I’m a clown, which could be a public health role.” -- Patch Adams, M.D.

Last week was National Public Health Week(www.nphw.org). Established in 1995, the week draws the nation’s attention to timely and impactful public health issues. In addition, it provides an opportunity to recognize the contributions of physicians, nurses, researchers and others who devote their talents to the betterment of public health.  

In this post, I would like to celebrate the family physicians who dedicate their careers to public health, as well as recognize the contributions that each of you make to the betterment of public health in your communities.

My colleague and family physician Julie Wood, M.D., is recognized as a national leader on the integration of public health and primary care. Beyond leading the AAFP’s efforts in this area, she drives the larger public dialogue on many public health issues and the role of primary care in addressing those issues.  

In 2015, she assisted in drafting The Practical Playbook: Public Health and Primary Care Together(www.practicalplaybook.org), which was a joint effort of the CDC, the de Beaumont Foundation and the Department of Community and Family Medicine at Duke University. In this text book, Dr. Wood described the relationship as follows. “Primary care and public health have natural links that strengthen each other.”

Public health has its origins in the United States dating back to 1798 when Congress created the Marine Hospitals to care for sick and infirm seamen. In 1870, the nation’s network of Marine Hospitals were reorganized into a centrally controlled Marine Hospital Service and placed under the supervision of the Supervising Surgeon -- a position later renamed Surgeon General.  In 1871, John Maynard Woodworth, M.D., was appointed the first Supervising Surgeon/Surgeon General.

In 1889, Congress created the commissioned officer corps as a means of providing physician workforce to the various Marine Hospitals. The commissioned officer corps later became known as the United States Public Health Service Commissioned Corps (PHSCC). The PHSCC is the federal uniformed service of the U.S. Public Health Service (PHS) and is led by the Surgeon General.  

The AAFP and family medicine have a long and proud history as a leader on public health issues. The earliest days of public health, outside of the military system, are grounded in primary care and community medicine. Family medicine and the AAFP remain strong contributors to the nation’s public health. Thousands of family physicians have and continue to serve in the Public Health Service Corps and each of you, in your own important ways, contribute to the health of your communities through your day-to-day practice of medicine.  

No single topic exemplifies our leadership more than the issues related to smoking and tobacco use. It is indisputable that the AAFP’s advocacy efforts on these issues drove changes in law and have been a major driving force behind national efforts to limit smoking and tobacco use. Clearly there is more work to do, but family medicine should be proud of the changes you have caused through your advocacy on these important public health issues.

Our work on public health issues is far-reaching. Honestly, there are few public health issue that the AAFP is not working on. We are at the forefront of efforts to curb the opioid and heroin epidemic, working closely with Surgeon General Vivek Murthy, M.D., the White House, governors(www.nga.org) and the CDC to identify and disseminate information that will allow family physicians to better identify abuse and intervene on behalf of patients in their communities.

The leadership of family medicine is on display each day through the work of AAFP President Wanda Filer, M.D., M.B.A., and countless others who are working tirelessly to educate the public, policy-makers, physicians, and health care providers on this important issue.

In addition, the AAFP is working on Zika, childhood immunizations, antibiotic resistance, obesity and countless other important issues.  

The AAFP has a full set of public health and social determinants resources available for you and your practice.   

One of the greatest demonstrations of family medicine’s commitment to public health occurred earlier this year (and continues to this day and will for years to come) when our colleagues and friends in Michigan stepped forward and provided demonstrable leadership to the community of Flint.  Most of you are aware of the series of tragic events that have come to light with respect to the water supply in Flint.  As family physicians you should be proud of the manner in which your colleagues in Michigan have responded to this tragic event.  I am especially moved by a quote on the Michigan AFP's website(www.mafp.com) which reads in part, “It is clear that Family Physicians have a large role in screening for lead poisoning and developmental issues in the children and families afflicted by the Flint water crisis. Their expertise, however, goes far beyond the provision of comprehensive medical care. … the heart of Family Medicine is community.”

I think it is important to reflect on the significant and important contributions family medicine makes to public health -- at the policy level, but more importantly at the community level. In 1989, the AAFP established a Public Health Award that recognizes individuals who have made or are making extraordinary contributions to the American public’s health. If you know of a family physician or group of family physicians who are making a difference in the health of the public, please nominate them so we can celebrate their contributions.

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Stephanie Quinn, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.