Obesity, substance abuse, and depression are chronic diseases Kathy Mariani, M.D., sees every day practicing medicine.
Even in a state like Vermont – consistently ranked one of the healthiest places to live – Mariani finds plenty of work to do, especially when it comes to public health.
Public health is no longer just about managing epidemics in faraway, impoverished nations. Instead, public health is becoming an integrated component of pediatrics, family and internal medicine. The Affordable Care Act has a strong emphasis on the integration of public health and primary care, and many quality measures and approaches were part of the law, she explains.
Over the next decade, Mariani sees public health becoming more integral to primary care practices right here in Vermont.
“Across the world and Vermont, public health is evolving to have less of a focus on infectious diseases and more on chronic diseases issues,” says Mariani, a student in UVM’s Master of Public Health online program and assistant professor at the UVM College of Medicine. “Environmental changes and issues are impacting health here in Vermont, as well as across the world. Unfortunately, the issues that we face in Vermont, such as substance abuse, depression, obesity, and diabetes, are major issues everywhere.”
With 18 years of experience as a family physician, Mariani became the medical director of UVM Medical Center’s South Burlington Family Medicine in January. The practice is one of UVM Medical Center’s 11 patient-centered Medical Homes, which provide comprehensive, team-based, coordinated, accessible, and quality health care.
This approach to health care allows patients to spend more quality time with their primary care provider and actively partner with their care team to take control of their health. The work at a medical home is closely aligned with the practice of public health.
Pursuing a Degree in Public Health
Studying public health online at UVM prompted Mariani to change direction in her career and lead a patient-centered medical home. Prior to joining South Burlington Family Medicine, she was the Women’s Health Coordinator at the UVM Center for Health and Wellbeing.
“My studies in public health gave me new knowledge and understanding, and served as a catalyst for me to be interested in leaving student health to become a medical director at one of the new medical home sites in Vermont,” says Mariani, a mother of three. “I believe this is an opportunity to be part of the solution to challenges in health care in Vermont and across the country.”
Even with nearly two decades of experience as a physician, Mariani says studying public health will enhance her skills as a primary care physician.
“It will help me recognize big picture issues impacting the health of my patients, including the challenges around access and health insurance,” she says. “As a medical director, I will be better prepared to improve quality in our office and UVM Medical Center’s primary care network.”
Mariani says she’ll also be better prepared to create and be involved with community health projects as a UVM faculty member. She also plans to focus her studies and master’s project on global health, possibly involving women’s health.
“As a primary care doctor, we are constantly trying to care for the consequences of long- term exposures and poor health decisions,” she says. “It’s important that clinicians be involved in planning for prevention.”
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