The launch of Disaster Medicine and Public Health Preparedness, an official publication of the American Medical Association (AMA), clearly demonstrates the commitment of American medicine to the health and security of our citizens and the citizens of the world.
This publication recognizes the need to address the health response to catastrophic events based on an all-hazards, multidisciplinary approach in the same way that we have addressed the proper response to individual health needs; that is, to ensure that interventions are based on sound scientific evidence, in accordance with ethical and legal principles, guided by individuals provided the requisite education, training, and tools for the delivery of effective, quality services. This publication recognizes the inherent need to codify and validate the emerging body of knowledge in disaster medicine that is based primarily on epidemiological and health services research, but also relies heavily on social science and empirical methodologies. Inherent in this construct is the recognition that this knowledge base is not the sole domain of any one specialty or discipline, but rather a legitimate academic field for all health and response personnel. The evolution of this concept clearly brings us to the intersection of medicine, in the broadest sense, and public health as the critical elements in public health preparedness and response, and also appreciates the necessary contributions of others from the commercial, academic, charitable, and government sectors as well as community support organizations to ensure effective response.
In 1847 the AMA, in its first published Code of Medical Ethics, defined physicians’ 3 obligations as being to the patient, the profession, and the public (ie, public health). By extension, in disaster medicine this ethical construct is applicable to all health care workers regardless of specialty or discipline. The obligation to the public implies that we all must be ready to respond effectively to public health emergencies, and the professions have an obligation to ensure that their practitioners have been trained and educated properly. The overarching goal of this journal is to provide a vehicle, or platform, for all health professionals to define both discipline-specific and cross-cutting skills and knowledge that are required in the event of a disaster or other public health emergency. To achieve public health preparedness we must realize that it is not the responsibility of the public sector at the local, state or federal level, nor is it the responsibility of the private sector—it is the collective responsibility of all of those components that comprise our health system, the individuals within them, as well as all of the required support elements that will allow us to evolve a disaster medicine system. It has taken years of collaborative planning and effort to build a system for trauma care; the same type of initiative is now needed to address disaster medicine.
The above being acknowledged, as an AMA journal the critical role of individual physicians in preparedness and response will be underscored and addressed. Regardless of specialty or practice, all physicians—and all health care professionals—need to be prepared to respond to emergency situations. This response requires knowledge and skills beyond those typically acquired in medical training and practice, and needs to encompass competencies for preparedness and response for all hazards. It further involves extending the clinical mindset to a population-oriented focus, with better understanding of the clinicians’ role in the broader public health system. This journal provides an enabling resource to accomplish this goal and will facilitate an environment in which public health preparedness is a secondary specialty for us all.
The overwhelming support for this effort that we have received from across the health professions, the response community, and so many others representing the broad fabric of society itself has been gratifying and appreciated. We hope that this first issue meets the high standards we have set, the expectations of our readers and contributors, and reflects the breath and depth of ongoing efforts to ensure national and global health security.
