15. Public Health Medicine Competency ꟷ Prerequisites and Responsibilities
- T Michael White MD FACP
- Nov 2
- 3 min read
Updated: Nov 4
Fixing United States Health Care - Letters to the File
Part I. The Hot Mess
Part II. The Solution
by
T Michael White MD FACP
The Realization of Universal Access to ABC-STEEEP
(Affordable, Basic, Compassionate - Safe, Timely, Efficient, Effective, Equitable (Just), Patient-Centered Care)
******
15. Public Health Medicine Competency ꟷ Prerequisites and Responsibilities
“All mankind... being all equal and independent,
no one ought to harm another in his life, health, liberty or possessions.”
John Locke
The WhiteHouse on the Belleair Bluff
Sunday, November 2, 2025
Dr. Mike,
A letter to the file…
Through experience, training and inclination, you strive to realize kind, decent,
respectful communications ꟷ especially in the midst of energized, potentially contentious dialogue. Now, you are chagrined to admit your hackles have been bristling as unqualified political types have begun to provide clinical advice that is undermining our fine country’s public health medicine infrastructure. So, the time has come for you to collect yourself and, as a life-long medical educator, convey these kind, decent, and respectful thoughts…
Basic Ground Rules:
Practicing public health medicine is a privilege.
Responsibility accompanies this privilege.
Always take care to first do no harm ꟷ primum non nocere.
One may not practice public health medicine without a license ꟷ a serious
consideration.
Harm done by practitioners (licensed or unlicensed) may require restitution ꟷ a
serious implication.
Public Health Medicine Competency Prerequisites:
Through education, training and experience, demonstrate ascension of Dreyfus’
stages of skill acquisition: novice to advanced beginner to competent to
proficient and ever onward towards expert and master.
Demonstrate proficiency in the following seven training requirements:
Knowledge: demonstration of expertise in public health matters;
Compassionate Care: demonstration of respect for patient-centered
care;
Professionalism: ethically place the interest of every individual
foremost (and ahead of any personal considerations);
Interpersonal Communications: demonstrate consistent
conveyance of accurate, clear, concise, evidence-based, non-
contradictory, trustworthy messages.
Commitment to Continuous Improvement: provide evidence of
continuous self-scrutiny of personal work and manifest a career-long
commitment to continuous improvement.
Team Leadership and Teamwork: demonstrate the ability, as a
team member and a team leader, to partner to analyze and synthesize
complex information into sound public health medicine processes and
policies.
Vitality: while tending to advancement of personal, financial, political
and professional goals, demonstrate foremost concern for the
advancement of the well-being of the souls (patients, colleagues,
community) entrusted to her/his care.
(Kind, Decent, Respectful) Summary:
A politician who uses the bully pulpit to provide public health medicine advice
may be practicing medicine without a license.
The caveat, “check with your personal physician and decide for yourself” is
hollow as: 1) many residents do not have access to a personal physician; and 2)
most residents do not have the educational background to convert complex
information into sound clinical decisions for self, family and community..
If/when their advice causes the individual harm, the politician must realize they
may be held clinically, ethically, financially, legally, politically and scientifically
responsible.
To ameliorate personal exposure for practicing public health medicine without
adequate prerequisites, when politically (not scientifically) declaring that
vaccinations are now a personal, philosophical, religious choice (and no longer a
clinical, economic, herd, scientific, national security consideration) politicians at
the public health medicine bully pulpit must: 1) assist residents to clearly
understand the up-to date, age-specific recommended vaccine schedule; 2)
make, at government’s expense, vaccines freely available to all; and 3) assist
residents with a balanced (risks versus benefits) ꟷ clinical, educational, financial,
social (collateral damage) ꟷ understanding of a decision not to vaccinate.
Dr. Mike, after review, the stakes are high here. Those with the privilege of the public
health medicine bully pulpit have significant responsibility. They must take care to bolster health. They must take caution to avoid harm. Their constituents require their care and their caution. (540 words)
Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File ꟷ Part I. The Hot Mess
1. Introduction ꟷ An Orientation to Letters to the File
2. About Dr. Mike
3. My Perfect Health Care ꟷ An Uncomfortable Paradox
4. From the Watershed into Universal Access to ABC-STEEEP
5. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm
6. Quality United States Health Care Defined ꟷ ABC-STEEEP
7. United States Health Care ꟷ Sounding a Three-Alarm Fire
8. Health Care ꟷ Recruiting Devine Intervention
11. Health Care ꟷ The Wolf Is (and Has Been) at Our Door
12. The 2025 United States Health Care Contract
13. Triskaidekaphobia
14. The 2025 United States Health Care Contract ꟷ An Implicit Understanding
15. Public Health Medicine Competency ꟷ Prerequisites and Responsibilities
(more to follow)
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