1) AAPHP Educational Focus At APHA - Disaster Management:

AAPHP President Arvind K. Goyal, MD, MPH has scheduled the semiannual AAPHP sessions at Philadelphia as follows:

SUNDAY, DECEMBER 11, 2005

10:30 - 11:30 am: AAPHP MEMBERSHIP BUSINESS MEETING
Tentative location: Philadelphia Marriott, Room 301.
The agenda will be announced by 2005-12-04 in E-News.
Agenda will also be posted at http://www.aaphp.org
under the "Meetings" tab by 2005-12-04.

12:00 noon - 2:00 pm: APHA OPENING SESSION
Location: Pennsylvania Convention Center.
The APHA does not allow "Related Organizations" to
hold meetings that conflict with this session.

2:00 - 7:30 pm: AAPHP EDUCATIONAL SESSION
Tentative location: Philadelphia Marriott, Room 301,
AMA's disaster management course "Core Disaster Life
Support (CDLS)" will be presented by Public Health
Physician JAMES J. JAMES, MD, DrPH, MHA and his
teaching team from the American Medical Association.

***

There is no fee, and there is no registration requirement, for the morning's AAPHP Business Meeting.

The afternoon session will involve a half hour of "Registration and Welcome"
at the beginning, and a half hour of testing and evaluation at the end.
There are three ten-minute breaks during the afternoon. Four hours of Category 1 Continuing Medical Education (CME) are available for the CDLS course.

The AMA customarily charges tuition for the CDLS course. Along with APHA and AMA, we are exploring mechanisms to cover the tuition fees. AAPHP will do everything we can to help make this course affordable for all Public Health physicians.

(If your agency requires detailed financial projections in advance, please let them know that course fees will be as low as possible in the range of zero to $100. As soon as we know the actual cost, we will inform E-News
readers.)

We're grateful to Dr. James and to Public Health physician Georges Benjamin, MD, Executive Director of the APHA, for their cooperation in the arrangements for this program.

Please attend if you can -- and forward the meeting notice to others.

For those who will also attend the APHA sessions, today is the LAST DAY for advance registration. Registration forms and related materials are available at http://www.apha.org/meetings/reg_housing.htm.

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2) Updated Tuberculosis Control Recommendations From CDC:

The American Thoracic Society, Centers for Disease Control, and Infectious Diseases Society of America have issued an update of the 81-page document on "Controlling Tuberculosis in the United States." The new document, dated 2005-11-04, is available in both HTML and PDF versions at the "MMWR Recommendations and Reports, Current Volume" web site at http://www.cdc.gov/mmwr/mmwr_rr.html.

It appears that Category 1 CME credit is not available for "Controlling Tuberculosis in the United States". Self-study is eligible for Category 2 CME, though, if the material comes from authoritative sources and is relevant to the physician's practice.

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3) AAPHP Education Project To Stress Preventive Services:

AAPHP Past President Joel L. Nitzkin, MD, MPH, DPA sent this for E-News:

***

AAPHP Grant Application Funded

Late in July we found out about a grant opportunity from CDC with just a few weeks to prepare the application. Seeing a marvelous opportunity to develop a high-quality educational seminar-workshop that might be of substantial practical value, and increase the visibility and prestige of AAPHP -- we decided to apply. We're pound to announce that our application, entitled "AAPHP Project to Improve Preventive Services in Healthcare Settings" has been funded in the amount of $100,000 per year for (hopefully) three years.

Joel Nitzkin is the Principal Investigator and Project Manager. Major roles in this project are also being played by Kim Buttery, Robert Harmon, and Dave Cundiff, with support roles by Jon Weisbuch and Hugh Fulmer. The AAPHP Board will serve as the governing board and control the purse-strings of this cooperative agreement project with the newly formed CDC Division of Health Marketing.

This project will enable AAPHP to develop a one-day workshop/seminar to be presented at national and state-level healthcare and public health meetings to teach practical skills in the following six areas: 1) Evidence Base for Clinical and Community Preventive Services; 2) Epidemiology as a Policy Tool; 3) Planning and Evaluating Health-Related Programs on a Group or Population Basis; 4) Principals of Community Oriented Primary Care (COPC);
5) Power Structure Analysis (a form of stakeholder analysis for developing advocacy strategy) and 6) Privacy, Confidentiality, and Data-Management Issues.

In essence these workshops (consisting of all six modules noted above) will teach public health and public administration skills of practical use in healthcare delivery settings, and focus on skills not currently covered (to our knowledge) in any of the current MPH programs.

Because the focus is on skill-building rather than imparting factual knowledge, there will be extensive telephone and e-mail follow-up with willing seminar participants in the six months following each presentation, and, for one or two programs or facilities from each seminar presentation -- on-site consultation to assist them in applying these skills to enhance preventive services in healthcare settings and establish mutually-beneficial healthcare/public health partnerships.

Over the three-year course of this project we anticipate 3 pilot presentations, 11 at national meetings, and 13 at state-level meetings, with a total of 41 facilities or programs to receive on-site consultation.

***

The first program to be scheduled will be an all-day seminar, presented as a pre-meeting workshop at the American College of Preventive Medicine annual meeting, on WEDNESDAY, FEBRUARY 22, 2006 in Reno/Tahoe, Nevada. Please attend if you are able. Presentations will be scheduled soon with other national partner organizations.

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4) Isolation and Quarantine - Theory and (Tabletop) Practice:

CDC's Public Health Law News of 2005-11-02 notes an upcoming lecture:

*** Isolation and Quarantine Program.

The State University of New York at Albany, School of Public Health¹s Center for Health Preparedness will host a lecture on isolation and quarantine on November 10, 2005 from 10:00-11:00 a.m. EST. Frederic E. Shaw, MD, JD, Medical Officer at the CDC Public Health Law Program (and Supervising Editor of the News) will give a lecture on state and federal quarantine laws and their impact on legal preparedness. The program is free, and can be viewed by satellite downlink. For more information, visit:
http://www.ualbanycphp.org/GRS/eventCurrent.cfm?id=46
<http://www.ualbanycphp.org/GRS/eventCurrent.cfm?id=46> .

Also from the CDC and abstracted in the Public Health Law News for
2005-11-02: CDC investigators report the results of a recent "tabletop exercise" on voluntary quarantine. The exercise focused on a fictional outbreak in San Diego. The most challenging problem appeared to be the residents' concerns about lost income. The full report, from the journal Emerging Infectious Diseases, is at http://www.cdc.gov/ncidod/eid/vol11no11/05-0661.htm.

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5) Businesses Told Not To Over-Reach for a Healthy Workforce:

Also from the CDC's Public Health Law News, 2005-11-02:

***

Business and industry managers in Connecticut held a conference last week to explore how far employers can go in their efforts to prod workers into adopting healthier lifestyles. Benefits experts said managers trying to cut costs by hiring healthier workers and encouraging healthy behaviors will have to navigate some legal issues along the way. Several Connecticut companies screen applicants to make sure they are physically capable of handling a job, and many have adopted wellness programs that offer financial incentives for employees who adopt healthy behaviors. But the limits of such efforts have become a topic of national debate after news of a leaked Wal-Mart memo that suggested changing the company¹s hiring practices as a way to cut health care costs. None of the Connecticut companies said they would consider the bold strategies outlined in the Wal-Mart memo, but conference speakers said worker screening and wellness programs make economic sense. A World Health Organization study showed that employers save
$3 in medical costs for every dollar spent on employee wellness. Michael J.
Soltis, director of a benefits consulting firm, said employers have to be aware of laws designed to protect workers against discrimination and harassment when creating such programs. ³These issues are just beginning to evolve,² he said.

***

Original source: Ritu Kalra, ³Moves to hire, mold healthier workforce are limited by law, experts say². Knight Ridder 2005-10-29, at the Hartford Courant web site:
http://www.courant.com/business/hc-benefits1029.artoct29,0,5355684.story .
Registration is not required.

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6) How Patients Perceive U.S. Health Care:

How about "Disorganized"? "Error-Prone"? "Unaffordable"?

Supported by the Commonwealth Fund, Cathy Schoen and colleagues surveyed residents of six countries (Australia, Britain, Canada, Germany, New Zealand, and the USA). U.S. residents reported the highest rate of perceived medical errors (34%), and the highest rate of disorganization in medical information handling (33%).

U.S. healthcare is also perceived as costly by our patients. From the Commonwealth Fund's summary:

"As was found in past surveys, the U.S. is an outlier in terms of financial burdens placed on patients. One­half of adults with health problems in the U.S. said they did not see a doctor when sick, did not get recommended treatment, or did not fill a prescription because of cost."

A more complete summary of these findings is on the Web at http://www.cmwf.org/publications/publications_show.htm?doc_id=313012 .

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7) Extended Deadline for Contributions to AAPHP Bulletin:

Twice a year, AAPHP publishes a written AAPHP Bulletin. This printed publication is sent to all AAPHP members, including some retired members who don't get the E-News. The AAPHP Bulletin allows space for more thoughtful, less time-sensitive articles than we can publish in the E-News.

Any AAPHP member may contribute material for consideration by the AAPHP Bulletin editor. New material for the November issue should be sent to Arvind K. Goyal, MD, MPH, before Wednesday, 2005-11-09, to assure full consideration.

Proposed articles may be sent to Dr. Goyal in care of the Secretary at cundiff@reachone.com. Thanks to those who have already contributed!

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8) Member Update:

Thanks to Gloria A. Casale, MD, MSPH; Hossein Farsad, MD; Douglas A. Mack, MD, MPH; and Marc J. Yacht, MD, MPH. These public health physicians have joined or renewed membership in AAPHP since the last E-News.

2006 membership forms are available on the Web at http://www.aaphp.org/Membership/2006MembershipForm.pdf. Medical students and resident physicians (in any specialty) are eligible for free membership for 2006 and 2007. All others may join or renew at the 2005 membership rates until 2005-12-15.

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9) Acknowledgements:

Thanks to the CDC and especially to the Public Health Law News
(http://www2a.cdc.gov/phlp/cphln.asp) for much of the material presented this week.

Thanks also to AAPHP's president Arvind K. Goyal, MD, MPH; to APHA's Executive Director Georges Benjamin, MD; and to AMA's James J. James, MD, DrPH, MHA for their work in planning AAPHP's December 2005 business and educational sessions.

We hope to see you in Philadelphia!


Dave Cundiff, MD, MPH (cundiff@reachone.com) AAPHP Secretary and E-News Editor

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