Opinion

Doing what's best to prepare for the worst

The AMA launches a new journal on public health preparedness and disaster response.

Posted July 16, 2007.

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The nation -- indeed, the world -- has seen its share of grand-scale disasters in the past decade. Hurricanes. Wildfires. Earthquakes. Tsunamis. SARS. Terrorist attacks.

In each instance, physicians had a critical role to play. It is a guarantee that doctors will be called upon after future deadly disasters strike, whether man-made or wrought by nature. It's the reality of the world we live in.

And it won't be just doctors. Other health care professionals need to work in tandem with physicians to provide care in these extreme times of need. The information and skills needed to do the best job possible are beyond those that doctors acquire in medical school, and beyond those that other health professionals receive in their training. Consequently, a special niche of disaster medicine is emerging.

Recognizing these factors, the American Medical Association is doing its part to ensure that physicians and others in the health care community will be prepared to provide the best care possible to those who find their lives in jeopardy or in upheaval after the next major event.

In late June, the AMA launched the first comprehensive, peer-reviewed journal to emphasize public health preparedness and disaster response for all health care professionals. Disaster Medicine and Public Health Preparedness is a quarterly publication that will include best practices, guest commentaries from global leaders in disaster medicine, updates on topics such as public health law and ethics, advocacy, policy and education. The inaugural journal examines topics ranging from what was learned after the 1995 Oklahoma City bombing to lifeboat ethics and hospital surge capacity and excess mortality in the Katrina aftermath and physician relocation after the hurricane.

The welcome letter from the editor-in-chief, James J. James, MD, DrPH, MHA, stresses the importance of taking disaster medicine and public health preparedness to the next level, noting that the new publication "recognizes the need to address the health response to catastrophic events based on an all-hazards, multidisciplinary approach in the same way we have addressed the proper response to individual health needs; that is, to ensure that interventions are based on sound scientific evidence, in accordance with ethical and legal principles, guided by individuals provided the requisite education, training and tools for the delivery of effective, quality services."

Dr. James also acknowledges that disaster medicine is not the sole domain of any one specialty or discipline. Instead, he notes that it is an academic field for all health and response personnel, saying "the evolution of this concept clearly brings us to the intersection of medicine, in the broadest sense, and public health as the critical elements in public health preparedness and response and also appreciates the necessary contributions of others from the commercial, academic, charitable and government sectors as well as community support organizations to ensure effective responses."

In addition to producing the journal, the AMA is working with other organizations to ensure that patients receive better care during disasters. Also in June, the Association joined with the National Assn. of Chain Drug Stores, the National Community Pharmacists Assn., state Medicaid programs and others to announce the In Case of Emergency Prescription Database, or ICERx.org. It's an online resource that lets licensed prescribers and pharmacists caring for disaster victims access patients' comprehensive medication history -- securely (link).

The program will let health care professionals renew prescriptions for evacuees, reducing the risk of harmful prescription errors and potentially harmful drug interactions.

The nation has seen some horrible events unfold in recent years. The new disaster journal, ICERx.org and other projects in this vein are a positive response to these tragedies. So armed, the medical community will be better able to deliver the best care possible in the face of the worst that can happen.

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