Ready for anything: From bioterrorism to environmental hazards

In this age of superlatives, "exceptional" or "first ever" are words that get thrown around a lot -- often when not entirely warranted. So it is noteworthy when an event occurs that truly deserves such billing.

Such is the case of the First National Congress on Public Health Readiness, a meeting co-convened last month in Washington, D.C., by the American Medical Association and the Centers for Disease Control and Prevention.

The conference brought together leaders from both medicine and public health to discuss community readiness strategies for terrorism and naturally occurring events. It offered a rare opportunity for these professionals to explore ways to address related and deadly serious health care challenges.

And the meeting was worthy of one more superlative -- it was a resounding success.

Nearly 1,000 professionals attended, evenly representing the two disciplines. The event began with CDC Director Julie Gerberding, MD, MPH, and AMA President John C. Nelson, MD, MPH, delivering keynote speeches underscoring the importance of the link between clinical and population medicine in ensuring that people in all communities are protected from infectious, environmental and terrorist threats.

Sixteen sessions then followed over the next two days, furthering the discussion of technical issues related to preparedness, work-force training and collaboration between all stakeholders. Experts delivered state-of-the-science lectures about diagnostic methods and therapeutics, among other things.

Maybe most important, the event presented the chance to shore up critical relationships -- those among clinicians, hospital and health plan administrators, and public health officials -- that ultimately will make the difference if a mass-casualty event occurs.

This aspect was one of the central themes -- reforging the medicine-public health partnership. The buzzwords were connectivity and communication. And the to-do list involved a rededication to community-level emergency planning -- an exercise that relies heavily on clinicians.

The House of Medicine long has demonstrated its commitment to disease prevention and health promotion. A cornerstone of this commitment is the ethical obligation to work toward the health and safety of our communities and nation.

Even before the 2001 anthrax attacks, the AMA was focused on ways in which organized medicine could roll up its sleeves and work toward this goal, especially in terms of disaster preparedness for bioterrorism and other weapons of mass destruction.

As a result, when the crisis occurred, the organization was poised to act. The AMA worked with the CDC to offer a satellite broadcast and Webcast of information for clinicians on diagnosing and treating anthrax. This is one of many ways the AMA was able to give physicians up-to-the-minute scientific information during that difficult time. Since then, the AMA Office of Disaster Preparedness and Emergence Response has further advanced the Association's involvement and presence.

In the background are the AMA policies that support this work. They encourage the creation of reliable and open links between individual physicians and the public health system, extending from national to local levels. AMA policy also urges the education of physicians across the continuum, from the undergraduate and residency years to continuing professional development.

Within these marching orders for the Association lies a take-home message for practicing doctors who will be on the front lines in the event of any incident. If progress is to be made in planning and preparing for a public health emergency -- whether it is a pandemic flu or a biological or chemical attack -- the key ingredients of local physician involvement and leadership cannot be substituted.

In this era of what can rightly be described as exceptional threats, coming from both man and nature, the medical and public health communities can fully expect to be tested by events. It is for the best that they are talking now.