Stephen C. Shannon, DO, MPH
Innovation and the Future of Health Care
On April 27, AACOM and the Association of Osteopathic Medical Educators and Directors (AODME) concluded an incredibly successful joint Annual Meeting in Baltimore, Maryland (see related article). It was successful in many ways—the speakers were terrific, the program covered the full panoply of medical education issues, and attracting nearly 850 registrants was a marker of how important the meeting has become to the osteopathic medical education community. I believe the theme of the meeting, Foundations for the Future, also served as a galvanizing force. With so many challenges facing the U.S. health care system, there has never been a more important time for osteopathic medical college administrators, educators, students, and policy makers to gather and share future-oriented ideas with one another.
Certainly, our collective efforts will be needed if we are to turn today’s myriad health system issues into future opportunities for osteopathic medical colleges and the physicians they graduate. Josiah Macy Jr. Foundation President George E. Thibault, MD, who addressed Annual Meeting attendees during a special two-part plenary session devoted to “Innovation and the Future of Health Care,” believes that there is a strong connection between medical practice redesign and medical education redesign. Without simultaneous innovation in both, he said, there can be no significant progress made in improving the nation’s health care system.
Dr. Thibault identified six areas of necessary health professions education innovation:
- Interprofessional Education: With evidence demonstrating that health care delivered by well-functioning teams is better care, teaching and assessing team-based competencies should be a core goal of health professions education.
- New Models of Clinical Education: Health professions educators must develop new community-based, chronic disease-oriented clinical education models that promote continuity among patients, teachers, and educational sites, and that include special learning tracks for medical students.
- New Content: To meet current and future physician demands, population medicine, social determinants of health, quality improvement/patient safety, health economics and professionalism all should be addressed in the medical school curriculum.
- Competency-Based Education: To address workforce needs and reduce medical education-related costs, student time to practice should be based on competence rather than number of rotations or time spent in medical school.
- Increased Efficiency: Eliminating redundant training and improving the transitions from undergraduate medical education to graduate medical education to training to practice will help eliminate current inefficiencies in medical education.
- Better Use of Technology: Better use of educational information technology could improve medical education, assessment and, ultimately, medical practice.
The bottom line, said Dr. Thibault, is that in order to meet changing societal needs, medical education must also change, a mandate that was echoed by the members of the Blue Ribbon Commission on the Advancement of Osteopathic Medical Education (BRC) who presented during the second part of the special plenary session.
Recognizing the many challenges and solutions Dr. Thibault outlined during his address, the BRC has been working for the past 18 months to identify unique opportunities for the osteopathic profession to offer leadership in medical education so as to improve the health of the U.S. population in the 21st century. Established by AACOM and the American Osteopathic Association, the BRC includes representatives from the full osteopathic community, from medical educators to practicing physicians. At the Annual Meeting, BRC Co-Chairs Marc B. Hahn, DO, Executive Vice President, Academic and Medical Affairs Provost and Dean, KCUMB-COM; and Boyd R. Buser, DO, Vice President for Health Affairs and Dean, UP-KYCOM, along with BRC members Robert A. Cain, DO, Director of Medical Education, Grandview Medical Center, and 2013 AODME Program Chair; and Karen J. Nichols, DO, Dean, CCOM/MWU, and 2013 AACOM Program Chair, described both the BRC’s work and the recommendations it has developed for the future of osteopathic medical education. While much more will be written about the BRC’s recommendations in the months ahead, the focus of the recommendations is to produce a different product—physicians who have gained the competencies necessary to meet current and future societal needs.
Will Dr. Thibault’s and the BRC’s thoughts combined mark this meeting as the beginning of a “reformation” in osteopathic medical education? Perhaps. Certainly, we will need to graduate more of what one BRC member called “super docs” if we are to meet the nation’s increasing health care demands. Our concerted and collective efforts will be needed to innovate and intensify learning so that physician competencies match patient and society needs now and in the future. Ultimately, the role of osteopathic medical education in “creating” that future will be up to each of us individually—and all of us collectively.