Wisdom Teachers

Great expectations: IPs enter field of opportunity

'The second generation of infection prevention'

As infection prevention enters a new era of transparency, regulatory activity, and consumer activism, unprecedented demands are being placed on a profession that long labored in relative obscurity.

Patrick JosephYet within this new dynamic is the classic example of a current problem representing an emerging opportunity, for people with skills in infection prevention and health care epidemiology are going to be in demand as never before.


"I know of nothing that opens up more doors for the practice of health care in the future than establishing a foundation in infection prevention and epidemiology," says Patrick Joseph, MD, a veteran health care epidemiologist and president of California Infection Control Consultants in San Ramon.

The bottom line is that health care-associated infections (HAIs) are on the national radar, creating political pressure and unprecedented opportunity. The word "MRSA" is bandied around by the people at the grocery store, and Consumer Reports is focusing on HAIs like a new model car.

Basic training

The key for the new infection preventionist is to establish a bedrock skill set, says Joseph, consulting editor of Hospital Infection Control & Prevention.

"Take advantage of every educational opportunity," he emphasizes. "Don't skimp on understanding the basics of the field. This is the time to get a very solid foundation in the basic principles of infection prevention and epidemiology. This is one of those fields, if you build the foundation there is no limit to what you can do."

Once establishing expertise, the new IP will see more doors open to them than their predecessors had. "Some of these open to traditional hospital infection prevention, but others lead to private consulting, research, teaching, consultation to industry and pubic policy," Joseph says. "All of that is in the field of infection prevention — and each of these is growing. Positions cannot be filled, especially in public policy."

Indeed, a background in infection prevention means the IP has opportunities beyond the hospital as those addressing this national problem seek skilled workers to help them solve it. "There is now public interest and concern and when that gets to a certain threshold then we start to get political pressure and legislation," he says. "That, I think, is the era we are moving into and it clearly needs additional personnel."

Among the drivers behind this new trend are state and federal legislators, who are responding to patient advocacy groups by codifying infection reporting and prevention practices. At the same time, payers are tamping down reimbursements for infectious complications. Prevention could scarcely be more imperative.

"I started in this in 1980 and had an opportunity to be involved when the field was being defined," Joseph says. "We now have an exponential increase in public concerns and political involvement. This is the second generation of infection prevention, where we have to address public concerns, political pressures and limited resources. Each of these areas needs people with skills in infection prevention and epidemiology."

For the new IP, there is an element of excitement and enthusiasm — great expectations — that may eventually change the traditional demographics of the job. Infection prevention often has been a "second career" post, dominated primarily by nurses who bring valuable bedside experience and clinical training. However, if the demand for IP skills grows as expected, new graduates in a variety of nursing, public health, microbiology, and medical technology areas might be drawn to the field at an earlier career stage.

"I can foresee that," Joseph says. "There is so much science in the field now that it may become an area of interest at an early stage of an individual's career."