Each Assistant Health Officers is expected to identify and take on a project of interest to herself or himself that also serve the needs of the health department’s constituency. Some projects are begun during the initial orientation period, during which the residents visit and observe all activities and programs undertaken by members of the department. Others, such as outbreak investigations, are taken on as situations develop.
The first Assistant Health Officer had a law degree in addition to his MD. He decided to write a county ordinance to limit youth access to tobacco products. At that time, few states and espeially few local jurisdictions had such ordinances in place. The project required contacting other jurisdictions with such ordinances in place or that were trying to get them approved. After many drafts and reviews with the county prosecuting attorney, the Assistant Health Officer presented the proposed ordinance to the Board of Health, and was asked to get a “reading” of the five incorporated cities and towns in the county. This involved getting onto the meeting agenda of each of their governing bodies, attending subsequent meetings if time ran out, and so on. The resident found this process instructive, although in the end, the Board of Health decided to wait until the state of Washington passed its law limiting youth access to tobacco products, scheduled to come before our state legislature the following year.
The second resident had a particular interest and ability in computing. He helped the department set up its first local area network, and provided tutorials to the 22 full- and part-time employees. Many of these individuals were trying to become computer literate in addition to their other responsibilities. Some found the machines intimidating and were grateful for the resident’s time and expertise.
During the autumn of the third resident’s year as Assistant Health Officer, one of the local family physicians reported that a patient of his had been hospitalized in Seattle with what turned out to be E. coli 0157:H7-associated illness. Several telephone calls later we learned that we had an outbreak of this illness in a group of families attending a week-long Bible study group. Fortunately, only three people were hospitalized out of 17 identified cases, and no one died.
The illnesses were traced to contamination of a salad by home-butchered beef. This outbreak provided opportunities for the resident to master several desirable competencies. In addition to investigating the outbreak itself, including formulating a questionnaire that pinpointed the most likely vehicle of transmission, the resident (and I, for that matter) received plenty of practice in communication with members of the print and electronic media.
The next Assistant Health Officer was an emergency room physician making a transition to pursuing interests in international and domestic public health and issues of health equity. He wrote a position paper on these issues, which was circulated among selected citizens.
Our next resident, a family physician, worked with our newly designated Assessment Coordinator to help assemble and interpret data for the first health assessment of Kittitas County. She assembled, analyzed, and interpreted data for the report and was tireless in making presentations of the data to community groups.
An indoor air quality issue at a local high school provided ample opportunity to demonstrate the next resident’s interest in environmental health in the context of a highly participatory community process.