Vital Times 2017 - 75

Why I am passionate about
public health (and you
should be too!)
By	Emily	Methangkool,	MD

P

eople often ask me, "Why are you so interested in
public health?" With a superficial glance, public health
doesn't have much to do with anesthesiologists. After
all, we are not on the front lines advocating for tobacco
cessation, mammography screening, or childhood
vaccinations. Furthermore, no one ever embarks on
public health campaigns with anesthesiologists in mind.
However, I propose to you that public health has a
profound impact on our work in anesthesiology, and here
is why.

Public health is about patient safety
As physician anesthesiologists, we have always been
the first advocates for patient safety. We made one
of the most dangerous procedures in medicine -
undergoing anesthesia - one of the safest, and we are
the only medical specialty to have our own patient
safety foundation. Every day, our usual routine involves
numerous safety checks, even before the patient enters
the operating room. We should and must maintain our
position as the most vocal advocates for patient safety.

Public health is about quality
improvement
Patient safety and quality improvement often go hand in
hand. Improvements in perioperative outcomes would
not have been possible without concerted efforts in
quality improvement. The stepwise nature of work in

the operating room is perfect fodder for quality work,
as there are numerous entry points for improvement
with potentially high gains. Indeed, as "quality" and
"outcomes" become more important for reimbursement,
efforts in QI will become even more significant.

Public health is about epidemiology
The very first lesson any public health student learns is
about John Snow, who discovered that a deadly cholera
epidemic in London was linked to a contaminated water
pump on Broad Street. John Snow is often called the
"Father of Modern Epidemiology," and coincidentally
enough, also happens to be an anesthesiologist. As long
as there continues to be morbidity and mortality that
results from anesthesia, epidemiology will be important
as a tool for us to understand why.

Public health is about global health
Although perioperative morbidity and mortality have
declined precipitously since the 1970s, these gains are
seen more in developed countries rather than developing
countries. In many low-income countries, perioperative
mortality (in the OR and within 30 days) is unacceptably
high, due to lack of infrastructure, equipment, medicines,
and qualified personnel. As the global burden of disease
shifts from communicable to noncommunicable chronic
disease, more and more people around the world will
need surgical interventions, and the need for safe
anesthesia will become even more important.
(continued)

Annual	Publication	2017	|	 	75



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