Advisory Board Spotlight: Interview with Ray Barishansky, DrPH

Ray Barishansky, DrPH, is on the advisory board for the Domestic Preparedness Journal and has a passion for public health and emergency management. He sat down with the Journal’s Nicolette Casey to share the story of his journey from an EMT to a doctor of public health. 

Nicolette: What inspired you to join the Domestic Preparedness board?

Dr. Barishansky: I started writing, originally, for Domestic Preparedness Journal [Journal] in either 2008 or 2009. I was getting my feet wet regarding the still-emerging discipline of public health preparedness. I had just moved to the Washington, D.C.–area, and I started writing articles. I was communicating with Cathy Feinman [editor of the Journal] and some other advisors on the Domestic Preparedness board in the 2012-2013 timeframe. I had various work obligations and had to leave the board and when I had more time, I started writing again, and a whole bunch of my articles made their way into the pages of the Journal. Cathy reached out to me in the beginning of this year and asked if I would rejoin the board, and I was more than honored to. I think the message that the Journal brings out to practitioners is extremely important, and I consider it a privilege to be on the board.

Nicolette: That is wonderful. I am so glad to hear that, and we’re fortunate to have your perspective. You lead me to my next question: What do you see as the biggest challenges and opportunities in emergency preparedness right now from a public health lens?

Dr. Barishansky: I think right now we are in a really interesting time in what I’ll call the post-COVID era, even though I think COVID is still a threat as it moves from pandemic to endemic. But I think that, in general, we are not seeing the same number of people sick or dying from COVID, and public health preparedness has gone from being a front-page issue to once again being a back-burner type issue.

It is sad to see this because even though we have seen things like a resurgence in COVID and even Mpox, we’ve seen things like that that clearly impact the public’s health and clearly show the need for the public health preparedness efforts we’re seeing. There are impacts in regard to funding, and then when we don’t have enough funding, the first thing that gets cut is personnel. And then, when you start cutting things that are infrastructure-based, such as personnel and other programs, it will impact your overall preparedness. It is sad right now, but we’re seeing this strange domino effect of people who are forgetting what public health is and what public health professionals did during the COVID pandemic.

Nicolette: That is an excellent point. Now, can you share a bit of your background and how it ties into emergency preparedness?

Dr. Barishansky: Sure. So, mine is kind of interesting. I started off as an emergency medical technician (EMT) in northern New Jersey, and I was a volunteer, and it kind of was one of those things that really helped me pull it all together.

I got a paid position as an EMT as well and became a supervisor. And most of my background was really related to emergency medical services (EMS). One of the things I saw is that decision makers, policymakers – they were all people with structured degrees. And so my EMS background really helped push me to finish a long, lingering bachelor’s degree and then move toward a master’s in public health.

I was in EMS administration, but I took a job in public health preparedness. And it was eye-opening. People were driving initiatives in public health preparedness, and it was great.

It was great to see, and it really gave me an opportunity to kind of, you know, get my feet wet in public health preparedness. My career has kind of been on two separate tracks. It’s been in EMS but also in public health preparedness, and my last position before I became a consultant was as a deputy secretary of health in the Commonwealth of Pennsylvania. Two of the bureaus that I oversaw were EMS and public health preparedness.

And it was really kind of an interesting moment where I got to see two of my, let’s say, occupational loves, for lack of a better term, coming together and seeing the team really work together toward shared goals.

Nicolette: What is one key takeaway you’d like to share with our readers about staying prepared?

Dr. Barishansky: I would tell people to not focus on the last event. I think that’s one of the pitfalls that we tend to fall into in emergency preparedness. We tend to think of the closest thing in the rearview mirror. But at the same time, there are so many other things that we should be focusing on. I think that true preparedness isn’t about focusing on the last thing, but true preparedness is understanding the systems, the personnel, the infrastructure, and everything that goes into it. And so, you know, if we focused only on, say, COVID, we might not be as prepared for something like Mpox, or even for a natural hazard, with significant public health impact. We need to look at things holistically. We need to look at them in totality.

Nicolette: To focus on what is to come, we have to be able to learn from what worked and what didn’t. That is what Domestic Preparedness is all about. Would you agree with that?

Dr. Barishansky: I totally agree with that. I think it’s about looking at what worked and then also what did not work but understanding why it didn’t work. It is not about how you trip and fall. It is about how you pick yourself up and dust yourself off. We really need to focus on the moments where things did not go as planned – what we did about it and how we persevered.

Nicolette: Do you have a specific article that you particularly enjoyed writing for the Journal?

Dr. Barishansky: The one that I would say I really enjoyed writing was “Are Public Health Agencies Ready, or Just Prepared?” It made a clear delineation between what preparedness is and what readiness is and how, in the beginning of the discipline of public health preparedness, when it was okay to be prepared, because we were kind of finding our legs. But we’ve moved into a much different era. And at the risk of repeating myself, as we look at things like COVID or Mpox – and even if they’re not public health-specific – we need to very clearly move to a state of readiness. Being able to write that article, actually, I felt very proud of that article.

Nicolette: Do you have any advice for someone who is new to the field?

Dr. Barishansky: I do. Speak to as many people as possible and learn as much as possible. When I got my position in Prince George’s County, Maryland, I was the chief of public health preparedness. I very quickly realized what I didn’t know.

And it was a lot. And speaking with people around D.C., learning as much as possible, asking as many questions as possible, really was the difference between success and failure.

And I had a lot of great mentors and a lot of people who showed me the way. But we are all in positions, or we all potentially could be in positions where we just don’t know as much as you thought. Those are the moments where you need to stop, reflect, and ask as many questions as possible to then figure out your own personal and professional answers and move forward with them.

I also can’t say enough for structured educational programs. There are so many good ones out there specific to emergency management, public health preparedness, and areas just like that. And it is really important for our professionals to be well-trained and well-educated.

Nicolette:
Do you have anything that you would like to say just to finish up here about your time with Domestic Preparedness? What do you see on the horizon in emergency preparedness? Is there anything you would like to leave us with?

Dr. Barishansky: I have always been impressed by the Domestic Preparedness Journal, and the staying power of the Journal is extremely impressive to me personally and professionally. I think that as we move forward, one of the things that we need to focus on in the disciplines of emergency preparedness is succession planning and really picking out the next round of leaders and making sure that they are as well-trained as possible, so they can pick up the reins potentially when we’re not there to pick them up. This is an area where some professions are lacking. I am not saying all, but some are. And as we move forward, we’ll need to focus on that overall as a profession, as well.

Nicolette: Thank you so much for your time.

Raphael M. Barishansky

Raphael M. Barishansky, DrPH, is a public health and emergency medical services (EMS) leader with more than 30 years of experience in a variety of systems and agencies in positions of increasing responsibility. Currently, he is a consultant providing his unique perspective and multi-faceted public health and EMS expertise to various organizations. His most recent position prior to this was as the Deputy Secretary for Health Preparedness and Community Protection at the Pennsylvania Department of Health, a role he recently left after several years. Mr. Barishansky recently completed a Doctorate in Public Health (DrPH) at the Fairbanks School of Public Health at Indiana University. He holds a Bachelor of Arts degree from Touro College, a Master of Public Health degree from New York Medical College, and a Master of Science in Homeland Security Studies from Long Island University. His publications have appeared in various trade and academic journals, and he is a frequent presenter at various state, national, and international conferences.

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