Surveys suggest that while most US physicians are willing to play a role in responding to natural and manmade disasters, most do not feel adequately prepared to fulfill that role. Toward helping physicians and health care systems understand and fulfill their obligation to provide medical care in disasters, the January Southern Medical Journal* is a special issue on disaster medicine and physician preparedness. The official journal of the Southern Medical Association, the SMJ is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The special issue includes 22 reviews and original papers on preparing for the medical response to disasters and catastrophic events. Dr. G. Richard Holt, Editor-in-Chief of the Southern Medical Journal, writes: "I take the position that it is a professional and an ethical responsibility to potential patients and society for physicians to engage in sufficient self-learning that would provide them with at least an acceptable level of clinical preparation to meet the demands of caring for victims of a disaster in their town, city, county, or state."

'Lessons Learned' from Experts in Disaster Preparedness

The articles were prepared by experts in the medical response to disasters - including those with real-life experience with patient care in disaster situations. The special issue is freely available on the journal website.**

Adding authoritative commentary in the special issue is Dr. Harold Timboe, a leading expert in disaster preparedness and medical response. A retired US Army Major General, Dr. Timboe's experience includes coordinating the health response to the September 11 terrorist attack on the Pentagon and leading a team of volunteer physicians and nurses on a US Navy hospital ship responding to the 2004 tsunami in Indonesia. He writes, "Each of us in our own specialty, subcomponent of our local health system, and building to the aggregate capabilities at the community, regional, state, and national levels contribute to a growing sense of confidence in our overall preparedness."

The special issue opens with a section on physician preparedness, emphasizing the need for doctors to play an active role in planning and supporting the response to catastrophic events. By being prepared, physicians can help to mitigate the impact of disasters in their community.

A section on healthcare system preparedness emphasizes measures to plan disaster-response measures on the local and regional level. Contributions include informative experiences with drills and simulations to build and assess preparedness for catastrophic events.

The concluding section on patient care preparedness discusses disaster preparation and response for specific patient populations and types of care - including mental health aspects of disasters and the importance of psychiatric consultation. Professionals involved in responding to Katrina and other recent Gulf Coast hurricanes and to the 2011 tornado in Joplin, Mo., share lessons learned in preparing for future disasters.

Other topics of special interest include:

• A description and evaluation of a one-day, competency-based emergency preparedness curriculum, which effectively enhances trainees' skills and confidence in providing patient care in a disaster
• An introduction to the concept of "complete self-sufficiency planning," outlining a comprehensive approach to designing and constructing hospitals to withstand and remain functional during disasters
• Insights into the unique health challenges facing older adults involved in disaster situations, focusing on mobilizing resources to improve health outcomes and recovery

Dr. Timboe encourages all physicians to familiarize themselves with resources on disaster response and responsibilities and to consider which aspects are most relevant to their training and experience. He concludes, "We hope this duty never calls, but if it does, we will demonstrate our readiness - the moral ethics of our profession, duty to the public good, and commitment to serve others require our utmost diligence."