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BLOG: Should the optometric curriculum include public health?
The Wall Street Journal published an opinion piece by Dr. Stanley Goldfarb on Sept. 12, “Take two aspirin and call me by my pronouns.”
In this piece, Dr. Goldfarb makes a case that the medical education has made a “left turn” into political issues by teaching medical students about social justice issues such as gun control and climate change. He believes that traditional American medical education that emphasizes a scientific approach to treatment of disease is being squeezed by the political agenda of many of the young progressive faculty members.
This article has generated a firestorm of criticism from doctors and medical educators and prompted a disclaimer by the dean of the University of Pennsylvania – Perelman School of Medicine. The letter from the dean noted that as a medical school, they “...deeply value inclusion and diversity as fundamental to effective health care delivery, creativity, discovery and lifelong learning.”
This controversy raises the question of the role of public health in optometric education. As a former member of the Accreditation Council on Optometric Education, I can attest to the compliance of the schools and colleges to the rigorous Standard of Accreditation. These standards include, in Standard II, Curriculum: 2.9.6, “The graduate must be able to apply knowledge of professional, ethical, legal and public health principles to the delivery of optometric care.” As an adjunct faculty member at Salus University, providing annual lectures in the public health curriculum, I can also attest to the importance that our course plays in teaching the students about our role as primary care optometrists in the American health care system.
To prepare for this work, I am an active member of the American Public Health Association. This organization takes a very strong position on social issues such as gun violence, climate change and the social determinants of health. They also advocate for public safety issues such as seat belts, infant restraints and bicycle helmets. They support prohibitions on smoking, drug and alcohol abuse, and sugary beverages. And, of course, they are big on wellness and prevention.
It is hard to consider issues of public health and safely without supporting socialization. Clean water, clean air, waste disposal, and road building, repair and maintenance are all examples of public programs that are best handled at the governmental level. The issue of health care and the degree of socialization continues to be a hot topic. Although the government-sponsored health care programs for the elderly and the poor, Medicare and Medicaid, are widely accepted, any consideration of government involvement in universal health care makes one a Socialist.
The inclusion of public health in optometric education requires an exploration and understanding of social issues and social justice by definition. Although Dr. Goldfarb seems to equate traditional science and evidence-based medicine to biological systems, the research and science behind epidemiology and population health are on par with other science-based programs and important to the overall health and well-being of our patients.
In my opinion, the inclusion of public health in optometric education is of critical importance to optometry. Just as we can never look at a pair of eyes without consideration of the whole body and the risk that systemic disease can pose to the visual system, we cannot consider the health of our patient without consideration of their social and economic environment. With our expanded role in primary care and its emphasis on prevention, safety and wellness, the public health agenda is even more important.
As with the debate in medicine over Dr. Goldfarb’s editorial, I urge a similar debate of this issue for optometry. Blog forums are an ideal place to generate this discussion, and I would love to hear your comments. Click on the comment button and let me hear your thoughts.
Reference:
Goldfarb S. Wall Street Journal. Take two aspirin and call me by my pronouns. Posted September 12, 2019. Accessed October 15, 2019.