Hospitals will play a key role in the transition from a "treatment society" to a "prevention society," U.S. Surgeon General Richard Carmona, M.D., said last week. Carmona, the 17th surgeon general, vowed to bring hospitals, patients, physicians, insurers, attorneys and government agencies together to establish best practices and reassess healthcare priorities and reimbursement strategies.
"We cannot afford to continue doing things this way," Carmona told an audience of academics, public health officials and students at a public forum on healthcare research and policy last week at Southern Illinois University in Carbondale.
He said hospitals and healthcare executives would play vital roles in furthering prevention as a healthcare system model.
"Clearly they need to take advocacy positions in their communities," he said, suggesting community/hospital collaborations to improve health and increase prevention awareness. "They are part of the solution."
Carmona can't force the nation's public schools to mandate more physical education classes, compel McDonald's to offer smaller portions or order children to leave their computers, televisions and video games to exercise or eat healthier.
But America's top doctor, who was confirmed in August, can use his bully pulpit to focus attention on issues. In addition to shoring up the nation's public health infrastructure and preparing for bioterrorism, the trauma surgeon, former hospital administrator and high school dropout also is targeting one of the country's most vexing health problems-obesity. Carmona said he's focusing on obesity because it is an aggravating factor in other preventable conditions such as asthma, diabetes, heart disease and hypertension. "Prevention! Prevention! Prevention!" he said, citing his administration's goal. "Everything I do is about prevention. Intelligence. Research. Counterterrorism. Infrastructure. Taking on obesity. It's all about prevention."
Carmona also said he would advocate for more scholarships to expand the number of midlevel practitioners, such as nurse practitioners and physician assistants, serving rural areas and poverty-stricken urban settings. He said our healthcare system employs "perverse incentives" that fail to reward physicians and hospitals for keeping patients healthy.
President Bush selected Carmona, in part, because of his role as an Arizona public health official in developing that state's Southern Regional Emergency Medical System and bioterrorism-response program. Carmona, former chief executive officer of the Pima (County) Health System, said the job of surgeon general has evolved dramatically since Sept. 11, 2001.
"Now we need to improve the public health infrastructure to meet any healthcare threat that could come before us," he said.