Ephraim Back, M.D., M.P.H.’06

Melding Public Health and Clinical Practice

By Amy Halloran, B.A.’90

Ephraim Back completed his master’s degree at UAlbany’s School of Public Health while working full time as a physician. He took one course a semester; his concentration was in epidemiology.

As a doctor, Back saw that public health and clinical medicine rarely interact. “Clinicians see a problem in one way, and public health officials see it in another,” he observes. “They speak different languages, and even though public health and clinical practice should be more closely melded, they often are not.”

After attending medical school in Buffalo and completing his residency at the University of Rochester, Back spent the next four years working in public health with the Indian Health Service and the Centers for Disease Control.

Since 1991, Back has been a physician in Schenectady. Now, he is the associate director of the Family Medicine Residency at Ellis Hospital. The practice serves low-income patients and is a training site for residents.

Back’s patients include some of the several thousand Guyanese immigrants who settled in Schenectady within the past two decades. He noticed that they “have a high incidence of diabetes” that “didn’t look like other diabetes.”

The adult-onset Type 2 form of the disease, Back notes, tends to show up in older people and obese people, but that was not the case with the Guyanese. He organized a research study that confirmed the rate of this diabetes, at about 30 percent of adults, was significantly higher than that of other populations. The Schenectady County Public Health Department obtained a grant from the Centers for Disease Control to address this problem.

Back hopes to inspire others to view clinical problems from a public health perspective – and to have public health officials examine situations from a clinical viewpoint. He’s succeeded with at least one person: his daughter Rebecca, who earned her M.P.H. in medical school. She is now a family medicine resident in Rhode Island.