Continued Counseling for the Relationship Between State-Level Medicine and Public Health

Published:December 22, 2020DOI:


      Public health and organized medicine have operated somewhat independently of each other since the early 1900s. In the wake of the COVID-19 pandemic, the necessity of healing any divide between organized medicine and state and local health officials seems self-evident. Using the recommendations abstracted from a 2005 article by Dr. Ronald Davis, “Marriage Counseling for Medicine and Public Health,” this cross-sectional study explores the formal relationships that existed between state-level public health and medical practice across the U.S. at the end of 2019.


      A questionnaire was distributed to every state's senior public health official and medical society executive (N=104) between August and December 2019 to examine the extent of these entities’ partnerships. Analysis was completed in January 2020.


      Among the respondents, 40%–63.1% (n=65) currently engage in the recommended activities, with 1 exception: state health departments infrequently invite medical society executives to speak at major conferences or meetings (26.2%). The majority of respondents (71.1%–85.9%) judged that each recommended activity would improve the practices of medicine and public health.


      Survey results illustrate a desire for reconciliation, but poor implementation of recommended strategies aimed at building a healthy marriage between the 2 sectors. More formal efforts are needed among state medical and public health organizations to capitalize on the current climate of rapprochement. The burden of COVID-19 on the national health system could provide a worthy cause around which these efforts would coalesce.
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