Want to prevent the next public health crisis? Ensure a strong preventive medicine workforce

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Face the facts: Our healthcare system was not prepared for COVID-19. From skyrocketing emergency department and intensive-care unit admission rates, to plummeting levels of critical supplies, consistent misinformation, and inconsistent testing—we were caught off guard.

Prior to COVID-19, our healthcare system was already bowing under the weight of the epidemic of type 2 diabetes, hypertension, heart disease, and other chronic conditions that were common indicators for higher mortality with COVID-19. These diseases impact more than 129 million Americans and take more than 1.7 million lives every year–more than double the lives the pandemic claimed in the U.S.

Recently, the Biden administration announced plans to invest more than $7 billion from the American Rescue Plan to improve the public health infrastructure through training and hiring. As preventive medicine physicians, we commend the administration on this proactive effort, but warn that unless these efforts are directed at training the public health and clinical workforce responsible for addressing the chronic disease epidemics, our systems and our communities won’t be prepared for the next disaster when, not if, it happens.

To effectively achieve the goal of improving the public health infrastructure, this one-time influx of money must be paired with a longer-term, strategic investment in public health-trained physician leaders, including preventive medicine physicians. The American College of Preventive Medicine encourages hospital and health system administrators, public health officials, and clinical advisers to invest in elevating the skill set of a healthcare workforce that is uniquely trained in both clinical and public health.

A strategic move to evolve us from sick care to well care sets up on solid footing to begin building a system that prioritizes the practice of prevention. By screening for diseases and promoting wellness initiatives at the population health level, we can address common chronic illnesses that currently impact half of all Americans and cost the country more than $3.8 trillion. Unless strategic investments are made now, these figures will only continue to grow and further deteriorate the health of our nation.

Formal public health training and real-world practice-based experiences provide opportunities for specific skill building. While meeting the growing demands of healthcare require these future leaders to have competency in clinical preventive medicine, it is crucial they also have a firm grasp on the C-suite perspective, the healthcare needs of their populations, and the evidence-based approaches to address clinical and public health challenges.

Competency-based training in all these areas provide future leaders with the business reality of operating a high-quality and sustainable health system, an administrative understanding of preventive medicine, population health and clinical training. This broad and formal instruction allows for quick and efficient integration and engagement across a wide range of health settings from hospital administration and public health to preventive medicine and clinical care.

The appropriations of emergency COVID-19 relief funds to public health workforce development provide a unique opportunity for healthcare organizations and systems to enhance their infrastructure in dealing with current and future health challenges. To ensure long-term public health preparedness and success, ACPM encourages hospital and health system leaders to build a future workforce that understands their workplace at the clinical, population and administrative levels. These investments will provide health systems the infrastructure to respond quickly and ably to challenges we face now and in the future.

Dr. M. “Tonette” Krousel-Wood is president of the American College of Preventive Medicine.

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