This Month's News
Equipping the next generation of physicians to improve health outcomes
Physicians are committed to reducing the burden of chronic disease for all Americans and helping their patients live longer, healthier lives. And remarkable progress has been made over the last two decades, as described in a major study published in the Aug. 13 issue of the Journal of the American Medical Association. Life expectancy has increased while all-cause death rates at all ages decreased.
Unfortunately, “morbidity and chronic disability now account for nearly half of the U.S. health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.”
To help meet these challenges, the AMA is galvanizing a new, bold professional movement in pursuit of healthier people, better health care and lower health care costs. Through its improving health outcomes initiative, one of the AMA’s three major focus areas, the association will work to prevent heart disease and type 2 diabetes and to improve outcomes for those suffering from these diseases.
To do so requires a new approach: focusing on health as well as medical care and strengthening links between the clinic and community through novel strategies and collaborations.
For example, the AMA is partnering with the YMCA of the USA (see a recent article highlighting some initial successes in Minnesota) to increase physician referrals of patients with prediabetes to prevention programs. AMA also is joining with Johns Hopkins University—specifically its Armstrong Institute for Patient Safety and Quality and its Center to Eliminate Cardiovascular Health Disparities—to help meet the government’s Million Hearts™ goal of bringing 10 million more Americans’ high blood pressure under control by 2017.
The role of medical education in this effort is pivotal. Without the proper training in population health and public health concepts, and exposure to team-based and patient-centered care, tomorrow’s physicians will not be able to help the AMA (and the nation) move the needle on these ambitious goals.
These needs are reflected in a second AMA focus area, Accelerating Change in Medical Education. “The overarching goal of this effort,” said AMA President Ardis D. Hoven, MD, “is preparing medical students of today for health care tomorrow. By identifying specific changes in medical education that can be shared in medical schools nationwide, we will enable students to thrive in a changing health care environment and improve the health of our nation’s patients. In this way, the goals of our medical education and improving health outcomes focus areas are interwoven—to ensure a better, healthier future for all Americans.”
Indeed, a brief look at the 11 medical school awardees of the AMA’s $11 million in funding highlights this connection. For example, at Penn State College of Medicine, work is underway to align medical education experiences with health system needs and prepare students to work within all aspects of the complex health system, including hospital, home, skilled nursing and community/social agencies.
Meanwhile, at the Warren Alpert Medical School of Brown University, a dual MD-MS degree program in primary care and population health will produce a new type of physician with a primary care background and the skills to promote the health of the population they serve.
Out west, at the University of California – San Francisco School of Medicine, the goal is to create the "collaboratively expert physician," one who embraces the responsibility to work within interprofessional teams to continuously improve the quality and value of health care. And the University of California – Davis School of Medicine is offering an accelerated three-year pathway leading directly into a local primary care residency slot. Students will be immersed in an integrated health care system and patient-centered medical home model, with training in population management, chronic disease management, team-based care and preventive health skills (with special emphasis on diverse and underserved populations).