Integrate or Perish
Recently, someone asked me what the top three concerns affecting specialty societies were. While I was tempted to list healthcare delivery and payment reform; quality improvement and performance measurement; scope of practice; undergraduate and graduate medical education; continuous professional development; data registries and data management; electronic health records and interoperability; shared accountability…I realized that on any given day we are required to shuffle the list and alter the perspective. It occurred to me, however, that all physician organizations are faced with three huge problems: In this issue of the Bulletin we focus on research and quality. The burden on “research” has included basic science and clinical research goals, but has broadly extended to health services research and integrative processes to ensure the maximal benefit and widest positive effect of the new knowledge we gain. So as you read these pages, keep an eye on the challenge you face—to constantly know and learn more and find meaningful ways of applying this explosion of knowledge to improving patient care. On April 25, I was the guest of the American Board of Medical Specialties (ABMS) at its National Policy Conference entitled “Future of Practice: Implications for the ABMS Boards’ Certification System.” Preceding the main meeting, some associate member organizations shared reports and actions each group was taking. Each report focused on a particular challenge pertinent to its organization. Most of these discussions required the use of data acquired from health services, education, or clinical research to inform the debate and solutions. One of the most enlightening presentations of the conference came from the keynote speaker George Thibault, MD, president of the Josiah Macy Jr. Foundation, entitled “The Doctor of the Future.” In the future, physicians will no longer be distinguished by “what they know,” but more by how well they work in teams, how resilient they are, how developed (Continued on page 5) their critical thinking and analytical skills are, and their ability to use information. Further, excellent communication skills, new forms of leadership (and “followership”), and most importantly, change management skills will be required—integration. Current physician education will be replaced by inter-professional education focusing on delivering care in integrated, highly functioning teams. Longitudinal, community-based, and chronic disease-oriented integrated approaches will take precedence. For decades we have been too quick to embrace technology advances in clinical, therapeutic, and diagnostic methods, and too slow to embrace and implement integrated educational and information technology facilitators and tools. Erin Fraher, PhD, an expert in workforce data, reminded us in her presentation of the challenges of education systems lagging in reform processes. She challenges us, instead of asking how many of each specialty we need, to ask, “What are the needs of patients for healthcare, and how can the overlapping scopes of various specialties meet those needs?” A summary comment from one of the panels is worth noting: We have to find solutions with the teams we have, not with the team we wish we had. So while we continue our traditional research and gain new clinical skills, we must simultaneously apply research methods to improve our education systems, reform payment and delivery of care, and integrate what we know to build a new level of team function and effective patient care.
Recently, someone asked me what the top three concerns affecting specialty societies were. While I was tempted to list healthcare delivery and payment reform; quality improvement and performance measurement; scope of practice; undergraduate and graduate medical education; continuous professional development; data registries and data management; electronic health records and interoperability; shared accountability…I realized that on any given day we are required to shuffle the list and alter the perspective. It occurred to me, however, that all physician organizations are faced with three huge problems:
In this issue of the Bulletin we focus on research and quality. The burden on “research” has included basic science and clinical research goals, but has broadly extended to health services research and integrative processes to ensure the maximal benefit and widest positive effect of the new knowledge we gain. So as you read these pages, keep an eye on the challenge you face—to constantly know and learn more and find meaningful ways of applying this explosion of knowledge to improving patient care.
On April 25, I was the guest of the American Board of Medical Specialties (ABMS) at its National Policy Conference entitled “Future of Practice: Implications for the ABMS Boards’ Certification System.” Preceding the main meeting, some associate member organizations shared reports and actions each group was taking. Each report focused on a particular challenge pertinent to its organization. Most of these discussions required the use of data acquired from health services, education, or clinical research to inform the debate and solutions.
One of the most enlightening presentations of the conference came from the keynote speaker George Thibault, MD, president of the Josiah Macy Jr. Foundation, entitled “The Doctor of the Future.” In the future, physicians will no longer be distinguished by “what they know,” but more by how well they work in teams, how resilient they are, how developed (Continued on page 5) their critical thinking and analytical skills are, and their ability to use information. Further, excellent communication skills, new forms of leadership (and “followership”), and most importantly, change management skills will be required—integration.
Current physician education will be replaced by inter-professional education focusing on delivering care in integrated, highly functioning teams. Longitudinal, community-based, and chronic disease-oriented integrated approaches will take precedence.
For decades we have been too quick to embrace technology advances in clinical, therapeutic, and diagnostic methods, and too slow to embrace and implement integrated educational and information technology facilitators and tools.
Erin Fraher, PhD, an expert in workforce data, reminded us in her presentation of the challenges of education systems lagging in reform processes. She challenges us, instead of asking how many of each specialty we need, to ask, “What are the needs of patients for healthcare, and how can the overlapping scopes of various specialties meet those needs?”
A summary comment from one of the panels is worth noting: We have to find solutions with the teams we have, not with the team we wish we had. So while we continue our traditional research and gain new clinical skills, we must simultaneously apply research methods to improve our education systems, reform payment and delivery of care, and integrate what we know to build a new level of team function and effective patient care.