Involve Physicians in State Disaster Preparedness Planning

Written Testimony on Disaster Preparedness

House Homeland Security and Public Safety

March 29, 2016

The Texas Medical Association (TMA), representing more than 49,000 physicians and medical students, appreciates the opportunity to submit our comments on this committee’s charge to review the functions of the Texas Division of Emergency Management and the effectiveness of our state natural disaster preparedness planning.

Physicians are engaged in many aspects of disaster preparedness planning and response in Texas. TMA is committed to its role in providing physician education and communication resources for physicians to use in informing their staff, patients, and the public before and following a disaster. 

When it comes to best practices, improved coordination among municipalities, counties, and the state cannot happen without considering the role of community physicians. We believe that improving overall preparedness involves a combination of trained leaders, informed planning, and a stronger communication system. We recommend several items for your consideration: 

  • Local and regional disaster planning activities should include local county medical societies and their leadership. Physicians are on the front lines of responding to natural disasters, and in particular, in identifying infectious diseases that can rapidly affect our most vulnerable residents. Physicians in nonhospital settings do not have grant funds for planning, equipping, and practicing their responses to disaster.  
  • The state needs to consider the physicians practicing in the community when planning and allocating resources. Physician offices may be affected in a natural disaster. Physicians may need personal protective equipment (PPE) or other resources to protect themselves, their staff, and their patients so they can continue to care for their patients following a disaster. The cost of basic PPE can be significant for physician offices; and as recommendations and protocols change, this cost burden escalates. 
  • Preparedness requires clinical experts. As TMA frequently commented during the sunset and appropriations process, we continue to call on state leaders to ensure ongoing clinical input in disaster planning, and state and local public health initiatives that involve physicians. Over the past decade, we have seen a significant decline in the number of physicians working in public health at the Texas Department of State Health Services (DSHS) and in leadership positions in particular. This includes physicians trained in public health and prevention medicine, and epidemiologists to support disease surveillance for every county and the state. The shortage in Texas of primary care physicians and those trained in prevention-related specialties is well documented. As Texas addresses the gap in critically needed graduate medical education, these specialties should be included among the top of priorities for new state investment. 
  • The public health communications structure needs strengthening so it meets the needs of the communities. A strong communications network is critical for planning and responding to disasters. We believe the Public Health Information Network/Health Alert Network must be enhanced to ensure timely delivery of urgent communications and targeted outreach to physicians. We believe that with TMA’s support, the state should and could develop a “best practice” communication process that prioritizes the most critical public health messages such as whatever the current urgent situation might require. 

This year TMA convened a workgroup of physicians to review the roles and responsibilities in local disaster management response. TMA has been represented on the DSHS Preparedness Coordinating Council and other select committees and taskforces, and we will continue to participate in preparedness planning, bringing the perspective of our membership and relaying back to our organization ways we can contribute to Annex H, the state’s Health and Medical Services plan. We pledge to work with other organizations to communicate and help educate the public through the news media in regard to a strong disaster response in Texas. When Texas is worried, it is our patients who are worried, and health care suffers so Texas physicians stand ready to assist as needed. 

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Last Updated On

March 08, 2017