Environmental cancer diagnosis and treatment program for primary care physicians

Occupational and environmental medicine education is offered minimally, if at all, in the curriculum of U.S. medical schools & residency training programs. In 2012, there are only 28 occupational medicine residency/fellowship programs in North America. With the growing scientific cognizance that environmental insult plays an important role in human disease, it is imperative that more physicians be trained either in continuing medical education programs or other alternative routes. We describe a novel approach to physician training which has had impressive positive results. In cooperation with the ATSDR, Blue Cross Blue Shield of Michigan (BCBSM), and St John Providence Healthcare system, the Karmanos Cancer Institute has established a mechanism which allows for online CME credits and financial incentives for physician participation. Working with BCBSM we identified 3 leading causes of lung cancer in Michigan--asbestos, radon and arsenic---and after agreeing on the use of the ATSDR Case Studies in Environmental Medicine as the appropriate educational vehicle, we offered these CME credit-carrying on-line modules at no charge. Upon completion of required course work, an honorarium was paid to participating physicians. Over the past 2.5 years, more than 500 Michigan primary care physicians (including pediatricians) successfully completed the Environmental Cancer Program. Based on participant feedback, we expanded the program in 2012 to include educational modules specific for neurologists, obstetrician-gynecologists, and additional modules for pediatricians.