Want to improve public health? Stop thinking like a doctor.


The replacement of guards in US public health is imminent. This is a chance to revitalize unstable areas. Anthony Fauci is retiring in the shadow of the worst preventable disaster in history, and President Biden is moving to make new appointments. Established Permanent White House Office for Pandemic Preparedness and Response Policy. In doing so, Biden and his advisers must confront the fact that public health corruption is structural. Building a decent national health infrastructure will require confronting pervasive public health distortions and reinventing the system of leadership appointments that has made America’s public health agency a prisoner of partisan interests.

Part of what makes public health vulnerable and a toy of partisan politics is Gradual medicalizationFor example, consider the history of the most important public health agency in the United States. Since 1953, all directors of the Centers for Disease Control and Prevention (CDC) have earned a Doctor of Medicine (MD) degree as their primary qualification, with secondary degrees used primarily as resume adornments. I’m here. Given that medical intervention is a component of Only 10-20% of modifiable factors Affecting health, the background reflected in CDC’s leadership, and likewise most state and local public health agencies, is narrow, at the expense of other areas that represent the remaining 80-90% of relevant knowledge. Notable for consistently prioritizing biomedical expertise. to formulate public health policies;

Physician and Public Health Scientist Milton Roemer one time Observed For public health work, “most medical education is irrelevant.” But neither physicians’ irrelevant medical knowledge nor their relative ignorance of important areas such as labor history, social anthropology, political economy, epidemiology, and environmental science are among the most troublesome for physicians in managing public health. not the sides. Rather, it is a lack of epistemological humility, an inability to recognize the limitations and dangers of clinical reasoning that medical training often imbues them with. Not just not. It’s often the exact opposite.

Danger of clinicalism

When we treat patients, doctors try to properly care for the patient in front of them. We generally recognize that we cannot change their living circumstances. For example, economic and housing conditions, employer demands, student and medical debt, neighborhood violence, and social isolation. existing constraints.

Public health, by contrast, is about treating populations. Like medicine, the goal of public health is to break free from health restrictions that limit an individual’s ability to live as they please. But public health pursues this in a very different way. Work is not about helping individuals adjust to oppressive social or work situations. Instead, use the power of government to change the conditions that limit people’s freedom. The core tools of public health are therefore not only vaccines and laboratory tests, but also corporate regulations and policies regarding consumer safety standards. labor protection; public jobs and housing programs; investment Community Health Workers, Decriminalization, and Jailbreaks. and civil rights litigation.

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