Medical education must put greater emphasis on public health and prevention

Closer ties between academic medicine and public health will better serve patients and the profession, says American Journal of Preventive Medicine supplement

If future physicians are to best serve the changing health needs of patients and their communities, medical education must put greater emphasis on public health and prevention, experts say in a supplement to October's American Journal of Preventive Medicine (AJPM).

The supplement, including more than 30 research papers and commentaries authored by top medical educators and public health professionals, is sponsored by the Association of American Medical Colleges (AAMC) and the Centers for Disease Control and Prevention (CDC). It grew out of a conference, "Patients and Populations: Public Health in Medical Education," that the AAMC and CDC organized in 2010 as part of a commitment to strengthen collaborations between academic medicine and public health.

Historically, the public health, population health, and prevention aspects of medical education were often omitted from physician training, supplement editors Rika Maeshiro, MD, MPH, of AAMC; Denise Koo, MD, MPH of CDC; and C. William Keck, MD, MPH, of the Northeastern Ohio Universities College of Medicine, in Rootstown, Ohio, write in an introductory essay.

But, they add, "efforts to develop health professionals who can improve health, and not just deliver health care, should be a continuing priority for the academic medicine and public health communities." There is an urgent need for physicians "with a better appreciation for these issues to help address complex public health challenges that include rising chronic disease burdens, persistent health disparities, and healthcare financing that encourages treatment over prevention," they write.

In his commentary, Institute of Medicine President Harvey V. Fineberg, MD, PhD, notes that although public health and medicine "approach the challenge of health and health care from distinct, complementary perspectives," many initiatives "are bringing the principles, values, experience, and analytic perspectives of public health into the daily practice of medical education."

A number of papers in the supplement go into detail about how some of those initiatives are more effectively integrating public health and prevention principles and practices into medical education.

AAMC Chief Academic Officer John E. Prescott, MD, underscores the need for that trend to become even more common. "Producing better physicians for the future clearly requires a reconsideration of their education," he says in his essay. In the future, he notes, physicians must be "skilled team players, who excel in systems-based practice, who provide patient-centered care, and who can work with and in their communities to improve health."

Judith Monroe, MD, the Director of CDC's Office for State, Tribal, Local, and Territorial Support, concurs in her essay, noting that "There is power in the collaboration of medicine and public health, and we need to find better ways to harness this power to meet our current and future challenges."