J. Lloyd Michener, MD
APTR President

The Long Route to Prevention – and Some Opportunities Found Along the Way

April 2008

My interest in prevention has come from a long route, including almost 30 years working as a family physician, and watching generations of patients and their families sicken from diseases that we know can be prevented. Living in a small Southeastern city with an abundance of doctors and hospitals made it clear that physicians may be good at fixing some problems, but as a group, we’re woefully undertrained in prevention. But working with folks trained in prevention, public health and business, alongside community partners, allowed us to redesign our local health care system. Now, the Duke Health Care System is the proud sponsor of a network of community clinics and programs, each crafted with community partners in response to community concerns. Together, they have provided health care to those poorly served by traditional health care systems, helped thousands of people improve their diet and exercise, and not incidentally, also decreased the frequency with which people visit our emergency rooms. It has been a long, but utterly convincing journey.

I share this story in part so you know a bit about me, but even more because there are many others who do not yet know of APTR, and who would benefit from the services and the colleagues that can be found here. For decades, preventive medicine has been on the outskirts of American medicine, poorly funded and little recognized. But the growing costs of health care, and the slow recognition that most health care problems are now chronic and must be prevented and slowed, not cured, is forcing a painful realignment.

For instance, look at the National Institutes of Health.  Center and Institute directors have grown concerned that the benefits of research are slow to reach their intended populations, and have concluded that researchers, practitioners, and communities need to engage, so that community and practitioner concerns are known to the researchers, and so that the results of research are quickly known and can be applied within practices and communities. For many diseases, that collaboration is turning to prevention of illness and to identification of early opportunities for treatment. Prevention, in other words, is no longer just the province of preventive medicine.

Where does that leave the real experts in prevention – such as members of APTR? We can either move quickly to help those new to the field learn how to be effective practitioners and researchers in prevention, or stay on the margins. The APTR leadership believes, quite strongly, that this is a time for APTR and its members to lead, but we need your help. There are two immediate opportunities

First, APTR is leading the effort for a joint NIH, CDC, AHRQ, HRSA conference on “Accelerating the Dissemination and Translation of Clinical Research into Practice” The meeting appears likely to be oversubscribed, but if there is still time and room, you can register on the APTR web site. Funding for the program is from the CDC, with in-kind support from the participating agencies.

Second, APTR is sponsoring a series of five regional workshops, again with CDC funding, supplemented by the NIH. The dates and locations are being finalized and will be posted on the APTR website. Please sign up, attend, and contribute. This is an opportunity for NIH-funded researchers to meet with and learn about the work APTR members are doing with their communities to prevent disease, and to teach these skills to others. The NIH’s Clinical and Translational Science Awards (CTSAs) have funding for community engagement and for training, and this is an opportunity for APTR members to showcase their work, and build new partnerships.

There will be more opportunities for APTR members in the months ahead. Please check the APTR web page every few weeks for announcements and offerings. It is time to share our expertise, and to help bridge the divide between medical care and prevention, and between medicine and public health. I know of no better group to lead this transformation than APTR and its members, and look forward to working with a group that had the sense to take a direct route.

 

 

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