For the past decade or so it’s been all the rage among emergency medicine physicians to go back to school and get a Masters Degree in Public Health (MPH). Apparently under the theory that prevention would be the NEXT BIG THING in emergency medicine and by extension EMS.
Of course the public health people, abetted, or maybe lead by the federal government have turned everything in medicine into a “public health emergency”. Originally public health referred to the containment and eradication of things like Diphtheria, Dysentery, Leprosy, Tuberculosis, Smallpox and other dangerous, highly contagious diseases. And it worked, as most of those diseases are rare, if not eradicated. At least in the US.
Now, because it’s original mission has been successfully completed, public health as an entity needed new threats to conquer. So, what are the latest public health emergencies? Gun crime, not wearing your seat belt, smoking, domestic violence, and eating “bad” foods. While all of these things might in fact be bad for you, none of them are threats to the general public. Even the second hand smoke studies aren’t conclusive, but that’s a different story.
So, EM physicians, or some of them are on the public health band wagon. Now patients have to answer endless, pointless, questions about smoking, eating, domestic relationships, and whether or not they wear seat belts before they can be treated for their hand laceration. And the doctors wonder why their ED visit satisfaction rates are so low.
None of which really matters now as with health care reform a lot of this is going to change. Not necessarily for the better either, but time will tell.
Thinking about it, the EM doctors picked the wrong field of study for their degrees. If they had looked ahead sufficiently, they would have seen that they should have studied business administration instead. They forgot the Golden Rule; He has has the gold, makes the rules. Now they understand how contagious not wearing your helmet while riding a motorcycle is, but they have no idea how medicine is funded, where the money comes from, or how to get more of it. So, they (and we) are now likely to have care decisions made by accountants than by doctors.
I just guess this shows how hard it is to plan for the future.
So help me out with this; do you have a low opinion of people with a Master in Public Health degree? Is that what you're saying? /g/-LT
Actually, not at all. I have a low opinion of people who are engaged in the business of public health, which is telling people how best to live their lives, but that's a different story. I think that for a physician, having a degree in public health is like someone in EMS having a degree in EMS. A lot of money is spent for a degree with limited utility.
And I for one refuse to answer those intrusive questions… I will take my business elsewhere. Drs trying to branch into 'something' that will get them more $$ is usually a recipe for failure (remember REITs, then Farm land trusts???
Money or not, it's intrusive Nanny Statism and I don't like.I like my primary care doctor, he's a good guy and a good doctor. A couple of years ago he asked me if I had any guns. "Lots" was my answer. "Do you keep them loaded?" "Wouldn't be much good to me if they weren't would they?"He hasn't mentioned it since. Which is fine with me.
Old NFO,The questions have been mandated by JCAHO(the Joint Commission for Accrediting Healthcare Organizations), which is now known as TJC (The Joint Commission). Whether JCAHO/TJC appreciate the irony of naming themselves after marijuana cigarettes and their policies being less effective than something dreamed up by a bunch of stoners, is not clear. This intrusion of JCAHO/TJC into emergency medicine is required by the people in charge of Medicare. Since Medicare sets the rules, we can only expect more of this brilliance.I met a woman who had broken her ankle. Being the curious sort, I asked her about the treatment she received from EMS. She stated that she was in severe pain, but did not receive any pain medicine before she arrived at the hospital. Not a surprise. However, she did ask me why she was asked a bunch of questions about whether she feels safe in her home, how much alcohol and cigarettes she consumes, and other non-emergency questions. Knowing where this happened, I am pretty sure I know who the nurse was who treated her. He is book smart, but what good did it do this patient. If I am wrong about who it is, that just means that there are more of these clowns out there. Augh!He carries plenty of pain medicine, but used none of it. EMS does not need to ask these questions, but if one is attempting to show off for a nurse at the receiving ED, maybe providing the answers to these questions seems charming to him.This nurse is ahead of the curve on dragging this nonsense into EMS. We need people who understand patient care outside of the classroom, not a bunch of clipboard medics. End rant, for now.