April 27, 2020 01:50 pm David Mitchell – Douglas Kamerow, M.D., M.P.H., never aspired to be a writer, but his way with words has proven to be an important part of his career as a physician.
"When you look back at your career, it seems like you had all these steps planned," he said, "but the reality is that opportunities arise, and you take them as they come. It's just how it turned out for me."
After working as a general practitioner for two years at a community health center in Rochester, N.Y., Kamerow completed his family medicine residency at the University of Rochester and Highland Hospital in 1983. He then continued his training with a master's degree in public health from Johns Hopkins University in Baltimore and an epidemiology fellowship at the National Institute of Mental Health.
"It didn't take long in practice to realize that a lot of my patients' problems weren't related strictly to medicine," said Kamerow, who was an assistant surgeon general from 1997 to 2001. "There were other issues I couldn't fix, often related to socioeconomic factors."
Working in U.S. Public Health Service research settings led to writing, editing and publishing. Kamerow has contributed to more than a dozen books and more than 140 journal articles and editorials.
From 1988 to 1994, Kamerow directed the clinical preventive services staff of the Office of Disease Prevention and Health Promotion in the Office of the Assistant Secretary for Health. In that role, he led the staff who worked with the U.S. Preventive Services Task Force and he edited the task force's first two books. He also advised the assistant secretary for health on issues such as screening tests and immunizations -- topics addressed by the then-fledgling task force.
"That was a great experience," he said. "In the early days, the task force was ignored and sometimes condemned. Now it's respected. Not only are its opinions followed, it has been put into law that Medicare has to cover its A and B recommendations."
In 1994, the task force moved with Kamerow to the Agency for Health Care Policy and Research, which later became the Agency for Healthcare Research and Quality. As director of the Office of the Forum for Quality and Effectiveness in Health Care, he led the development of AHCPR's clinical practice guidelines. Later, as director of the Center for Practice and Technology Assessment at AHRQ, he conceived of and led development of the Evidence-based Practice Center Program and the National Guideline Clearinghouse.
In 2001, Kamerow retired from the PHS Commissioned Corps and left the AHRQ to become a chief scientist at RTI International, where he led research on health-related behaviors, prevention, evidence-based care and quality improvement for more than a decade.
During that time, Kamerow also became editor of BMJ USA, which was a sister publication to The BMJ. In 2006, he became U.S. editor of The BMJ and was named an associate editor two years later. From 2007 to 2011, he also provided regular health policy commentaries for National Public Radio, a role he continues to fill for the journal.
"It's been fun to have a global platform to talk about what's going on in the United States, whether it's Obamacare, e-cigarettes or something else," he said. "It's been a nice opportunity to have a voice."
"There was a lot of comment in the press about ER and ICU doctors," he said. "They were being called heroes, and indisputably they are. But primary care doctors are at risk, too.
"Also, some family physicians have cut back on their own practice and have been redeployed to other areas of need. We are so flexible, and our training is so broad, that we can help with surge capacity in ICUs and ERs."
Kamerow gave up clinical work last year after more than 35 years supervising Georgetown family medicine residents, but he continues to lecture and teach medical students there on issues related to health policy.
In addition to his roles at Georgetown and The BMJ, Kamerow is the senior scholar in residence at the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care. The Graham Center works to improve individual and population health care delivery through primary care-focused health policy research.
"I basically have three part-time jobs, which is very lucky," he said. "In all of them I try to be an advocate for the use of best evidence, whether in clinical practice or health policy. I even flatter myself in thinking that my opinion pieces have an evidence base, which may not, of course, always be true."