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President's Page
September 2004
DCMS & Health Department:
Working together for Dallas
2004 DCMS PresidentThe new medical director of the Dallas County Health Department and I have met occasionally to explore ways the health department and DCMS can better focus our organizations on the many potential problems relating to our communities’ health. This especially is important with the specter of bioterrorism and disease outbreaks such as SARS. In addition to health considerations, the cost of not being prepared is staggering. The cost to Toronto, with fewer than 40 confirmed cases of SARS, was in the billions of dollars.
My latest meeting with David Buhner, MD, had a sense of urgency. In the past three months, the medical director and liaison for the public health department retired and the county’s epidemiologist died suddenly. Dr Buhner is trying to gather support for the many challenges of his new position, and he has no time to waste. DCMS members can help in many ways.
Our Dallas County Health and Human Services Department does an enormous amount of work, and, like health departments throughout the country, faces difficulties resulting from inadequate funding. Decreases in federal, state, and county funding have placed serious constraints on the department’s ability to maintain services at a time when increases in services are being demanded. The department focuses on disease detection and monitoring—funding for treatment is nonexistent. The department has computers to help implement data collection and interpretation, but they sit in boxes while the staff awaits funding to provide software support.
Fortunately, the department has some positive news. Despite the limitations, our public health department does a great job, and it would like to do better. Zac Thompson is proving to be a true leader in his new role as DCHHS director. He has been impressive in trying to improve immunization rates in Dallas County, an area he has set as top priority. He has been effective in trying to preserve funding for the department. He has allowed Dr Buhner to take over the medical aspects of the department while he deals with the politics of the Commissioners Court. Dr Buhner, a rheumatologist and now epidemiologist, has leadership and communication skills that will serve the department well. He realizes the vacuum between the work of his department and the practicing physician, and the immense value in having the support of more than 6000 DCMS members. He is eager to earn that support. We have the potential to accomplish great goals if we work on public health issues together.
Dr Buhner’s work is more difficult because of one basic problem—there is little connection between our two organizations and no connection between the health department and the practicing physician. Dr Buhner says that the department does not rely on physicians in tracking disease in our county. Most physicians do not know much about the health department and consider that whatever it does, does not relate to us. If the health department doesn’t seek our help and we don’t offer help, Dallas will continue to have real problems. More than 90% of the health care in Dallas County is delivered by our members, which makes it important to emphasize that Public Health is our health. Only when the physician believes in his individual responsibility for the health of the community will great strides be made in the public health.
DCMS and the health department are working well together in several areas. We have used our blast fax capabilities to disseminate information to our physicians about department activities and West Nile, rabies, and potential bioterrorism alerts. This is an excellent start to connect to our members on a real-time basis. Even the cardiothoracic surgeon who may never see a patient with West Nile virus can become a volunteer of potential vital information if he sees himself in the much broader role as a physician involved with the community’s health, not just his patients’ health. Without DCMS support, the cost of a blast fax in time and money to the health department would be prohibitive. The society’s investment in software and communication systems again is paying off in its ability to keep members informed. We also have begun to work with the TMA Committee on Public Health to lobby for more funding directed to our county’s health department.
The Medical Reserve Corps has been created by the health department as a first-responder system to integrate the county’s health agencies in response to bioterrorism. Initial meetings have seen a good response from our membership. We can do far better because most of the attendees are nonphysicians. Your leadership and the health department are exploring the organizational aspects of such a system. There is no national standard as other cities and counties attempt to create an effective system of both detection and response to the unknowns of disease and bioterrorism. We hope to develop a coordinated model of integration with the health department and DCMS that will serve as an example across the country.
These are but two examples of how DCMS is increasing its involvement with the future of the health department. It is important that we as physicians understand that our own health and well-being is dependent on our community’s health, and that ultimately we are responsible for both. Dr Buhner and I have emphasized the possibilities of a much stronger public health initiative. Perhaps a more aligned medical society and health department could begin to direct our efforts toward air quality, obesity, and other societal ills. The possibilities are exciting.
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