By George Thibault, MD
In 1978, primary care leaders from around the globe met in Alma Alta (now part of Kazakhstan) and declared that all patients should have the “right and duty to participate individually and collectively” in planning and implementing their health care. Thirty six years later, US health care leaders continue to wrestle with how to meaningfully achieve that goal in this century. Although great strides have been made to fix, reform, transform and revolutionize US health care, we have been less effective at making sure those who care, learn, teach or work within that system can truly partner with patients.
If clinicians are to uphold the 1978 Alma Alta Declaration, we must move beyond business as usual – inviting patients to fill out satisfaction surveys, participate in advisory panels, or attend focus group sessions. These steps have been important but they haven’t been comprehensive or effective enough.
We need to be viewing patients and families and leaders in the communities as full and equal partners whose input matters. That means making sure their perspective is recognized at each level of the health professions education and care delivery system — from designing curricula to setting research priorities to building faculty capacity.
To get us on that course, the Josiah Macy Jr. Foundation is calling on health professions educators and health care practitioners to strengthen how they partner with patients, families and communities. With our support, 42 leaders in health care, consumer advocacy, and health professions education have issued a set of recommendations to make sure that health professions’ schools graduate practitioners who can not only truly partner with patients, families and communities but build capacity to sustain those partnerships over time.
What does this mean for educators? This means changing what and how health professions students are taught. It means making sure learners are exposed to the value of partnering with patients before they even enter into clinical settings; ensuring that the concept of partnership is infused in lectures and learning opportunities throughout their training; and creating new models of clinical education that get students out in the community in more routine and useful ways – training in health centers, clinics, and doctor’s offices. It also means making sure that the members of that community are receptive to offering these opportunities and that the public is helping to shape those experiences to enable practitioners to deliver the most effective care.
Changing the content and conduct of health professions education will undoubtedly be seen by many as a fundamental shift in the traditional health professions education model. It will be disruptive and may even be uncomfortable to some. But it’s a disruption we believe is urgently needed to achieve optimal health and wellness.
We have been working hard to connect health professions education with all of the reforms now occurring in clinical practice so that we adequately prepare the next generation. If we don’t find ways to create equal, respectful, and mutually beneficial partnerships with patients at every level and in every health-related endeavor, we risk further disconnecting patients from the system and the professionals that they rely on for care.