Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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1 Introduction
1 Introduction
Pages 5-13
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From page 5... ...
Unaware of this potential shortcoming and faced with growing concerns about the potential health effects of environmental damage and contamination, people seek help from their physicians because, in general, they trust them and value their advice (McCallum and Covello, 19891. In order to respond appropriately, physicians need to be clinically competent in environmental medicine and dissuaded from the all too common practice of reflexively offering blanket reassurance to patients who feel they have been exposed to, or harmed by, an environmental toxicant.
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From page 6... ...
Although the precise impact of environmental illness and injury is virtually impossible to compute—partly because adequate surveillance mechanisms do not exist and partly because environmentally related disease often goes unrecognized as such there is enough undisputed evidence of the relationship between environmental exposure and disease to justify moving from concern to action. For example' the Centers for Disease Control and Prevention estimates that 3 million preschool children in the United States have blood
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From page 7... ...
These same advances in biology pose every likelihood of providing direct insights into the relationship between environmental factors and common diseases. Finally, physicians' skills and knowledge must be adequate not only for treating their patients but also for explaining their actions in public health, legal, and regulatory arenas, if necessary.
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From page 8... ...
Thus, many of the most effective prevention activities of environmental medicine occur outside the traditional clinical paradigm. However, many of the interventions flow directly from an individual physician-patient encounter that identifies a health problem or risk attributable to specific environmental factors or conditions.
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From page 9... ...
indicates that courses in environmental medicine are rare and, when offered, are usually elective in nature, competing with many popular alternatives. Medical education's focus on the individual patient with disease has not encouraged faculty and students to step beyond the medical mode} and consider the health of He population be it the physician's practice population, a worker population, a neighborhood or community population, or the population of a state, region, or nation.
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From page 10... ...
Noting that primary care physicians are often the health _ ~ ~ ~ professionals of first contact for patients with environmentally related illnesses, the TOM suggested that as a minimum, all primary care physicians should be able to identify such illnesses and refer patients appropriately for follow-up (Institute of Medicine, 19881. Two subsequent TOM reports on occupational and environmental medicine addressed physicians' needs for medical information (Institute of Medicine, 1990)
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From page 11... ...
; · be advocates for individual patients by co~rununicating with employers, landlords, local public health authorities, and other relevant agencies, as needed; · become involved at the community level by advising and educating local citizens, groups, colleagues, public health officials, and community leaders about environmental health; and · participate in public health policymaking at the local, national, or international level. kc health and the environment.
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From page 12... ...
The report articulates a general program of implementation strategies and provides immediate practical advice to individual educators, students, and practitioners who either are interested in integrating more environmental medicine content into medical education or need resource information to help them address clinical situations. Chapter 2 begins by laying the foundation for an environmental medicine curriculum centered on six competency-based learning objectives.
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From page 13... ...
, environmental associations and organizations, regional and international information services, computerized information services, resources by selected topic (e.g., air pollution, clean water, and radon) , general reference books and journals, a medical school listing of environmental medicine activities, and several tables of toxic chemicals, health effects, and occupational exposures.
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