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Growing and Strengthening Preventive Medicine Miriam Alexander, MD, MPH, FACPM President-elect of ACPM and Director of the General Preventive Medicine.

Published byClement Ellis Modified over 8 years ago

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Presentation on theme: "Growing and Strengthening Preventive Medicine Miriam Alexander, MD, MPH, FACPM President-elect of ACPM and Director of the General Preventive Medicine."— Presentation transcript:

1 Growing and Strengthening Preventive Medicine Miriam Alexander, MD, MPH, FACPM President-elect of ACPM and Director of the General Preventive Medicine Residency Program Johns Hopkins Bloomberg School of Public Health February 19, 2011

2 Our Goal Today Do you want to treat the patient or do you want to improve health?? What the history of public health can teach us What prevention really is… Lesson learned from Industrial Hygiene and Safety

3 The History of Public Health (in one slide!) Quarantine Sanitary Idea World of Work Education and mothering Body spaces: from inoculation to immunization Professionalization  Courtesy of Graham Mooney, PhD

4 Preventive Medicine (PM) The medical specialty dedicated to health promotion and disease prevention—ACPM 1954 One of the 24 specialties recognized by American Board of Medical Specialties ABPM 1947 Only board-certified specialty that combines clinical and population-based health practice

5 Fellowships—unstructured Fellowships—structured Residencies—generally defined Residencies—increasing structure Training Programs in Preventive Medicine

6 Residency Training Yesterday Today Fights, Battles and Wars Tomorrow

7 What can we learn from Public Health??

8 Twentieth Century U.S. Mortality Rate: 1900-2001

9

10 Cause of Death (U.S. 1990) Tobacco19% Diet/Activity14% Alcohol5% Microbial agents4% Toxic Agents3% Firearms2% Sexual Behavior1% Motor Vehicles1% Illicit Drug Use<1% McGinnis & Foege, JAMA, 1993 Tobacco Diet/Activity

11 Who is our patient? Individual Patient Medical Office Health Care System Public/Population

12 How Can We Make Prevention A Continum A Win for One and A Win for All

13 How do we Make Decisions? Evidence/Science Social Will Political Will

14 WHAT CAN WE POSSIBLY LEARN FROM THE INDUSTRIAL HYGIENE/SAFETY WORLD??

15 Hierarchy of Controls Engineering Controls (ie. substitution, elimination, etc) Administrative Controls (ie. Scheduling, policies and procedures, work practices, etc) Education (ie. Training, certifying, etc) Personal Protective Equipment (protect the person) Hope the person does their best!

16 How should we choose the right control?? Best: At the source Second Best: Along the Path Least Desirable: At the worker  UIC.edu/sph/glakes/hierarchyofcontrolfactsheet.doc

17 What do you think???

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