Public health physicians: an endangered species

Questions have arisen regarding the competency levels of the various professions within the public health sector, including those of physicians. Protection of the nation's health requires that physicians on the public health team be competent practitioners of both medicine and public health. Physicians practicing in this arena are required to possess a vast array of knowledge, skills, and attitudes to be effective contributors in the field.

Using focus groups of key informants in public health, the context of practice, inventory of required competencies, current competencies, and identified gaps in these competencies, measures to address the situation were identified and discussed.

Recommendations from the focus groups include: use of distance-based learning, development of educational materials and programs, use of the American College of Preventive Medicine as a facilitator, improved remuneration, changes to the certification process, utilization of mentoring programs, introduction of new marketing strategies, use of professional publications, and increased governmental/agency support. Contributors to this endeavor are identified.

While we strive to improve the physician workforce entering the field, creative strategies for continued lifelong learning are urgently needed to facilitate ongoing development of physicians in the current public health workforce. This situation presents a major research agenda for public health practice. Identification of the essential knowledge, skills, and attitudes for public health physicians is the first step toward narrowing gaps in required competencies.