Public Health Becomes a Profession *

The prevention of illness and premature death and the promotion of health has attracted able minds from the beginning. Public health as a cause has always offered substantial though often intangible rewards. It has become a profession in itself, offering essential satisfactions to thousands of people who devote their careers to this cause. It is astonishing how this cause has gradually amalgamated such varied professional interests into what is now a profession. Until recently this diverse origin has resulted in a rather amorphous mass of personnel, but of late a few crystals of mature conclusions have formed. Among them are standards for training and education, special graduate schools for such training, and criteria for the accreditation of these schools. This is evidence of professionalization characteristic of the developmental stages of other and older professions. One should recall that medicine itself is not among the oldest recognized piofessions, and that it was a gradual outgrowth of the priesthood and of alchemy, with a smattering of witchcraft. Today the American Medical Association lists 15 specialty boards and 4 sub-specialty boards. Some 30,000 of the 125,000 members of the American Medical Association are certified as specialists.3 Will this new public health profession go the way of other professions in developing workers who are more and more highly special-ized? If, as in engineering and medicine, many new scientific truths accumulate rapidly, specialization is probably inevitable. In fact, it has already begun in public health. In medicine, specialization has progressed to the point of presenting some disadvantages along with the advantages. How rapidly and how far this concomitant of professional-ization will go in public health is the subject of this discussion.