The doctor and the obnoxious question

My friends will laugh but they can attest that this week, I have been smitten with a doctor who visited our class to talk about his experiences serving communities from Louisiana to Africa. RVJ is a "true product of Carolina", graduating from the University's undergraduate, medical and public health schools. Go Heels!

Why smitten? I'm not so easily swooned by a Southern accent but rather inspired and captivated by the honesty with which RVJ talked about the path that led him to becoming a doctor and obtaining an MPH. Said doctor relayed his experiences serving patients after some of the world's greatest horrors - living and providing care in the slums of Nairobi, treating patients in the SuperDome post-Katrina, and working in Jacmel, Haiti just days after the devastating earthquake. RVJ recounted his experiences evoking serious undertones of the grave situations facing his patients juxtaposed with his humor and the adventurous lens, in which he sees the world. This doctor is a great storyteller - an art I have been fortunate to appreciate from an early age. While recounting his stories, the good doctor emphasized the importance his public health degree played into the services he provided to his patients across the globe.

Tonight, RVJ was the featured speaker at the Gillings School of Global Public Health's 43rd Annual Fred T. Foard Jr. Memorial Lecture. Again, said doctor filled the room with laughter and inspired another group of students and faculty with his thoughtful anecdotes of his medical career to date (though this audience was quite a bit larger than my little lecture from earlier in the week). I was pleased to see the good doctor in action again - a requirement of another class but one that I did not mind fulfilling.

After the lecture, the floor was open to questions and someone asked something like this: "You have been asked to speak at the School of Public Health's annual event yet you are a medical doctor who has stood up there and talked about treating individuals. Where is the public health?"

Note: If you were waiting, this is the obnoxious question.

I was astounded. Really, is it one or the other? Yes, public health is about the health of a population and medicine is about treating individuals but we cannot fully divide the two as completely separate entities. In my "health development world" we talk about "integration" as the best thing since sliced bread. "Let's integrate HIV/AIDS and Family Planning." "Let's integrate nutrition into MCH." "Let's integrate to avoid silos and have more vertical approaches. "

What we need is more public health integration. Public Health and all facets of health must be integrated including medicine, nursing, dentistry, mental health etc. Public Health is more than the health of a population and medicine is more than treating an individual. There is no jury that says one is more important than the other and in truly upholding the ethics of healthcare, we owe it to populations and individuals to provide high quality prevention and treatment. Physicians and healthcare providers, especially amidst the backdrop of the reality of globalization, absolutely must recognize the value of bridging the sciences of public health and medicine.

I know one thing - I sure do hope my doctor has an MPH.