By Ann Bonham, Ph.D.
In this New Year, we have witnessed another presidential inauguration, the symbol of a peaceful transition of power in the democracy we are privileged to call our own. As we reflect on the President’s words that day, it is fitting to think of how the opportunities he described for the country are reflected in the narrower but equally lofty possibilities in patient-centered care. “My fellow Americans, we are made for this moment,” the president reminded the country in his inauguration speech, “And we will seize it—so long as we seize it together.”
But this moment can only be seized if we are healthy and have access to evidence-based medical care that meets our needs. As clinicians, researchers, educators and advocates, we are destined to be on both sides of the bedside. The need to focus on knowledge translation and evidence-based care in an aging society and complex world has never seemed so pressing. At the same time, the polarized political and fiscal climate makes these ventures challenging. Over the next weeks and months, Congress is expected to craft eleventh-hour tax, debt and budget deals that may only postpone—rather than make—hard choices. The ensuing uncertainty requires us to be more creative and resourceful in realizing the goals of providing the right care to the right patient at the right time. It will demand new ways of thinking, a re-engineering of resources and the creation of health education, research, care and delivery systems that can produce first-rate clinicians, safer and healthier patients, and cost efficiency.
The research enterprise, which faces the possibility of severe cuts if budget sequestration eventually takes effect, is already seeking to meet the challenges presented by shrinking budgets at home and rising global competition abroad. Working groups advising the NIH director recently proposed ways to modernize the research data infrastructure, incentivize innovation in workforce training, and make diversity a central precept of research. The NIH has moved quickly to implement these recommendations. Similarly, PCORI enters its first full year of actively funding research and testing new research methodologies it has created. More ACA provisions take effect, with Medicaid expansion and the creation of state exchanges testing the ability of health networks to vastly expand coverage. Rarely has the opportunity to innovate and improve been more fertile, and the mandate to do so more compelling.