Are public health doctors a waste of money? Readers reply to columnist Alan Maynard

As a member of the Faculty of Drain Doctors, I wholeheartedly agree with Alan Maynard's cri de coeur on the utility or otherwise of my profession.

He regards purchasing advice as public health doctors' central function in health authorities, and needs assessment as a distraction.

Unfortunately, this is not how the faculty sees public health: advice on purchasing is not mentioned in the training manual.

The effect of this training is insidious. Public health doctors tend to regard health promotion, needs assessment and communicable disease control as 'real public health', and are disparaging about 'purchasing hips and hernias'.

So if we are not being trained for the job we will have to do, what exactly are we being trained for?

To pass the written submissions for faculty membership, 'the candidate must describe explicitly the contribution they have made as a physician in public health'.

Why this strange requirement? To encourage us to believe that there really is some special reason why we need to have trained in medicine - usually couched in terms of the special understanding which doctors (why not nurses or physiotherapists?) have of +patient care.

Dr Tom Marshall

Honorary clinical lecturer in public health medicine

Department of public health and epidemiology

Birmingham University