Please send items of interest for the E-News -- and any other feedback -- to E-News editor Kevin Sherin, MD, MPH. . Thanks!
CONTENTS:
1) AAPHP Annual Meeting - Chicago, June 14, 2008
(Ron Davis, MD, MA, AMA President, Address)
2) AAPHP Resolutions passed at AMA Annual Meeting!
3) New AAPHP Officers and Board Elected at Annual Meeting
4) President Sherin's Inaugural Address
5) CDC Prefers Blood Tests, Not Saliva, For HIV Screening
6) Letter to the Editors on Tobacco, and AAPHP Response
7) Please Help Us to Help You - 2008 Membership Dues
Special Alert: VOTE NO on FDA/TOBACCO BILL! H.R.1108, the FDA/Tobacco Bill, is expected to come to the floor of the US House of Representatives this next week. This bill is a masterpiece of legislative deception. It has been widely endorsed on the basis of a fanciful summary. It was written by a single self-appointed representative of the public health community and the Altria/Philip Morris Company. The powers given to FDA are so limited that, if passed, this bill will do more harm than good in terms of future levels of tobacco-related illness and death. The most recent deception relates to the provision in the bill that specifically allows menthol as a flavoring agent. This provision favors cigarette
company profits over the health of African American teens and adults.
Despite a promise of "responsiveness" to this concern, this provision has not been amended. For additional information go to www.aaphp.org and click on "tobacco issues." Today's AAPHP update on menthol issues is at http://www.aaphp.org/special/joelstobac/20080724HR1108Menthol.pdf.
PLEASE CONTACT YOUR HOUSE REPRESENTATIVE TODAY. URGE HIM OR HER TO VOTE AGAINST THIS BILL IN ORDER TO PAVE THE WAY FOR A TECHNICALLY SOUND AND POLITICALLY VIABLE BILL TO BE DEVELOPED FOR NEXT YEAR. THE MOST IMPORTANT REPRESENTATIVES TO CONTACT ARE THOSE IN THE CONGRESSIONAL BLACK CAUCUS. If you or your representative have any questions, please contact Dr. Joel Nitzkin, Chair of the AAPHP Tobacco Control Task Force, at (504) 606-7043.
THE HOUSE SWITCHBOARD IS (202) 224-3121. PLEASE CALL TODAY!
1) AAPHP Annual Meeting - Chicago, June 14, 2008:
(Speaker: AMA President, Ron Davis, MD, MA)
Ron Davis, MD, MA, AMA President 2007-2008, spoke to the Annual Meeting of the American Association of Public Health Physicians held in Chicago in conjunction with the AMA on Saturday, June 14, 2008 at the Hyatt Regency Hotel. Ron came to the AAPHP meeting after addressing a packed AMA House of Delegates and sharing his own experience as a patient newly diagnosed with Pancreatic Cancer. Dr.
Davis brought the tearful audience to a standing ovation which lasted for over 5 minutes as he shared his personal experiences with Pancreatic Cancer. (This address is archived for reading/viewing at
http://www.ama-assn.org/ama/pub/category/18670.html.) Dr. Davis serves as the Chief Medical Officer of the Henry Ford Health System in Detroit and was chief of the US office of Smoking and Health in the 1990's. Ron is the foremost physician in Preventive Medicine and Public Health in the U.S. He is the only AAPHP member and public health leader who has risen to the role of President of the American Medical Association. We will continue to work with Ron and pray for him and his family with his battle with pancreatic cancer.
N.B.- * AAPHP is joining with other organizations in the Preventive Medicine Section Council in honoring Ron Davis through the AMA's "Ronald M. Davis, MD, Legacy Honor Fund". AAPHP's Executive Committee is forwarding a check to this fund.
AAPHP Members are encouraged to make donations to the Pancreatic Cancer Action Network (http://www.pancan.org/), recommended by Ron and his family, as well as to consider the AMA's Ron Davis Legacy Fund [Anne Smith anne.smith@ama-assn.org (312) 464-4701, or Patrice Maurer patrice.maurer@ama-assn.org (312) 464-5852].
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2. AAPHP Resolutions for the Annual Meeting:
Our AAPHP introduced five resolutions for the AMA's 2008 Annual Meeting.
Two of five resolutions were successful in the House of Delegates; two were referred to the AMA Board for study, report, or action; and one was defeated.
*** AMA A-2008 ***
Public Health Hazards associated with Landscaping Services
Outcome: Referred to the Board for further study
Submitted by: American Association of Public Health Physicians
Joseph L. Murphy, M.D. Alternate Delegate and
Arvind K. Goyal, MD, MPH, Delegate
Resolved that our AMA study the burdens to the physicians injured patients, the public health systems, the workers and disability compensation programs and the liability imposed upon various parties in case of injuries caused by landscaping services, and report back at the I-2008 AMA meeting.
*** AMA A-2008 ***
Prevention of FIREARM VIOLENCE: A Public Health Crisis
Status: Defeated in the House
Submitted by: American Association of Public Health Physicians
Arvind K. Goyal, MD, MPH, Delegate and,
Joseph L. Murphy, MD, Alternate Delegate
Resolved, that our AMA adopt a public health leadership role in the prevention of firearm violence by calling for establishment by the U.S. Congress of a multidisciplinary Federal Firearm Safety Board, funded by user fees, which will be charged with promptly developing uniform requirements for purchasing and safekeeping of all types of firearms by civilians other than those in law enforcement across the country.
* (Your new President and three other AAPHP officers spoke to the reference committee and offered extensive testimony. Physicians from
other specialties, notably pediatrics, also supported our resolution.
There was spirited debate about "gun rights" and about the role of firearms in successful suicides. The motion was defeated in the House of Delegates.)
*** AMA A-2008 ***
Subject: Greening our AMA
Outcome: Referred to the Board
Submitted by: American Association of Public Health Physicians:
Arvind K. Goyal, MD, MPH, Delegate and
Joseph L. Murphy, MD, Alternate Delegate
Resolved that our AMA conduct an audit of its operations to identify opportunities to conserve energy, reduce waste, save money, and protect the environment and human health and present those audit findings and potential strategies to achieve a "greener" AMA to the House of Delegates at its I-08 meeting.
*** AMA A-2008 ***
Subject: Memorial Resolution: Dr. EDWARD PRESS, MD, MPH
Status: Unanimously approved on the HoD Consent Calendar
Submitted by: American Association of Public Health Physicians
Arvind K. Goyal, MD, MPH, Delegate and
Joseph L. Murphy, M.D. Alternate Delegate
Resolved, that our AMA pass a resolution commending and memorializing Dr.
EDWARD PRESS' honorable service to the public and the noble profession of medicine, and that a copy of this resolution, if adopted, be shared with his family and the Governor of Oregon.
*** AMA A-2008 ***
Subject: Compilation of the AMA President and Board Chair's Written Materials
Status: Passed
Submitted by: American Association of Public Health Physicians
Joseph L. Murphy, M.D. Alternate Delegate and
Arvind K. Goyal, MD, MPH, Delegate
Resolved, that our AMA compile annually, in an electronic and/or print format, the pertinent written materials authored by our AMA President and the Board Chair, during their respective terms of office, starting with the 2007-2008 terms.
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3) New AAPHP Officers and Board Elected at Annual Meeting:
At the AAPHP Annual Meeting, we confirmed serving officers and Board members
-- and elected several new ones. Decisions were made or confirmed regarding officers and board members in ALL CAPS:
AAPHP EXECUTIVE COMMITTEE 2008-2009:
President (transition from President-Elect):
KEVIN M. SHERIN, MD, MPH, Orlando FL (2008-2010)
Vice President (newly elected):
NEIL E. WINSTON, MD, Chicago IL (2008-2010)
Secretary (re-elected):
DAVE CUNDIFF, MD, MPH, Olympia WA (2008-2011)
Treasurer (confirmed):
JOHN POUNDSTONE, MD, MPH, Lexington KY (2007-2010)
President-Elect (newly elected):
TIMOTHY P. BARTH, MD, Ann Arbor MI (2008-2010)
Immediate Past President (transition from President):
ALFIO RAUSA, MD, MPH, Greenville MS (2008-2010)
AMA Delegate (re-elected):
ARVIND K. GOYAL, MD, MPH, Rolling Meadows IL (2008-2010)
AMA Alternate Delegate (re-elected):
JOSEPH L. MURPHY, MD, Chicago IL (2008-2010)
*** AAPHP ELECTED BOARD OF TRUSTEES (in addition to E.C. members)
ELLEN S. ALKON, MD, MPH
(Elected for a first full term, 2008-2011) DAVID BLODGETT, MD, MPH, St. George UT
(Elected for a first full term, 2008-2011)
(Also nominated as AMA YPS Alternate Delegate 2008-2010) Mary Ellen Bradshaw, MD, Phoenix AZ
(2006-2009; first full term)
CAMILLE D. DILLARD, DO, MPH, Dolgeville NY
(Confirmed for a second full term, 2007-2010) Joshua Lipsman, MD, JD, MPH, New Rochelle NY
(2006-2009; second full term)
Sharon Marable, MD, MPH, Sharon MA
(2006-2009; first full term)
CHARLES C. MASHEK, MD, MBA, Fort Smith AR
(Confirmed for a first full term, 2007-2010) R. JASON NEWSOM, MD, MPH, Panama City FL
(Elected for an unexpired term, 2008-2010)
(Also nominated as AMA YPS Delegate 2008-2010) Sindy M. Paul, MD, MPH, Trenton NJ
(2006-2009; second full term)
Quentin D. Young, MD, MS, Chicago IL
(2006-2009; first full term)
Thanks to our officers and Board members, past and present, for their service!
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4) President Sherin's Inaugural Address:
At the 2008 Annual Meeting, our 2006-2008 president ALFIO RAUSA, MD, MPH handed the gavel -- amid thanks for Dr. Rausa's service -- to President KEVIN M. SHERIN, MD, MPH. Dr. Sherin addressed the group as
follows:
"Lessons from History for Public Health Physicians"
AAPHP, the American Association of Public Health Physicians, is "the
voice of public health physicians, guardians of the public's health".
From our country's earliest beginnings, the importance of public health was evident.
Smallpox entered America at Saco, Maine circa 1616 devastating Native American populations. Smallpox killed more human beings than all wars combined. America's physicians have been involved in public health from the earliest beginnings. The AAPHP website lists Benjamin Waterhouse MD who brought Jenner's smallpox vaccine to the United States.
My boyhood hometown of Uxbridge, MA has some early public health physician stories to illustrate this point.
Seth Read, physician, fought in the Revolution. His regiment suffered hunger and smallpox in the "Canadian Campaign". Read had influence with George Washington, who later added smallpox vaccination for continental army soldiers (aka "variolation").
Dr. Samuel Willard, who also ratified the US Constitution, treated smallpox in New England and offered variolation (begun by Dr.
Boylston). Willard witnessed the Uxbridge town meeting?s vote to refuse variolation in 1775, and spent the majority of his career as a country doctor in this town.
Leonard White MD, local health officer, was warned by a state pathologist about mosquito-malaria connections (later proven by Ronald Ross, MD in 1898 in India). Dr. White instituted malaria prevention in 1896, the first such documentation. Early physicians practiced real public health in America.
Physicians are sentinels for public health, adding value to U.S. and global health. Today we face new threats -- Bioterrorism (smallpox and weaponized Class A agents); Emerging Diseases (Hemorrhagic fevers like Ebola or blood borne Chikungunya virus); Global Climate Change and Tropical Diseases (such as Dengue in temperate zones); and Natural Disasters, where physicians from all specialties play key roles in surveillance and disaster medicine.
Who will see the first H5N1 human case in North America? An urgent care site near a major airport? When will someone eat undercooked wild chicken with H5N1?
Today's epidemics are chronic diseases -- due to tobacco and unhealthy lifestyles. One half of costs in the $3 Trillion dollar U.S. health system are due to unhealthy lifestyles. Will LACK of proper tobacco control regulation, ANEMIA of public health funding, and LAX food regulations or leadership leave us more vulnerable to infection, diabetes, and cardiovascular disease? Will FEARS of autism lead to re-emergence of outbreaks of measles?
Why does America lack national health financing? Sixty percent of US health costs are funded by Medicare, Medicaid, and tax deferred employer based plans, yet our outcomes rank below most industrialized
countries -- double the costs of the next most expensive, Sweden.
Massachusetts' health plan -- crafted in part by people like Sen. Dick Moore of Uxbridge, former FEMA executive -- points the way for our next President to help improve access to care.
Tonight I challenge AAPHP to stay on the cutting edge of advocacy for Tobacco control, and meaningful FDA regulation; to advocate reasonable Vaccine policy and autism prevention efforts; and to work for National Health reform joining together with our communities for a higher purpose.
Physician leaders like Read, Willard, and White have always made a difference. "A group of committed citizens can change the world."
(Margaret
Mead) "Coming together is a good beginning, working together is a good start, working as a team is success." (Henry Ford). Let's become the "Ethiopian Proverb" for America's public health -- "The thousand tiny spider webs that can tie up a lion". I challenge AAPHP to enroll 1000 new physicians into its membership rolls this year. Is it better to build a fence at the edge of the cliff, or to park an ambulance down in the valley? Together we can build more fences. To those who say NO, We will say YES. YES WE CAN and we will. Thank you!
Kevin Sherin MD, MPH, FAAFP, FACPM,
AAPHP President 2008-2010
Director, Orange County Health Dept.,
Florida Dept. of Health,
Orlando, Florida, USA
Kevin_sherin@doh.state.fl.us
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5) CDC Prefers Blood Tests, Not Saliva, For HIV Screening:
Bloomberg (6/19, Lauerman) reported that the Centers for Disease Control and Prevention (CDC), states that HiV/AIDS "clinics should use blood rather than saliva, when possible, to screen for infections that cause the disease." The report follows a statement made by Susan Blank, assistant New York City health commissioner, who "claimed that inaccurate results from" Orasure Technologies, Inc.'s "saliva tests"
showed that the number of people who "had the AIDS virus rose as high as 54 a month from November though April." Now, "CDC officials are investigating because, the false positive tests may cause people unnecessary concern, and their unpredictability suggests there may be an unknown cause of the fluctuations in accuracy." The agency also stated that in "general, testing with blood or serum specimens is more accurate than testing with oral fluid, and is preferred when feasible, especially in settings where blood specimens already are obtained routinely." Nevertheless, the "CDC continues to support rapid oral HIV testing because it increases the number of people who consent to testing."
At publication time, the full report was still available on the Web at http://www.bloomberg.com/apps/news?pid=20601202&sid=aTnB6qePblOs&refer=healt
hcare .
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6) Letter to the Editors on Tobacco, and AAPHP Response:
After the last E-News alert on the FDA/Tobacco bill (see new alert above), we received the following communication from public health physician RON STOUT, MD, MPH, who intended this as a communication to the full listserve:
*** Quoting "Stout, Ron" ***
"Ron Davis, former editor of Tobacco Control, Preventionist extraordinary and current AMA President; explained to AAPHP reps in Chicago last week why the FDA Tobacco Bill should be supported. The Preventive Medicine Section Council (which at the MOMENT AAPHP continues to be a member) discussed this issue and voted to support the passage of the bill.
"The basic premise is the politics will permit us to start with 'the good'
and then work towards 'the perfect'.
"AAPHP position will merely set us back 5-10 years.
"Thanks guys!
"If I were a touch more paranoid, I guess that AAPHP is in cahoots with the tobacco lobby!
"Ron Stout MD, MPH"
*** end of Dr. Stout's message ***
AAPHP Secretary DAVE CUNDIFF, MD, MPH replied the same morning:
No chance of such "cahoots", Ron. Just an honest difference of opinion, as AAPHP's longtime member and friend Ron Davis also explained and acknowledged at the AAPHP meeting on 2008-06-14. (Ron is one of the few supporters who I'm confident has actually read the bill. Almost everyone -- and pretty much all the grassroots activists
-- who have studied the bill appear to oppose it along with AAPHP.)
My best analysis is that PASSAGE of this bill will set us back at least 10 years, because there will be at least a 10-year window in which (1) nicotine researchers develop and produce "reduced exposure"
cigarettes without reduced risk, possibly producing a marketing windfall similar to the "low tar, low nicotine" fiasco; (2) most or all of the bill's advertising restrictions are neutralized first by injunction, then by Supreme Court decision; (3) Congress won't act because the 2008 bill "took care of that already"; and (4) the public, which believes Federally regulated products to be generally safe, is at least partly reassured by the fact that cigarettes are now regulated by the FDA.
There are a few positives in the bill, as I see it. First, it would standardize the content of each brand nationwide. Second, it would replace the largely ineffective warning system on cigarette labels with a somewhat more prominent, somewhat more strongly worded, warning system (for which I've seen no evidence of effectiveness either). The Senate version has stronger warnings yet; the "Coalition for Tobacco-Free Kids" (CTFK) opposed the strengthening in committee.
Passage of this bill is like turning off a fire alarm without doing more than spitting on the fire. That would indeed be a substantial net harm to public health.
I hope you'll take the time to read AAPHP's detailed analyses. Philip Morris has inserted dozens of lethal loopholes that almost entirely negate the "good" that you say the bill would accomplish. The story of how PM conceptualized and negotiated its response to the push for "FDA regulation" is pretty amazing.
Has any other Section Council member studied this bill as thoroughly as AAPHP? I doubt it. Most major national organizations have largely outsourced their tobacco policy development to CTFK, which won't release more than a four-page summary to the public. AAPHP reps met with CTFK's executive on 2007-12-09 (yep, that's a Sunday) for several hours. CTFK's analysis is based, in our opinion, almost entirely on wishful thinking.
If you have time to read divergent viewpoints on an ongoing basis, consider asking Bill Godshall* for membership on the TP-TALK
discussion list. All civil points of view are welcome on the list.
Most of the TP-TALK list members are grassroots activists opposed to the bill, but some strongly favor it as Ron Davis does.
AAPHP's list is moderated to prevent readers from spam, but not to prevent discussion of different viewpoints. I'm copying your feedback to Tobacco TF Chair Nitzkin and to President/E-News Editor Sherin, as well as to Ron Davis. Thanks for your feedback, and best wishes!
Dave C.
*[Bill Godshall, MPH, moderator of the TP-TALK discussion group, is at smokefree@compuserve.com --DRC.]
***
AAPHP welcomes feedback from all AAPHP members and from other E-News readers. Feedback from AAPHP members is especially welcome!
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7) Please Help Us to Help You -- 2008 Membership Dues:
AAPHP accomplishes its work with a maximum of volunteer labor and a minimum of cash expense. We are proud to make the E-News and other AAPHP materials available without charge to physicians and medical students interested in public health.
If you haven't done so already, please download AAPHP's 2008 Membership Form right away at http://www.aaphp.org/Membership/2008MembForm.pdf and send it to us by fax or postal mail. Please make your 2008 membership as generous as you can. Consider "Supporting" or "Sustaining" membership for 2008 if you are able to do so.
AAPHP is a 501(c)(6) professional membership organization that informs and represents Public Health Physicians. AAPHP dues may be deductible as an "ordinary and necessary" business expense under the Internal Revenue Code.
Details may differ based on your individual situation.
AAPHP dues can be paid by credit card -- either by faxing the membership form to (847) 255-0559 or by calling the AAPHP Secretary's secure mobile/voicemail at (360) 870-2483.
Please also tell your friends and colleagues about AAPHP's representation of Public Health Physicians. E-News subscriptions are still free, on request, to any interested physician or medical student. We welcome new subscribers and members. Thank you for your support!
Kevin Sherin, MD, MPH (ksherin@yahoo.com) AAPHP President and E-News Editor (with help on this issue from Dave Cundiff, MD, MPH, AAPHP
Secretary)
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