Public Health Law Map - Beta 5 - Medical and Public Health Law Site

Introduction
All medical care practitioners have duties under the public health laws.
Disease reporting is critical for controlling existing and emerging infectious
diseases.
Medical care practitioners have many statutory reporting duties.
From Pasteur’s and Koch’s discoveries in the 1800s through the conquering of polio in
the 1950s, public health was one of the most prominent and powerful medical
specialties. All physicians received training in basic public health and public health
officers were respected members of the community. With the advent of magic bullets,
effective vaccines, and widespread sanitation, public health fell into disrepute. When the
National Institutes of Health studied the public health system in the United States, it
found a system in chaos, with little consistent professional leadership. [Institute of
Medicine (U.S.). Committee for the Study of the Future of Public Health. The Future of
Public Health. Washington, DC: National Academy Press; 1988.]
In retrospect, it is clear that the disorganized public health system hastened the spread of
HIV/ AIDS in the United States. The advent of new emerging infectious diseases and the
resurgence of old foes such as tuberculosis and foodborne illness has made public health
newsworthy again. With the realization that bacterial and viral resistance is bringing the
golden age of antimicrobials to an end, public health is again becoming a concern for
every medical care practitioner. The internist who diagnoses salmonellosis in a patient,
the emergency room physician who suspects that a child may have been abused, and the
family practitioner who signs a death certificate, wear the cloak of public health in these
endeavors. Many medical care practitioners are unaware of these public health
responsibilities. This section introduces the basic legal and medical issues in public
health that every medical care practitioner should know. [Maxcy KF, Rosenau MJ,
Wallace RB. Public health and preventive medicine. Stamford, CT: Appleton & Lange;
1998.]
A. Disease Control
The control of communicable disease, the essence of traditional public health, is not
the same as the internal medicine subspecialty of infectious disease treatment. This
subspecialty is concerned with the treatment of individual patients infected with viral
and bacterial organisms, and the training is oriented to individual patients, not the
community. In contrast, disease control is concerned with the prevention of the spread
of diseases in the community rather than the treatment of individual patients.
Disease control was the core of public health until the last polio epidemics in the
1950s. With the development of antibiotics and effective immunizations, the public
lost its fear of communicable diseases, undermining public support for disease control
in the general populace and in schools of public health. Since the 1960s, public health
has become a broad umbrella, encompassing every cause from nuclear war to
controlling cholesterol levels. This loss of focus has weakened the disease control
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