Stakeholders in the American healthcare system are aware the trajectory of its future is unclear. The only guarantee, as evidenced by the efforts involved in the assembly of the Affordable Care Act, is change.
Physicians have bore testimony. Politicians have spoken. Business and legal experts have analyzed. However, little has been heard from those whom the change will impact the most: future healthcare professionals. From nursing staff to operating surgeon, tomorrow’s medical team must have a voice today. In order to handle the imminent challenges of a transforming industry landscape, our nation’s trainees deserve a say.
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What even qualifies our trainees to drive change, let alone brace for it? In order to validate the voice of our nation’s future healthcare workforce in shaping policy, a closer look at the preparedness of these individuals, specifically medical students and resident physicians, is warranted.
Medical education is constantly under review to explore further areas of improvement, which leaves few moments to celebrate its successes. Medical schools and training hospitals today recognize the need to impart more than clinical knowledge to future providers. An earthquake kit of intangible, vital skills is necessary to endure and thrive under the uncertainty of our system’s future. The very same skills that transform mere students into fully-fledged medical providers can be translated and scaled to tackle the problems facing patients, providers, and payers.
What comprises this invaluable earthquake kit offered by medical training? The lessons discreetly embedded within the curriculum that ensures survivorship during and beyond medical training are comprised of intellectual vitality, innovation, and leadership.
Dr. Frank Kretzer at the Baylor College of Medicine teaches medical students on the foundation of intellectual vitality. Through the artful incorporation of poetry from Lord Alfred Tennyson into the curriculum, he preaches curiosity by urging students to pluck every “flower in the crannied wall” and to never stop the quest for understanding. Inculcating an excellent approach based on evidence and understanding is prized over an excellent response. This intrinsically espouses the belief that being able to balance the curiosity to question with the systematic approach to process pays dividends in both treating complex disease and sustaining one’s career. It prepares our future physicians to remain hungry in perfecting the system no matter how technologically and politically dynamic the era is.
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At most medical institutions and teaching hospitals, pioneering innovation isn’t a response to the times but rather the fabric that strengthens its name. During residency and medical school training, novel research in addition to clinical duties is either expected or required. Medical students and resident physicians are contributing vitally to discovery. They challenge and re-challenge the norms of everyday clinical medicine by bringing to light unique truths that range from changing the practice of medicine to improving service quality. In fact, one of the research revelations by then-resident orthopaedic surgeon James Saucedo MD, MBA from a survey of Chicago-based orthopaedic surgery residents revealed 95% of respondents expressed a desire to learn business concepts. This research contributed to the birth of the “Business, Policy, and Practice Management In Orthopaedics” resident lecture series prepared for the American Academy of Orthopaedic Surgeons with the hopes that business-informed physicians would improve patient service. Without questioning the process, a new mechanism for delivering resident education would have never been instituted. Research and innovation go hand in hand, and the example is but a sample of the thirst trainees have for rethinking the problems that plague the industry.
In addition to intellectual vitality and innovation, the third and final component within medical education’s earthquake kit is leadership. Medicine is primarily team-based, which creates opportunity to lead. While the attending physician on the medical team is formally the leader, anyone with the ability to listen to the patient has an opportunity to make a difference. This is not to say it cannot occur outside the hospital. In 2012, two medical students at the Washington University School of Medicine in St. Louis, Elisabeth Askin and Nathan Moore, produced a clear, concise, and topical guide to the US healthcare system called The Health Care Handbook. Lost in a vast and complicated system, two students showed leadership by producing a book that paved the way for others to be brought up to speed in an increasingly complicated sector. Leadership is a quality not foreign to trainees, one that should not be overlooked when larger scale decisions are to be made.
As patients, physicians, and everyone in between play the waiting game with healthcare reform, the ones who will physically be implementing these changes are our current trainees. As such, their voice should be held with equal weight of any physician, politician, or expert when soliciting advice in reform. As Dr. Saucedo and the two medical students from Washington University in St. Louis pointed out, more from medical training is still needed to understand and pragmatically improve the system. However, the need for more should not devalue the existing earthquake kit of skills trainees have already acquired in intellectual vitality, innovation, and leadership. The earthquake kit offers our trainees the opportunity to not just deliver quality care and handle system disequilibrium but also the validation to drive our nation’s push for healthcare reform.
