Poison Control Centers on the Chopping Block--Will This Affect the Training of Future Medical Toxicology Fellows?

One of the issues potentially facing the subspecialty of medical toxicology is the decreasing number of poison control centers in the country. Most poison centers currently rely on a combination of federal, state, and local funding [1, 2]. While the current economic crisis has affected many poison centers, concerns about the stability of funding apply to most current poison centers. This is a complex topic that has directly affected many poison centers across the country. For example, in the state of California, in May 2009, there was a proposal to cut all funding to poison centers in an attempt to balance the state budget. This potentially would have resulted in a state-wide closure of all poison centers in the state of California. Fortunately, due to the efforts of many groups, half of the budget was preserved with the remaining amount matched by other funding. In the state of Washington, a substantial portion of the poison center funding was cut, resulting in the cutting of a majority of its outreach programs. Their decreased ability to maintain awareness with poisonings may be associated with their subsequent decrease in call volume. While there are 60 poison centers receiving more than four million calls annually, many are at risk for closure [3]. This may be relevant to our specialty, in particular for those fellowships that have a significant interaction with their poison centers. Medical toxicology fellowships vary in their interaction with their poison centers. I have spoken to other fellowsin-training who have little interaction with their poison centers whereas there are those who maintain a close relationship. I am currently at a fellowship where we are actively involved in the day-to-day activities of our poison center. While we serve as medical consultants for the Certified Specialists in Poison Information (CSPIs), I also occasionally “moonlight” answering phone calls we receive from the public as well as other health care providers. This experience has given me insight into the importance of poison centers and the complex job of the CSPI. My experience answering calls serves to illustrate some of the important functions of poison centers. I have received calls from frantic parents about an unintentional ingestion of a dreaded “silica gel” packet, in which the “skull and crossbones” labeling equate ingestion of this benign product with that of cyanide. I have helped to educate the parents about nontoxic exposure as well as prevent needless calls to 911 and visits to the emergency department, which no doubt would happen if poison center services were not available. It is estimated that over 80% of callers to poison centers are managed at home without ever having to visit the hospital. This no doubt results in savings in health care costs [4]. Poison centers are at the forefront of providing medical information to both health care providers as well as the general public. They are available 24 h a day and 7 days a week and they fulfill a variety of other functions. Several studies have demonstrated the savings poison centers provide. It is estimated that every dollar spent on poison centers results in a seven dollar savings in health care costs [3]. Poison centers also monitor for potential outbreaks of Editor’s Note: The Editorial Board of the Journal of Medical Toxicology (JMT) is pleased to announce the appointment of a new Fellow in Training (FIT) Member, Dr. David H. Jang. Dr. Jang is a first-year FIT at the New York City Poison Center and New York University. He will be responsible for a new opinion/editorial section, entitled, “The Fellows’ Perspective”. The opinions stated in this section are those of the author and do not necessarily reflect the opinions of JMT or the American College of Medical Toxicology (ACMT).