Training tomorrow’s doctors to put patients first

Brendan Murphy , Senior News Writer

Fundamentally changing the way patient care is delivered requires a Herculean effort, and it requires power in numbers.

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A presentation at the AMA Health Systems Science Summit framed a necessary and lofty task for medical educators: serve as health systems science influences to create health systems science (HSS) “citizens” among the next generation of physicians. To do that, today’s medical school faculty must champion concepts of health systems science (HSS) within the ranks their institutions and show them in action.

“Ultimately, our goal is to be in a position where we are developing humanistic, patient-centered, system-citizen change agents—and that's what HSS has meant for us,” said Brian McGillen, MD, associate professor of health systems science at Pennsylvania State University College of Medicine.

To create a generation of health systems citizens—physicians capable of studying and understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care delivery—the presentation by four leaders in the field offered a playbook.

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The point of health systems science is to expand the role of the entire care team for the benefit of the patient. Doing that requires a change in mindset among many of those who entrenched in the health system.

Dr. McGillen offered the example of a colleague who, on numerous occasions  has highlighted what they will not do—systems-related tasks they view as falling outside the scope of a physician’s responsibilities—in front of residents and medical students.

“There's a bit of, I don't know, a little bit of arrogance to that, but it's also a little bit of fear too, I think and not wanting to necessarily acknowledge how much more we need to know and how much more we need to apply to take care of our patients,” Dr. McGillen said.

To effect change, a physician needs to walk the walk and talk the talk. To do that in the health systems science arena, one must develop competency. Embracing opportunities for growth can go a long way toward growing your knowledge as a physician and allowing you to thrive as an educator and colleague.

“This is how we want you to extend your HSS influencer status: Learn it and speak it,” said Rachel Salas, MD, MEd, an associate professor of neurology at John Hopkins University School of Medicine. “You're here today [at the Health Systems Science Summit], you're learning the lingo, you're breaking out of your niche. I started my journey as the [quality improvement] person. I will tell you, I'm not the QI person anymore—I want to do everything. We want you to expand your skill sets.”

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Showing how health systems science advances patient care can go a long way toward creating more physicians who are passionate about it, according Dharmini Shah Pandya, MD, an associate professor of clinical medicine at the Lewis Katz School of Medicine at Temple University.

“The ultimate challenge of everyone in this room—we are calling you influencers—is to role model and challenge that clinical care is not just clinical reasoning. Daily clinical care will be way more comprehensive and inclusive through the HSS system citizen lens,” Dr. Pandya said.