Promotes Public Health In Partnership with Private Medicine
Kira Geraci-Ciardullo M.D., M.P.H. ’07, had envisioned a career as a private practice physician not a public health activist. But somewhere between hanging her shingle and experiencing the encroachment of managed care, the solo allergist-immunologist became a fierce advocate for public health.
“I wanted to be like Marcus Welby, M.D.,” Dr. Geraci chuckles, referring to the affable television physician from the early 1970s. So, in 1985, after capping a pediatrics residency with a clinical fellowship in allergy-immunology, she opened offices in the Westchester County villages of Rye Brook and then Mamaroneck, where she would spend the next30 years treating all types of allergic conditions, including asthma.
Dr. Geraci enjoyed the complexity of her cases, as well as running her own office. But as managed care marched forward, staying solo became difficult. Hoping that learning more about the new health care economy might help her navigate it, she began studying health policy and management, and later, public health at NYMC. Although the new knowledge didn’t lead her to a strategy for sustaining her practice any longer, it did re-ignite her passion for bringing health and health education into the communities where her patients lived. “As a solo practitioner in my office, I was detached. I wasn’t in my patients’ lives,” she recalls. “It took getting out of my silo and seeing what was happening out there.”
Dr. Geraci confesses that she only really began thinking about the environmental factors affecting her patients’ health in 1990, when incidences of asthma hospital admissions skyrocketed nationwide. That’s when she began introducing herself to school nurses and gym teachers throughout Westchester, to see how much they actually knew about minimizing the risks of asthma attacks.
The more children, teachers and parents she met, the more she discovered how widespread asthma was and how many affected children lived in toxic environments, inhaling second-hand tobacco smoke, along with pet hair, dust, mold and other allergens. “It wasn’t just that children had horrible asthma, or that parents weren’t trying to give their children medication. The children were exposed to environmental triggers parents weren’t even thinking about.”
Stepping into her patients’ lives while studying public health turned Dr. Geraci’s career around. “What became clear was that the world of health care wasn’t just me and my patients,” she notes. “I saw that my patients’ illnesses were a product of their environment, whether it was school, home, the workplace, Grandma’s house, ballet class or the soccer field. And, I was floored by how much environmental exposure––the air my patients breathe, the food they eat, the fabrics they wear, their occupations––affected their health and how I cared for them.”
Concerned about the ubiquitous relationship between environmental factors and illness, Dr. Geraci now contributes her allergy-immunology expertise to many public health initiatives.Following the September 11 attack on the World Trade Center, she joined the Emergency Preparedness and Bioterrorism Task Force of the Medical Society of the State of New York (MSSNY) to offer insights about the medical, in particular respiratory, effects of biological and chemical warfare. For many years, she participated in flu surveillance in Westchester County and during the H1N1 pandemic in 2009 she was ready for the onslaught of new cases that occurred in that year’s spring pollen season. She works with the New York State Department of Health on the State’s Health Prevention Agenda for 2013-2018. In 2014, she was elected to the American Medical Association’s (AMA) Council for Science and Public Health. For ten years, she served on the AMA Physician Consortium for Performance Improvement. Additionally, she lectures for the American Lung Association of the Northeast and is currently Speaker of the Medical Society of the State of New York.
Since closing her solo practice in 2009, Dr. Geraci partnered with several colleagues in her field of allergy and asthma, and then joined a large medical group, but her greatest satisfaction comes from her role as an advocate for public health and health care reform, and involvement with the public health community. “People might be surprised that a person such as myself, who really believes in the value of solo practice, would be such a proponent of working as part of a community,” she notes. “But at some point, any physician could be on the front lines of a public health disaster, which is why we all need to view health more globally,” she says. “It took studying public health for me to realize that.”