HC&P – The value of an MPH
The Master of Public Health, or MPH, degree provides clinicians and future clinicians with an introduction to the population sciences. This introduction consists not only of factual material but also of helping the clinician to understand the problems of improving health and delivering health care in new ways. The School of Medicine trains people to focus on the individual patient. The MPH degree adds the broader perspective of groups – or “populations” – and of population sciences to medicine’s focus on individuals.
The MPH degree provides more than a new way of viewing health and health policy issues; it is also an eminently practical degree. Medical students and physicians can consider the enhanced value of earning an MPH in at least three ways:
in caring for individual patients
in maximizing one’s potential to contribute to the health of the public
in training to participate in clinical research
1. Caring for individual patients
Some medical students and physicians may believe that people earning an MPH degree are looking for a way to leave clinical medicine, to practice “public health.” However, the great majority of clinical people earning an MPH at UNC are NOT leaving clinical medicine. Instead, they are seeking a way to practice clinical medicine more effectively.
MPH training can help clinicians do their clinical work better in several ways:
- First, by teaching how to read the medical literature critically, to distinguish the more valid literature from the less valid. This helps clinicians know which research findings to apply to their own patients. The MPH provides the decision tools that help clinicians determine the extent to which research findings can be generalized to a specific patient, and whether the benefits outweigh the harms.
- Second, by helping clinicians understand the health care system within which they deliver care, and, particularly, giving clinicians the tools they need to understand and use such concepts as quality of care and access to care. Individual patients will not achieve the most desired outcomes if they do not have access to care, or if they have access to care that is of poor quality. MPH training helps clinicians think in systems terms, using these and other concepts to understand how health care systems can be designed to optimize access and quality for individual patients.
- Third, by helping clinicians understand the critical role played by prevention in clinical medicine. This means learning how to consider the problems of prioritizing preventive care interventions and how to provide the most appropriate preventive care to each patient.
2. Maximizing one’s potential for making a contribution to the health of the public
Those of us who are in clinical medicine are doing what we do because we want to have a positive influence on the health of the public. We are taught in medical school how to care for individuals, and we should not forget these vitally important lessons. But it is apparent to most clinicians that many of the problems for which patients see us have their origins outside the medical encounter. Many times the solutions to these problems also lie outside the clinical encounter. To take just a few examples, the origins and solutions to domestic violence, obesity, heart disease, HIV/AIDS, and many types of cancer all lie outside the physician’s office. Many clinicians, in fact, are frustrated by the limits on their ability to address these outside forces affecting their patients’ health.
This context makes it easy to see how similar are the goals of public health professionals and clinicians. Public health and clinical medicine are not totally different disciplines, but rather groups of professionals working in different places, and in different ways, toward the same ends. Public health training gives clinicians a new set of eyes and a new set of tools with which to expand their ability to improve the health of the public. The health care leaders of tomorrow will be people who can think BOTH in terms of individuals (as taught by the medical school) and in terms of groups (as taught by the School of Public Health).
A clinician who has earned an MPH degree can begin to improve health beyond the medical encounter. He or she can work with others in the community (including public health professionals and community members) toward preventing disease and improving health in various venues, and in various ways. The MD-MPH clinician will play an important role, in concert with others, in understanding and beginning to solve health problems on local, state, national, and global levels.
3. Training to participate in clinical research
People often assume that the MPH degree is primarily a research degree. The fact is that many people earning an MPH never intend to conduct clinical research. Yet the MPH can also be the beginning of a career with a primary focus on clinical research or a career focused primarily on patient care or teaching, but with opportunities to join in research projects. Just as the MPH teaches critical appraisal of the health care literature (thus making one an informed consumer of research evidence), and teaches a systems perspective on health care (thus making one an effective leader in the health care system), the same training also teaches one how to develop new evidence that is valid, reliable, and useful.
The MPH curriculum is flexible. Clinicians interested in conducting research in such areas as clinical epidemiology, treatment, risk factors, health policy, or health services organization (among other areas) can take courses that prepare them for these types of careers. Indeed, it is difficult for many young clinical researchers to establish themselves as researchers without an MPH or similar training. Thus, although an interest in conducting research is NOT a prerequisite to earning an MPH, an MPH is a terrific entrée into the research arena.
Earning an MPH degree gives a clinician three broad new sets of tools for integrating the perspectives of medicine and public health. The MPH degree produces clinicians who understand the connections between the health of their individual patients, the health care systems through which they deliver care, and the health of the broader communities – and the world – in which they and their patients live.