Member of the Month:
Philip Huang, MD, MPH
Austin FP looks out for the health of the population
By Perdita Henry
There are many ways to be a family medicine doctor. Contrary to popular belief and the sometimes-discouraging attitudes found within academia, family medicine doctors don’t simply treat people with the flu day in and day out.
Some practice wound care exclusively, others really enjoy delivering babies, while some build mobile health care businesses and decide to ditch traditional health insurance. Some stand on the sidelines of college football games ready to treat players and put their sports medicine knowledge to work, others run boutique clinics in bustling cities, while some prefer wide open spaces and the friendly atmospheres of rural life. And some run city health authorities, like Philip Huang, MD, MPH.
Huang wasn’t always headed toward medicine. His plans changed when he realized his chosen career wouldn’t feed certain desires he had. “My undergraduate degree is in civil engineering and then I decided to attend medical school at UT Southwestern,” Huang says. “I went from civil engineering to medicine because of my interest, and my perception, that medicine was family practice. The opportunity to deal with entire families and build those long-term relationships, that’s what kept me interested through medical school and then residency training at Brackenridge in Austin.”
It was during his final year of medical school that he began toying with the idea of a career in population and public health. “After I’d already been accepted to my residency program, I did a rotation in international health with Johns Hopkins Bloomberg School of Public Health. It was in Nepal that I was introduced to this concept of global and public health,” Huang says. “A faculty person from John Hopkins told me, ‘You should also think about getting a Master’s in Public Health.’ I kept that in mind and after I finished my family medicine residency I thought, “You know I do want to see about making an impact on the broader community.”
After returning from Nepal, he learned about another potential opportunity. “My infectious disease professor said, ‘you should also think about this program at the CDC called the Epidemic Intelligence Service.’ Sort of like a disease detective. He told me, ‘If you want to get into international health, that’s one way to get exposure and experience.’”
“After I finished my family medicine residency I wound up doing both,” says Huang. “I got my master’s in public health at Harvard and then went to the CDC Epidemic Intelligence Service. I was assigned to the state of Illinois doing outbreak investigation, chronic disease epidemiology, and all sorts of things. Then I wound up coming back to Austin because I missed Texas.” The rest, as they say, is history.
Now, he is the medical director and Health Authority for the Austin Public Health Department and responsible for Disease Prevention/Health Promotion Division. It really does take all kinds.
What sent you down the path to family medicine and did anyone inspire you?
My mother had severe asthma when I was growing up. I remember waiting in the hospital emergency department while she was receiving treatment or being admitted. That was one of my first memories of medicine. Going through that experience from the patient perspective and seeing how important that relationship is; was something that stuck in my mind.
While training, I liked pediatrics, internal medicine, obstetrics, and surgery. When I was in engineering, one of the reasons I thought about medicine, was because I didn’t want to just crunch numbers and sit in some cubical somewhere. I really liked people. Being able to develop long-term relationships with people was the other thing that drew me to it.
David Wright, MD, one of my residency instructors, was an inspiration. This was during the early days of HIV/AIDS and he was one of the first doctors to take care of patients with the virus in Austin. He was so committed to it. Residents would be working in the emergency department at midnight on a Friday, and there he’d be, admitting some of his patients. He was so incredibly dedicated and has done so much for the issue over the years.
What drives your passion for public health?
Public health is great because you can make huge impacts on a population. It’s always interesting because there’s always something new. Family medicine is broad and public health is even more broad.
A couple of years ago we wouldn’t have imagined talking about the Zika Virus. Then we had to deal with the Ebola situation and now there’s renewed concern about what’s going on in the Democratic Republic of the Congo. As a family physician you’re dealing with immunizations, smoking, obesity, bio-terrorism preparedness. There’s just so much stuff we get to deal with.
Family medicine is a great background for public health because you have that breadth of knowledge of all these different aspects. When we deal with a problem, we look at the community, we look at the clinical, and we look at the social determinates. Family medicine gives you a relevant background for all of them.
How does your Master’s in Public Health complement your medical training?
It provides more of an educational foundation for public health. I think it’s important that people going into public health really know the science and the best practices. Even my engineering background helped me. Being able to deal with quantitative things, being able to deal with data and data systems, and understanding how data collection works and how you can use information for population and public health. My daughter just graduated from medical school and got her MPH so it’s encouraging to see programs are supporting that.
What has been the proudest moment or biggest success in your public advocacy career so far?
I would say it’s the work we have done with tobacco, because it’s been a long fight. When I was at Harvard, I worked to have them divest their tobacco stocks. I have worked with and testified for over 40 different communities in Texas, and even in other states, about smoke-free policies. Implementing those policies at work sites and assisting with smoke-free ordinances have helped change social norms on tobacco use. We have had some significant success, but we still have a lot to do.
Are there any public health initiatives underway you’d like your FP colleagues to be more aware of?
Tobacco. It’s still the leading cause of preventable death and disease. I always give the quote that, “Tobacco kills more than AIDS, crack, heroin, cocaine, alcohol, car accidents, fire, murder, and suicide combined; and it’s entirely preventable.”
When I worked with the Texas Attorney General’s Office and we sued the tobacco industry, I was one of the state’s expert witnesses on the epidemiology for tobacco use in the state. We won $17.3 billion and got some resources, but very little of the money went to address tobacco use and they’ve taken all that away now.
Over the years, Austin has received significant funding to address tobacco at the local level. We dropped the smoking rate almost 50 percent among adults. With our initial efforts at the state level, we created a pilot program and saw a 36 percent reduction in youth smoking, and a 27 percent reduction in adult smoking. These programs can have a real population impact.
With all the new tobacco technology and products being introduced to the market, do you think that it’s undoing some of the work you’ve done to reduce the amount of tobacco use?
Yes. Some people think we need to move on from this, but we cannot take our eye off the ball. It’s still the leading preventable cause of death and disease, and the tobacco industry itself is still so evil. They are doing all these things with e-cigarettes and so on.
I was the chair of the Food and Drug Administration Tobacco Product Scientific Advisory Committee. We were looking at some proposals from the tobacco industry about modified risk. The industry wanted to be able to market lower risk or modified risk products. When you look at the data, there is still a lot we don’t know about the impact of these new products – how they impact regular tobacco consumption, if there are people who otherwise might have quit using regular tobacco but are now using both products, and there’s a whole new generation of kids getting addicted to nicotine. We don’t know all the impact on the population, so it is still very concerning.
Another thing we are launching in Austin is Getting to Zero, an HIV initiative. We want zero new HIV cases and HIV deaths, but in the meantime, by 2020 we want to have 90 percent of people infected with HIV know their HIV status, have them be on sustained anti-retroviral therapy, and have 90 percent of those on the therapy have a zero viral load. Those are concrete goals we as a community can work toward and achieve. There’s a lot we can do with that.
What is one thing your professional journey taught you?
I still sometimes encounter academia elitism and people looking down on primary care, but you know the people that make the bigger impact and have the broader perspective aren’t just going into subspecialties.
From a population and public health aspect, looking at how much the United States spends on clinical health care and how much worse our outcomes are compared to other comparable countries, good outcomes are from investments in things like social services for social determinates of health and broader primary care.
TAFP’s Member of the Month program highlights Texas family physicians in TAFP News Now and on the TAFP website. We feature a biography and a Q&A with a different TAFP member each month and his or her unique approach to family medicine. If you know an outstanding family physician colleague who you think should be featured as a Member of the Month or if you’d like to tell your own story, nominate yourself or your colleague by contacting TAFP by email at email@example.com or by phone at (512) 329-8666. View past Members of the Month here.