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Medical Schools Need to Change Approach in Training Primary Care Physicians, Says Panel
By James Arvantes • Washington
Thibault said transformation of the health care system requires transformation of the educational process, a goal that can only be attained by having teachers in place to train students and residents about new and emerging health care payment and delivery models. "If we are going to have a reformed health care system, we need to pay attention to the workforce -- not just the numbers of the workforce, but the composition of the workforce," said Thibault.
- The ability to change the nation's health care system will require a primary care workforce that is trained in team-based and collaborative care, said three speakers at a recent American Board of Family Medicine policy event.
- Most medical school faculties are not trained in new and innovative health care models, making it difficult for them to properly train a primary care workforce to meet the needs of an evolving health care field.
- The speakers cited examples of how public and private partnerships are working to train a workforce that meets the needs of the health care system and the community at large.
Thibault also addressed interprofessional education, saying that most faculty members did not receive their training in an interprofessional setting. "They didn't learn from other faculty and leaders in other professions."
Moreover, most medical school faculties are unfamiliar with online learning and other technologies. "We want to and need to develop future leaders and innovators in education," said Thibault. But, he added, changes in medical school education will succeed only if entire faculties buy into the process. "The redesign of the education system and the redesign of the delivery system are only sustainable if they become the standard way we do business," Thibault noted.
Thibault and the two other speakers on the panel, Barbara Brandt, Ph.D., director of the National Center for Interprofessional Practice and Education, and Larry Green, M.D., professor and Epperson Zorn Chair for Innovation in Family Medicine and Primary Care at the University of Colorado, Denver, pointed out that medical education is undergoing fundamental changes in some parts of the country to better align with changes taking place in the health care system as a whole.
"There are physicians all across this country who are doing their (best) to change the training programs," said Green, who was the founding director of the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care. In fact, he added, the three main primary care residencies -- family medicine, internal medicine and pediatrics -- are all engaged in efforts to redesign their residency training programs to achieve better health care.
As an example of the changes occurring within medical education, Thibault described a primary care faculty development initiative spearheaded by the American Board of Family Medicine, the American Board of Internal Medicine and the American Board of Pediatrics to develop some common goals and competencies around curriculum development.
The initiative, funded by the Josiah Macy Jr. Foundation, the Health Resources and Services Administration (HRSA) and private foundations, has identified particular skills or competencies needed for the primary care workforce of the future. These include
- change management,
- population management and
- clinical microsystem skills.
To achieve this goal, the center will create and test new health care organizations and structures while training a workforce that operates in team-based delivery systems to improve health care quality, safety and access.
"We really do not have a lot of evidence as far as what works in training and education for this type of practice," said Brandt. "That is going to be one of the marks of distinction of this particular national center."
The ultimate goal, Brandt said, "is better alignment of the health care system and higher education."
Panelists Outline Needed Changes in Medical Education