Reform goes for both exam rooms

Reform may very well be the word and act of the past decade in healthcare.

Even during the Affordable Care Act’s birthing years, the word clung to the industry — at once a hypothetical mollusk, then a full-blown phylum when the Supreme Court passed the healthcare reform measure in late 2012. As such, now hospitals, practices, political offices, clinics, etc., all face the adaptive demands of reform, scrambling to align their front ends and front doors with the standards of the new world order. It’s hardly surprising then, that the back door — that which is framed by medical education and training — has been left to swing by one hinge in the haste of securing street-side entrances.

A funny thing about reform? It can’t help but affect numerous societal genera (and geniuses) at once and if you don’t secure the whole house, something is going to break in.

Where healthcare goes, so goes education, yet the latter seems to have been sidelined, a neglect that will prove to be much to the chagrin of the system if left alone for too long.

In Washington earlier this week George Thibault, MD, president of the Josiah Macy Jr. Foundation, spoke to the necessity of educational reform in a three-member panel for the American Board of Family Medicine.

"If we are going to talk about innovation and change, we often have to change the faculty, because their natural inclination is to teach what they have been doing their whole careers and what they were taught. That is different from what we want to transform the health care system into," Thibault was recorded saying in an AAFP News Now report.

"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," Thibault added.

An initiative, funded by the Josiah Macy Jr. Foundation, the Health Resources and Services Administration and private foundations has found the following features as most necessary to train the future workforce with:

  • teamwork,
  • change management,
  • leadership,
  • population management and
  • clinical microsystem skills.

And there are other grant initiatives — such as the American Medical Association’s “Accelerating Change in Medical Education”  — that follow this necessary path of altering education with general healthcare reform. For change that lasts and true reform, education leadership and the training system need to advance with the general thrust. More active attention and funding/support of education shifts can secure effective outcomes across the board.